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The Priority Dispatch SystemThe global standard for 9-1-1 call processing
Associate Director of Medical Control and Quality Processes| 1.800.960.6236 Ext 245 | E. [email protected] | W. www.emergencydispatch.org | M. 1+801.550.0187
© 2017 IAED /// All Rights Reserved 2
PRIORITY DISPATCH & THE INTERNATIONAL ACADEMIES OF EMERGENCY DISPATCH
Priority Dispatch works in partnership with the International
Academies of Emergency Dispatch (IAED) to further the
development of Priority Dispatch protocols and resources for
9-1-1 systems implementation.
The IAED is a research, standard-setting, certification, and
accreditation organization that:
• Researches and develops dispatch best practices
• Develops and maintains Priority Dispatch System protocols for
Medical, Fire and Police
• Certifies emergency communication staff
• Develops certification curriculum
© 2017 IAED /// All Rights Reserved 3
ABOUT THE IAED
The IAED is a non-profit
organization that oversees all
Priority Dispatch System protocols,
giving emergency response centers
a single, structured, scientifically-
developed protocol that guides
dispatchers through a predictable,
repeatable and verifiable process.
90,000+public safety members
3,600+emergency response centers worldwide
80industry experts in College of Fellows
45 / 23used in 45 countries in 23 languages
8,262international members
90,000,000+calls processed annually
© 2017 IAED /// All Rights Reserved 4
PRIORITY DISPATCH CUSTOMERS IN NORTH AMERICA
United States of America• 13 of the top 25 cities by population (52%) • 34 of the top 50 cities by population (68%)• 70 of the top 100 cities by population (70%)
Canada• All but one of the Provinces and Territories • All major cities – Toronto, Vancouver, Montreal, Calgary,
Edmonton, Winnipeg, Quebec City, etc.
Atlanta, GA (Grady)
Albuquerque, NM
Baltimore, MD
Baltimore Co. MD
BWI International Airport, MD
Cal-Fire (state of CA)
Charlotte, NC
Cleveland, OH
Cincinnati, OH
Columbus, OH
DFW International Airport, TX
El Paso TX
Las Vegas, NV
Louisville, KY
Miami, FL
Milwaukee, WI
New Orleans, LA
Philadelphia, PA
Prince Georges Co., MD
Raleigh Durham, NC
Sacramento, CA
Salt Lake City, UT
San Antonio, TX
San Diego, CA
San Francisco, CA
San Jose, CA
Washington DC
Pentagon, VA
Capitol Police, Washington DC
Multiple US Military Installations
Large Priority Dispatch System Users in the U.S.
© 2016 Priority Dispatch /// All Rights Reserved 5
PRIORITY DISPATCH CUSTOMERS GLOBALLY
Europe
Innsbruck, Austria
Vienna, Austria
Most of Austria
London, England
Manchester, England
Besancon, France
Berlin, Germany
Hamburg, Germany
Dublin, Ireland
Torino, Italy
Most of Northern Italy
Edinburgh, Scotland
Lugano, Switzerland
Zurich, Switzerland
Over 50 others
Middle East, Asia,
South America & Africa
Dubai
Abu Dhabi
Qatar
Kuwait
Malaysia
Mumbai, India
Panama
South Africa & Botswana
Suzhou, China
Sao Paulo, Brazil
Australia & New Zealand
Sydney
Melbourne
Queensland
Adelaide
Northern Territory
Tasmania
Victoria
ALL of New Zealand
© 2017 IAED /// All Rights Reserved 6
THE PRIORITY DISPATCH SYSTEM
Medical Priority Dispatch System
Fire Priority Dispatch System
Police Priority Dispatch System
ECNS Priority Dispatch System
© 2017 IAED /// All Rights Reserved 7
WHY A PROTOCOL-BASED APPROACH?
Establishes and Enables:• Identifiable Standard of Service/Care
• Prioritized Response Methodology
• Quality Management
• Certification/ Accreditation
Immediate Results:
• Improved responder safety
• Better patient care
• Liability exposure reduction
Meets & Exceeds: NTSA, AHA/ILCOR, NFPA, ISO, and DOJ best practice industry standards
Value: Save budget dollars by logically prioritizing responses, enabling shorter training cycles, and improving employee retention and performance
Quantifiable: Report module demonstrates and documents system efficiency / performance and process improvement
© 2017 IAED /// All Rights Reserved 8
A PERPETUAL PROTOCOL
The Priority Dispatch System is the most up-to-date, tested, and culturally-adapted protocol solution in the industry, by far.
