How to evaluate an emergency medical dispatch system: a Belgian perspective

Area of Science:

• Emergency Medicine
• Prehospital Care
• Healthcare Management

Background:

• Effective emergency medical dispatch is vital for patient care.
• Assessing the accuracy of dispatch decisions requires rigorous analysis of interventions and patient needs.
• Previous studies highlight challenges in matching prehospital resources to patient acuity.

Purpose of the Study:

• To evaluate the accuracy of a local emergency medical dispatch center.
• To compare the level of care dispatched with the actual medical needs of patients.
• To identify discrepancies in emergency medical service (EMS) resource allocation.

Main Methods:

• Analysis of 4601 emergency calls, dispatch recordings, and hospital reports.
• Post-hoc assessment of prehospital advanced life support (ALS) care needs based on clinical findings.
• Comparison of dispatched care levels (basic life support [BLS] and ALS) against assessed patient requirements.

Main Results:

• Significant mismatches were found: 41% of cases needing ALS did not receive it promptly, while 54% of ALS interventions were for non-ALS-requiring cases.
• Dispatchers underestimated emergency severity in 31% of cases and overestimated it in 22%.
• Overall, 82% of interventions involved only BLS teams, 14% involved simultaneous BLS and ALS, and 4% involved delayed ALS.

Conclusions:

• The study reveals critical inefficiencies in emergency medical dispatch, leading to both undertreatment and overtreatment.
• Improved dispatcher training and protocols are needed to enhance the accuracy of medical emergency assessment and resource allocation.
• Addressing these dispatching inaccuracies is essential for optimizing prehospital care and patient outcomes.