Implementation of a new emergency medical communication centre organization in Finland - an evaluation, with performance indicators

Veronica Lindström,Jukka Pappinen,Maaret Castrén,Ann-Charlotte Falk

doi:10.1186/1757-7241-19-19

Abstract

BackgroundThere is a great variety in how emergency medical communication centers (EMCC) are organized in different countries and sometimes, even within countries. Organizational changes in the EMCC have often occurred because of outside world changes, limited resources and the need to control costs, but historically there is often a lack of structured evaluation of these organization changes. The aim of this study was to evaluate if the performance in emergency medical dispatching changed in a smaller community outside Helsinki after the emergency medical call centre organization reform in Finland.MethodsA retrospective observational study was conducted in the EMCC in southern Finland. The data from the former system, which had municipality-based centers, covered the years 2002-2005 and was collected from several databases. From the new EMCC, data was collected from January 1 to May 31, 2006. Identified performance indicators were used to evaluate and compare the old and new EMCC organizations.ResultsA total of 67 610 emergency calls were analyzed. Of these, 54 026 were from the municipality-based centers and 13 584 were from the new EMCC. Compared to the old municipality-based centers the new EMCC dispatched the highest priority to 7.4 percent of the calls compared to 3.6 percent in the old system. The high priority cases not detected by dispatchers increased significantly (p < 0.001) in the new EMCC organization, and the identification rate of unexpected deaths in the dispatched ambulance assignments was not significantly (p = 0.270) lower compared to the old municipality-based center data.ConclusionAfter implementation of a new EMCC organization in Finland the percentage and number of high priority calls increased. There was a trend, but no statistically significant increase in the emergency medical dispatchers' ability to detect patients with life-threatening conditions despite structured education, regular evaluation and standardization of protocols in the new EMCC organization.

Highlights

There is a great variety in how emergency medical communication centers (EMCC) are organized in different countries and sometimes, even within countries
We identified performance indicators and compared them with data collected before and after the new EMCC organization
A comparison between the municipality-based centers and the new EMCC indicates that priority codes A and C were used in a different way in the new system, with more priority A and fewer priority C dispatch assessments as compared to the old system

Summary

Introduction

There is a great variety in how emergency medical communication centers (EMCC) are organized in different countries and sometimes, even within countries. The aim of this study was to evaluate if the performance in emergency medical dispatching changed in a smaller community outside Helsinki after the emergency medical call centre organization reform in Finland. EMCC organization and EMD in Finland - before and There used to be 45 municipality-based centers taking emergency calls in Finland. There was no consensus concerning training, education, or competence of the personnel answering the emergency calls in the old municipality-based centers. In the new EMCC organization the EMD needed one and a half years of formalized training to be qualified as a dispatcher

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