Response Time Zero

The best possible response time for any emergency is immediate. This is no simple theoretical goal, but a physical reality everywhere that a Public Safety Dispatcher, using standard Emergency Medical Dispatch protocols, can be reached by phone. These calm “voices of hope” quickly perform an initial triage to determine the type of medical or trauma situation being reported, dispatch appropriate emergency services as necessary, and provide quality instruction to the caller before any additional help arrives on scene.National Academies of Emergency Dispatch

The Navigator conference in Baltimore this week, sponsored by the National Academies of Emergency Dispatch, celebrated the efforts made in the last 33 years since Dr. Jeff Clawson developed a set of protocols in an attempt to reduce the number of Code 3 medical runs through proper resourcing and to promote dispatching as a profession. Now there are 65 million emergency calls for service each year to just over 3,500 Public Safety Answering Points (PSAPs) worldwide where the best are recognized as Accredited Centers of Excellence (ACE).

But not all calls requesting service are equal. Using the Medical Priority Dispatch System (MPDS) protocols, automated through software like ProQA, the initial triage phase is automated to provide a standardized format for carrying out the practice of priority dispatching. The acuity of the call is determined to categorize the dispatch response. Increasingly that response may include the possibility of alternative service endpoints in certain systems reforming the traditional “you call, we haul” strategy where each call ends with a transport to the hospital. For systems authorized to use it, like many in Europe, PSIAM provides a secondary level of triage, commonly performed by nurses, for any lower acuity incidents that should not require an ED visit. This is a dramatic departure from the norm in the US and one that will require vertical integration of healthcare providers starting with EMS, the practical gatekeepers to a significant amount of healthcare in the community. Recognizing EMS as healthcare providers is also a shift in thinking from the prevalent public safety mindset and one not taken in current healthcare reform.

The first link in the chain of the emergency response system, however, is the Emergency Medical Dispatcher. These are the true First Responders who are immediately present at the scene providing care even though they cannot see or physically be present with the patient.

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Comments
Jeffrey Hammerstein
Stop Dissing Response Times and Start Dissecting the Argument
I think that the position someone takes on this issue depends entirely on the circumstances of the particular EMS system they have in mind when they consider the question. If we're comparing a 7 minute response time to a 70 minute response time (or infinite as mentioned above), then of course it matters. That's a…
2015-07-03 11:44:45
Dave Shrader
Stop Dissing Response Times and Start Dissecting the Argument
I had meetings recently with a client in an underserved County. They have multiple tax supported volunteer organizations, and a City FD as EMS providers. The system is totally Balkanized with each agency doing it’s own thing. One agency failed to even respond to 66% of its calls last year. So, 66% of the time,…
2015-07-03 08:08:44
Matt Zavadsky
What Higher EMS Pay Requires
This article is spot on - the rapidly changing healthcare finance environment is a game changer for us - IF, and ONLY IF, we can prove that we bring value to the payer... Does our care make a difference in the patient's experience of care, outcome and cost of care... By assessing our patient satisfaction,…
2015-06-17 08:38:01
Steven Lichtenberg
What Higher EMS Pay Requires
The biggest issue in pay scales is one you hit on directly. Payment for service rendered is solely based on transports. Refusals/DNR/DOA etc are not reimbursed. Once Medicare determines that we are in fact medical professionals and not "ambulance drivers" and pays for care rendered we have a chance. Community paramedicine is one mechanism for…
2015-06-16 21:47:53
daleloberger
What Higher EMS Pay Requires
Thank you for making the comment, Kim. I suspect you may have missed my meaning in that statement though. The passionate folks in EMS are some of the hardest working people I know. My complaint is certainly not that "we" don't put enough into our jobs to deserve better pay, it is that we must…
2015-06-16 18:13:18

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