Saving Time Saves Lives: Optimizing Radio Dispatching in Out-of-Hospital Cardiac Arrests

Objective Activation of emergency medical services (EMS) through radio dispatching in the United States of America is the established first component in the link of the Chain of Survival. However, little is known about how auditory dispatch alerts operationally aid in the recognition and physical response of priority dispatch communications. This research aims to determine if a modification in radio alerting procedures will elicit a reduction in chute times for first responders.  Methods This study uses a retrospective pre-post design evaluating the impact on reaction times to cardiac arrest priority p-tones in a semi-urban/rural area. Data were collected by comparing a period of six months before and 10 months after the implementation of a system that replaced p-tones with digitized human speech notifications. The analysis of continuous data to determine statistical significance in response times (global positioning system (GPS)-measured) was conducted using the Student's t-test. For data normalization, Box-Cox transformations were utilized. The interpretation of control charts was used to assess process stability and evaluate the outcomes. Results  Of the 16 months of continuous data and 137 case response times for priority alarms, the average response time (GPS-measured) was 29.3 seconds (M = 29.375, SD = 19.69), well below the system target time of 60 seconds. Results of the paired sample t-test show that the mean time did not differ before treatment (M = 27.86, SD = 27.213) and after treatment (M = 30.88, SD = 27.872) at the 0.05 level of significance, t(65) =.802, n = 65, p<.425. 95% CI for the mean difference: -5.384 - 12.617, r =.032. Process control charts indicated a slight reduction in the process efficiency. A secondary finding indicated that radio utilization time was reduced by five seconds due to the intervention. Conclusion Response times for EMS, including the characteristics of the priority p-tone and speech influence, are understudied. This case study introduced a methodology for designing chute time process improvement interventions. Process stability charts bring increased opportunities to measure and manage response times in EMS.