Medical dispatchers\u2019 perception of the interaction with the caller during emergency calls - a qualitative study

Doris Østergaaard,Freddy Lippert,Thea Palsgaard Møller,Hejdi Gamst Jensen,Søren Viereck

doi:10.1186/s13049-021-00860-y

Abstract

BackgroundMedical dispatching is a highly complex procedure and has an impact upon patient outcome. It includes call-taking and triage, prioritization of resources and the provision of guidance and instructions to callers. Whilst emergency medical dispatchers play a key role in the process, their perception of the process is rarely reported. We explored medical dispatchers’ perception of the interaction with the caller during emergency calls. Secondly, we aimed to develop a model for emergency call handling based on these findings.MethodsTo provide an in-depth understanding of the dispatching process, an explorative qualitative interview study was designed. A grounded theory design and thematic analysis were applied.ResultsA total of 5 paramedics and 6 registered nurses were interviewed. The emerging themes derived from dispatchers’ perception of the emergency call process were related to both the callers and the medical dispatchers themselves, from which four and three themes were identified, respectively. Dispatchers reported that for callers, the motive for calling, the situation, the perception and presentation of the problem was influencing factors. For the dispatchers the expertise, teamwork and organization influenced the process. Based on the medical dispatchers´ perception, a model of the workflow and interaction between the caller and the dispatcher was developed based on themes related to the caller and the dispatcher.ConclusionsAccording to medical dispatchers, the callers seem to lack knowledge about best utilization of the emergency number and the medical dispatching process, which can be improved by public awareness campaigns and incorporating information into first aid courses. For medical dispatchers the most potent modifiable factors were based upon the continuous professional development of the medical dispatchers and the system that supports them. The model of call handling underlines the complexity of medical dispatching that embraces the context of the call beyond clinical presentation of the problem.

Highlights

Medical dispatching is a highly complex procedure and has an impact upon patient outcome
In its most time critical form, emergency call handling includes recognizing out-of-hospital cardiac arrest (OHCA), provision of dispatcher assisted cardiopulmonary resuscitation and referral to an automated external defibrillator with simultaneous and rapid dispatching of basic and advanced life support units. The importance of this process is emphasized in the recent guidelines for cardio-pulmonary resuscitation [4] and the new Global Resuscitation Alliance [5] where the interaction between the medical dispatcher and bystander, and the use of an automated external defibrillator is acknowledged as key elements for improving outcome for OHCA patients
Based on the medical dispatchersperception, a model of the workflow and interaction between the caller and the dispatcher was developed based on themes related to the caller and the dispatcher

Summary

Introduction

Medical dispatching is a highly complex procedure and has an impact upon patient outcome It includes call-taking and triage, prioritization of resources and the provision of guidance and instructions to callers. In its most time critical form, emergency call handling includes recognizing out-of-hospital cardiac arrest (OHCA), provision of dispatcher assisted cardiopulmonary resuscitation and referral to an automated external defibrillator with simultaneous and rapid dispatching of basic and advanced life support units The importance of this process is emphasized in the recent guidelines for cardio-pulmonary resuscitation [4] and the new Global Resuscitation Alliance [5] where the interaction between the medical dispatcher and bystander, and the use of an automated external defibrillator is acknowledged as key elements for improving outcome for OHCA patients. The study identified bystanders’ and medical dispatchers’ situation awareness, communication and attitude as main factors influencing the efficiency of the calls in terms of resuscitation [11]

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