Author: Neal Richmond, MD

Characterization of Call Prioritization Time in a Medical Priority Dispatch System

Emergency Medical Services (EMS) agencies have a pressing need to understand call prioritization time (CPT), a key sub-component of call processing time in Emergency Medical Dispatch, as it impacts response time to specific cases and overall EMS agency response time performance. Objective:  The objective of this study was to determine median CPT by dispatch priority level and Chief Complaint type. Methods: This retrospective study included data from six emergency communication agencies, each accredited by the International Academies of Emergency Dispatch (IAED). The...

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The Distribution of Recommended Care Level Classification by Time of Day within the Emergency Communication Nurse System

Research has shown that two-thirds of emergency visits occur after business hours (weekdays 9am – 5pm). Therefore, identifying primary healthcare providers available after business hours is one strategy for improving appropriate access to healthcare services. Previous studies have also shown a high and steady volume of secondary triage-eligible calls throughout the day and into the evening. However, because the Emergency Communication Nurse (ECN) performing the secondary triage has some discretion on selecting the Recommended Care Level (RCL) based on resource...

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Assessing Call Demand and Utilization of a Secondary Triage Emergency Communication Nurse System for Low Acuity Calls Transferred from an Emergency Dispatch System

Telephone nurse triage at the 9-1-1 dispatch point is relatively new in the United States despite its ability to significantly reduce expensive and scarce Emergency Medical Services (EMS) resource use and emergency department visits. A previous study investigated the distribution of 9-1-1-triaged call incident types within the Emergency Communications Nurse System (ECNS) and found that 9-1-1 triage systems yielded a variety of low acuity complaints that were handled by the Emergency Communications Nurse (ECN). This study explored the current and potential utilization...

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The Distribution of Recommended Care Levels by Age, Gender, and Trauma vs Medical Classification within the Emergency Communication Nurse System

An examination of the Emergency Communications Nurse-determined Recommended Care Levels (RCLs), for calls transferred for secondary nurse-triage has not been performed.  The outcome of such an investigation would help to gain a more complete picture of the type of care ultimately recommended for these patients. The Emergency Communications Nurse System (ECNS) studied contained 22 RCLs, ranging from urgent levels, including a country-specific 3-digit number Emergency response (911), and Emergency care as soon as possible to less time-dependent, low priority levels, such...

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911 Emergency Communication Nurse Triage Reduces EMS Patient Costs and Directs Patients to High-Satisfaction Alternative Point of Care

Recent estimates indicate that more than half of all Emergency Department (ED) visits could be avoided, reducing patient costs and increasing satisfaction with care.  Since 911 is increasingly the first point of contact for many patients entering the health care system—even those with non-emergency conditions—one potential approach to decreasing emergency costs and ED overcrowding is to reinvent the 911 dispatch center as a clearinghouse for directing patients to alternative care providers.  This study presents a cost avoidance analysis of two 911 dispatch centers that...

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