• Based on new science/industry standards
• User Proposals for Change
• EMD v 13.1 // EFD v7 // EPD v6
Always Looking Forward
The Priority Dispatch System Now Includes
Epi Pen Instructions
Narcan Injection Instructions
Tourniquet Instructions (April 2019)
High Risk Delivery Instructions
Delivery of quick CPR HOC times
AED Locator ability
Structure Fire Exit Instructions
Caller in Danger Instructions
Active Shooter processes
Rapid Dispatch for specific incidents
© 2017 IAED /// All Rights Reserved
9
© 2017 IAED /// All Rights Reserved 10
COUNCILS OF STANDARDS
Maintains the protocols based on the latest standards and practice
within all three disciplines
Employs a scientific process of evaluation and approval of proposed
changes to the protocols
Proposals for Change come from system users who demonstrate high
compliance to protocol
© 2017 IAED /// All Rights Reserved 11
PROTOCOL STRUCTURE AND FUNCTION
© 2017 IAED /// All Rights Reserved 15
BASIC PRIORITY DISPATCH ANATOMY
Case Entry ProtocolInitial Assessment
1
© 2017 IAED /// All Rights Reserved 16
BASIC PRIORITY DISPATCH ANATOMY
Chief Complaint ProtocolsSecondary Assessment / Investigation
2
© 2017 IAED /// All Rights Reserved 17
BASIC PRIORITY DISPATCH ANATOMY
Chief Complaint ProtocolsInstruction Sequence / Mitigation
3
© 2017 IAED /// All Rights Reserved 18
EXAMPLE OF “BASELINE RESPONSES”
E EchoD DeltaC CharlieB BravoA AlphaΩ Omega
© 2017 IAED /// All Rights Reserved 19
INTRODUCING PROQA
ProQA opens from CAD
CAD information is passed automatically to ProQA
CAD and ProQA share information—no double entry
ProQA sends dispatch code to CAD
© 2017 IAED /// All Rights Reserved 20
ADMINISTRATIVE OVERSIGHT
Quality Management• Case Review, Feedback, and ongoing education
Responder and administrative input• QIU / DRC / DSC
Data analysis and research• Outcome data in comparison to responder data
ECNS: A brief overview
NURSING NAVIGATING 911
Complicating Cascade of
Low Acuity 911 Calls
Lack of primary care capacity and/or limited access to care or follow up
EMS turn-
around times
and hospital diversion
911 resources
for critically ill
Cost of care
Quality of care
911 and ED utilization for non-emergencies = ER overcrowding
911 call → ECNS low acuity criteria met (selected
Omega and Alpha calls)
EMD alerted by pink ECNS-eligible call box
EMD sends call to ECN through interface link
The nurse uses LowCode ™ Software and
clinical judgment to process the call to
determine:
The stability of the patient
The correct protocol
How soon the patient should be seen
If the patient should be seen in person
Which resource in the community best meets
the patient’s needs
The best transportation available
Appropriate self-care instructions
Home Care Disposition
High volume of calls of parents regarding children
and the elderly
Many of these cases may be seen at a later time
Many cases have the patient disposition of Home
Care
Alternative Health Care to ED and Personal Physicians
0%
10%
0%
0%
7%
58%
0%
18%
4%
2% 0% 1% 0%
Sept. 2011 to May 2012 (195,401 calls)
Eye Doctor Health Info. Agency Community Center
Specialist RN OB/GYN/MW Self-Care
Social Services Poison Control or Pharmacy Urgent Dentist
Routine Dentist District Nurse Crisis Care
Contact Police
Managed with Home Care instructions
ECNS is available to IAED’s
ACE designated agencies
Compliance Is Key
EMD Accuracy
The Evidence and the Lower Acuity Patient
The Evidence
NAEMSP Medical Director Involvement
RLS Based on Protocols
Use Prioritization
Use Limitedly
Total EMS runs during 1996: 19,737
BRAVO-level runs: 9,608
HOT transports to hospital: 72
Outcomes less than alive/stable: 14
Number who rec’d ALS treatment: 14
SLCFD BRAVO Code Study:HOT vs. COLD Transport Frequency
BLS Response Times ---
1997 (HOT) vs. 1998 (COLD)
T-1 T-5 T-8 E-6 E-4 E-10 E-13 E-2
5:04 5:04 5:17 5:18 5:14 5:43 5:39 5:04
5:31 5:40 5:17 5:19 5:19 6:13 5:28 5:18
+:27 +:36 :00 +:01 +:05 +:30 -:11 +:14
1997
1998
Diff.
Fire Stations (Truck & Engine Companies)
T-1 T-5 T-8 E-6 E-4 E-10 E-13 E-2
5:04 5:04 5:17 5:18 5:14 5:43 5:39 5:04
5:31 5:40 5:17 5:19 5:19 6:13 5:28 5:18
+:27 +:36 :00 +:01 +:05 +:30 -:11 +:14
1997
1998
Diff.
Fire Stations (Truck & Engine Companies)
BLS Response Times
HOT vs. COLD
Dispatch Triage - The Evidence
Brian DaleAssociate Director of Medical and Quality Control [email protected]
Office: 800.960.6236
Mobile: 801.550.0187
Thank You
www.Emergencydispatch.org