Performance of a system to determine EMS dispatch priorities

Area of Science:

• Emergency Medicine
• Healthcare Systems Analysis
• Public Health Resource Management

Background:

• Inappropriate use of emergency medical services (EMS) for non-emergencies leads to resource strain and reduced efficiency.
• Protocol-driven dispatch systems aim to optimize resource allocation by prioritizing emergency calls based on initial information.

Purpose of the Study:

• To compare the accuracy of EMS dispatch priority decisions with actual patient needs assessed upon emergency department (ED) presentation.
• To evaluate the efficiency of current protocol-based dispatch systems in resource utilization for emergency medical services.

Main Methods:

• A comparative study involving 320 emergency department (ED) charts matched with corresponding EMS dispatch and run data.
• Priorities assigned by the protocol-driven dispatch system were compared against those determined by a panel of three physicians reviewing ED presentations.
• Agreement was assessed for both advanced life support (ALS) vs. basic life support (BLS) transport and a more detailed 4-level classification.

Main Results:

• Physicians and dispatchers achieved 74% agreement on the need for ALS versus BLS transport.
• Agreement dropped to 43% when using a more detailed 4-level classification system for dispatch priority.
• The dispatch system assigned the highest level of response (ALS and first responders) more frequently than physicians deemed necessary based on ED presentation.

Conclusions:

• Protocol systems for setting EMS dispatch priorities may lead to higher resource utilization than indicated by patient acuity upon ED arrival.
• Findings suggest a potential for optimizing EMS resource allocation by refining dispatch protocols to better align with patient needs.