Utilization of prehospital dispatch protocols to identify low-acuity patients

Area of Science:

• Emergency Medicine
• Health Services Research

Background:

• Emergency Medical Services (EMS) systems face challenges in efficiently managing patient flow.
• Identifying low-acuity patients at the dispatch level can optimize resource allocation.

Purpose of the Study:

• To evaluate an EMS agency's use of a dispatch algorithm to identify low-acuity patients.
• To determine if secondary telephone triage by a nurse impacted hospital admission rates for these patients.

Main Methods:

• Retrospective study of low-acuity patients identified by the Medical Priority Dispatch System (MPDS).
• Two phases of data collection with differing MPDS protocols; phase 2 included nurse-led telephone triage.
• Exclusion criteria included refusals, third-party callers, and referrals from specific facilities.

Main Results:

• Discharge home rates were 69.3% (phase 1) and 73.0% (phase 2).
• Pregnancy, psychiatric/behavioral, falls, and sick person determinants were associated with higher admission rates.
• Among 530 patients receiving nurse triage in phase 2, 25.3% required hospital admission, with 2.2% admitted to the ICU.

Conclusions:

• A dispatch-based method can effectively classify low-acuity patients.
• Secondary telephone triage by nurses is a viable strategy for managing these patients while ensuring appropriate care.