the priority dispatch system

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. Brian.Dale@Emergencydispatch.org | 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 ProcessesIAEDbrian.dale@emergencydispatch.org

Office: 800.960.6236

Mobile: 801.550.0187

Thank You

www.Emergencydispatch.org