Abstract
BACKGROUND: The efficacy and precision of dispatching right ambulance to right patient demands a proper decision-making. Wrong decisions may lead to overloading of emergency departments and shortage of ambulances. The aim of this study was to evaluate and improve the process of prehospital resource allocation conducted by a Swedish ambulance dispatch center.METHODS: A team of three experienced ambulance and dispatch nurses evaluated the decisions made by the dispatch center. The method chosen was “Action Research” divided into five actions during 76 days. In the first action, the team listened passively to the calls. The team gradually increased its involvement in the process of decision-making during the actions.RESULTS: During the actions, specific keywords indicating a need for evaluation were identified. The results showed a need to change the primary decisions in 486 cases out of 24,800 calls (2%). The most common measure after an evaluation was to change an ordinary ambulance transportation to an assessment vehicle staffed by a nurse or a physician who would select an appropriate care level (hospital vs. primary healthcare).CONCLUSION: This model not only optimized the prehospital resources but also changed the process of decision-making at the dispatch center and improved their staffs’ ability to optimize the allocation of emergency resources.
Highlights
Overcrowding at emergency departments and ambulance shortage is an everyday challenge (Claesson et al, 2012; Crilly et al, 2014), which necessitates a proper and appropriate utilization of existing resources within healthcare (Peyravi et al, 2015).The challenge to make correct decisions at the Ambulance Dispatch Center (ADC) in order to avoid over- and under-triage is well-known
We aimed to evaluate the impact it may have on the process of decision-making at the ADC by improving the staffs’ ability to allocate the right resources to the right patients at the right level of care
Focusing on words and sentences in the written information from the alerts, the second opinion dispatch team (SODT) discovered that the written information could mirror an ambiguity in the decision made by ADC staff
Summary
Overcrowding at emergency departments and ambulance shortage is an everyday challenge (Claesson et al, 2012; Crilly et al, 2014), which necessitates a proper and appropriate utilization of existing resources within healthcare (Peyravi et al, 2015).The challenge to make correct decisions at the Ambulance Dispatch Center (ADC) in order to avoid over- and under-triage is well-known. Earlier studies have shown a discrepancy in the decision-making between ADC and ambulance crews on site, with regard to patients’ prioritization and type of transport needed (Khorram-Manesh et al, 2011) The former over utilizes the available resources, while the latter endangers patients’ safety. In an Italian study, the nursing dispatch performance in detecting high-acuity patients in need of physician interventions revealed that ADC nurses without field experience (ambulance work) were not able to correctly identify the need for a physician on the scene. Their decisions resulted in an over-triage and over-utilization of available physicians (Leopardi & Sommacampagna, 2013). The aim of this study was to evaluate and improve the process of prehospital resource allocation conducted by a Swedish ambulance dispatch center
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
