Evaluating a training intervention for improving alignment between emergency medical telephone operators and callers: a pilot study of communication behaviours

Jennifer Gerwing,Owen Matthew Truscott Thomas,Olav Eielsen,Jon Erik Steen-Hansen,Pål Gulbrandsen,Bård Fossli Jensen,Trond Mjaaland

doi:10.1186/s13049-021-00917-y

Abstract

BackgroundCalls to emergency medical lines are an essential component in the chain of survival. Operators make critical decisions based on information they elicit from callers. Although smooth cooperation is necessary, the field lacks evidence-based guidelines for how to achieve it while adhering to strict parameters of index-driven questioning. We aimed to evaluate the effect of a training intervention for emergency medical operators at a call centre in Tønsberg, Norway. The course was designed to enhance operators’ communication skills for smoothing cooperation with callers.MethodsCalls were analyzed using inductively developed coding based on the course rationale and content. To evaluate whether the course generated consolidated behavioral change in everyday practice, the independent analyst evaluated 32 calls, selected randomly from eight operators, two calls before and two after course completion. To measure whether skill attainment delayed decision making, we compared the time to the first decision logged by intervention operators to eight control operators. Analysis included 3034 calls: 1375 to intervention operators (T1 = 815; T2 = 560) and 1659 to control operators (T1 = 683; T2 = 976).ResultsOperators demonstrated improved behaviours on how they greeted the caller (p < .001), acknowledged the caller (p < .001), and displayed empathy (p = 0.015). No change was found in the use of open-ended questions and agreeing with the caller. Contrary to expectations, operators who took the course logged first decisions more quickly than the control group (p < .001).ConclusionsThis pilot study demonstrated that the training intervention generated behavioural change in these operators, providing justification for scaling up the intervention.

Highlights

The dispatch of prehospital emergency medical resources is organized differently worldwide
Norway is unique in that health care professionals answer calls to 113 directly, whereas in Denmark, police officers answer calls to 112 and forward them to the EMCC after a decision-making process
This study aimed to evaluate a training intervention designed to enhance EMCC operators’ functional communication skills for aligning with callers regarding their

Summary

Introduction

The dispatch of prehospital emergency medical resources is organized differently worldwide. Calls to medical emergency lines constitute an essential component in the chain of survival, yet they have been characterized as a ‘black box’ in research on prehospital care [3] In these calls, operators rely on what they can elicit from callers to visualize the current and evolving situation [4], which they combine with professional guidelines and available resources to make critical decisions [5]. While operators achieve high levels of accuracy with the most urgent cases, their decision accuracy falters when the patient’s situation appears ambiguous or vague [5, 6] In this dynamic, interactional arena, operators acknowledge the essential role of smooth cooperation with the caller [7]. Operators and callers are in different worlds [7], in terms of their roles, responsibilities, knowledge, emotions, and familiarity with the situation (see Table 1)

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