A Quality Improvement Project to Enhance Health Care for Frequent Callers to an Emergency Medical Dispatch Center

BackgroundFrequent callers to emergency medical dispatch centers (EMDC) often have multiple problems, have contact with several care providers, and can be perceived as difficult to help.PurposeTo describe a quality improvement project aimed at enhancing health care for frequent callers.MethodsA project registered nurse (RN) was allocated to coordinate individualized care plans based on identified frequent callers' current problem(s), life situation, and medical history. The outcome was evaluated using an interrupted time series approach and by a review of medical records. Individual interviews were carried out with the project RN and one frequent caller.ConclusionsMost callers were middle-aged or older, more often male, and often lived alone or in a residence. At the time of intervention, frequent callers contacted the EMDC once per week on average and were transported by ambulance 1.4 times per month. Following the project, EMDC contacts and ambulance responses were reduced to 46% and 33%, respectively, of their peak levels.