Effect of a Comprehensive Quality Management Process on Compliance With Protocol in an Emergency Medical Dispatch Center

Abstract

Study objective: Modern emergency medical dispatch provides appropriate resource responses with the use of an emergency medical dispatch priority reference system (EMDPRS). The EMDPRS is a systematic protocol for all aspects of the dispatch process, including interrogating the caller, matching responses with severity, and providing pre-arrival care. We tested the hypothesis that appropriate performance feedback would increase dispatcher compliance with the protocol. Methods: We examined how emergency medical dispatchers complied with the protocols contained in the Advanced Medical Priority Dispatch System, a commercially available EMDPRS. Six key areas and overall compliance were studied. Dispatchers performed for 2 months without feedback and for a further 2 months with performance feedback. We used statistical methods to compare the dispatchers’ compliance with the protocols each month. Results: The mean overall compliance score improved from 76.4%±10.2% (mean±SD) in the absence of performance feedback to 96.2%±4.0% (n=217; P <.001) when performance feedback was provided. Five of 6 key areas showed similar improvements. Conclusion: Providing emergency medical dispatchers with regular and objective feedback regarding their performance dramatically improves how rigorously they follow a systematized dispatch protocol.[Clawson JJ, Cady GA, Martin RL, Sinclair R: Effect of a comprehensive quality management process on compliance with protocol in an emergency medical dispatch center. Ann Emerg Med November 1998;32:578-584.]