THANK YOU TO ALL WHO WERE ABLE TO PARTICIPATE! 16 RESPONDENTS, WHICH INCLUDES STATE RADIO Dispatch – EMS Best Practices Survey

FROM DISPATCH CENTERS What are needs of PSAPs? What direction do we want to take? FROM EMS PERSPECTIVE What would be nice to have. DOH DEMST What’s reasonable and realistic for both EMS and Dispatch Centers Discussion

Paging Question 3

Status Checks Does Dispatch do status checks while an Ambulance is on scene? Check all that apply. Comments: There has never been a request from the ambulance services to do so. However, we routinely do status checks while the ambulance is in route to assist them in getting to the correct location. Question 5

Factors contributing to routinely not doing status checks. 1 Comments: EMS personnel either do not routinely carry portable radios or they may be using a portable and be out of range of the radio repeater 2 Medics carry portable radios, EMT-Basics do not. Generally, if a call is very serious, there is law enforcement response also, so status is checked through officers rather than the ambulance personnel. Occasionally we will check with ambulance personnel for status on things such as LZ. 3 It has never been requested by the ambulance services we serve 4LE is sent on medicals 5 All services routinely do not carry a portable on scene; they bring the radio on scene only if they have concerns about the call. Dispatch has on occasion performed radio checks only when trouble may be perceived. 6 SR doesn't send EMS into an unsecured scene What other factors contribute to not having safety checks routinely performed by dispatch? Check all that apply. Question 6

Address and/or common sense directions Are the address and/or common sense directions provided to Ambulance Services either during the page or shortly thereafter? Check all that apply. 1 Comments: Address always provided, but not common sense directions in order to keep paging message brief. EMS asks for directions if needed. 2 All Ambulances have the County 911 system on a laptop in the rig. Question 7

Pre-arrival instructions Question 8

Reporting Service anomalies ND Administrative Code requires that Ambulance Services be enroute to calls within 10 minutes 90% of the time. If there are Ambulance Services routinely not able to meet this goal, would you be willing to fill out the online form to help identify which Ambulance Services need assistance in gaining compliance with this standard? Question 13 1 Comments: We would be unwilling to comply with request, unless somehow the compliance was mandatory We have not had this issue 2None 3 Yes, but right now all ambulances are in compliance. 4Have not had that problem 5This has never been an issue here. 6 yes, however we have none that routinely exceed this time frame 7 I would report only after I’ve exhausted all other possibilities. For example, if there were consistent problems with a service not responding to pages, and there have been with one service many years back, I spoke to the squad leader and explained to them the predicament the Dispatchers are placed in when there is not a timely response to a page. I also called them monthly for their monthly on-call schedule. This built rapport, and over many months the problem was resolved. 8I will and I have before. 9 Yes if it happens routinely. Most of the ambulance services that SR serves are volunteers and we want to help them

Sending ALS with BLS calls for trauma criteria * Question 14, Comments: (6 skipped the question) We provide dispatch based upon NAED protocols 2 It is not policy to dispatch ALS with BLS; however, many of our dispatchers will ask the responding BLS service if they would like ALS intercept at the time of dispatch. 3 We do not have a policy, but it is often initiated by the dispatcher 4 Some of the BLS are beginning to routinely prompt Dispatch right away to notify ALS they’re needed when BLS first learns the problem. This has been a good change, and something the Services are working out between themselves. 5 Dispatch makes that determination through ND EM Card questioning. Although it’s not required, does Dispatch have a policy to automatically send ALS with BLS if one of the previously mentioned critical criteria is met?

EMD trained Dispatchers Answer Options Response Percent Response Count Yes 92.9%13 No 7.1%1 * Other (please specify) 1 answered question14 skipped question2 * One provided comment that there are 3 new dispatchers that need to go to training. Question 16

EMD – Dispatch stay on phone after page Question 17

Quality Assurance Question 19 Is someone reviewing medical dispatch instructions provided by Dispatch to ensure they’re appropriate for signs and symptoms described and/or do you have a formal Quality Assurance Program? 1 3 Comments: We have discussed starting this type of program 2 We are now gathering information for a QA program. As of now, instructions are reviewed if there are questions. 3 We are currently working on creating a QA program

Quality Assurance Comments 1 Comments: (10 responded, 6 skipped question) EMS calls are routinely and informally discussed with the Dispatchers as to how a particular call was handled. 2Peer review and Supervisor review 3 We have a primary case reviewer and our supervisors are also EMD-Q certified. Cases are reviewed mostly at random however we do review calls of individual personnel if necessary. 4 The 911 Coordinator lists daily to all 911 Calls to ensure calls are done properly. I will notify the Dispatch Supervisor if a problem is found, then we go from there. All Dispatchers are also 1st Responder trained. 5We do not have a QA program as of yet. Am in the information gathering stage. 6We are currently in the process of creating a QA program for our dispatch center. 7National Academy's Quality Improvement Program 8All shift supervisors are Medical Priority Quality Assuance certified. 9No quality assurance program at this time; we lack the resources both in time and money. 10The ambulance, doctors and myself meet quarterly to review calls. Please describe what quality assurance program or method you are using. Question 20

Review of EMD cards in between updates Does your Medical Director review the EMD cards periodically in between published updates? 1 4 Comments: We don't have a Medical Director at this time 2 Not unless I ask him to and I haven't asked him to review them since we first got them. If we have an issue with something, then we would contact our Medical Director. 3 It is requested, but not always completed. 4 board of doctors review cards for my PSAP Question 21

Notification if primary paging system goes down 1 Comments: We are currently working on additional alternatives 2 Radio, DCC Communicator NXT, telephone 3 We have a reverse 911 system that could also be used. 4CodeRED 5 eDispatches "Priority Blast" because it's fast and can be initiated over a phone system quickly. CityWatch can also be used, but it involves more time to initiate. 6 Some services use eDispatches, other services have back up paging systems and others use backup telephone numbers Question 22

1 Needs: Help fund technology to support smaller dispatch centers to improve efficiency and capabilities 2 EMS personnel need to do a better job of informing Dispatch of their status. We are willing to keep track of the information, but it is not always provided. EMS crews also need to have a better understanding of both city and rural addressing schemes. 3Understanding of each others job and activity level proper radio operation 1 Ideas: Invite EMS staff into the Dispatch Center to see how Dispatch operates and why we ask them so many questions. 2create a dispatch users group 3 I think that standardizing the emergency medical dispatch process would be a wise direction in the State. As a long time user of the NAED protocols, we have found that the ongoing training is very beneficial to gain a deeper understanding of the importance of the EMDs role in delivery of EMS services. 4On stressful calls, we should automatically have a meeting to review how it went on both sides, Ambulance & Dispatch. 5Open dialogue, whether it's an Atta boy or a complaint. 6 Work with EMS to form a committee consisting of key people, such as Ambulance leaders, Hospital representative, 911 Coordinator, possibly the Sheriff and any other community members that could contribute to focusing on EMS needs together. This builds communications and helps Ambulance Services understand they don’t have to ‘make it on their own’. Pool resources together to come out stronger and gain ideas from one another. Identification of needs / ideas Question 31, 32

Collection of time data as required Question 23

Collection of time data for EMS Question 24, 25

Meetings with Ambulance Services 1 Comments: Every other month 2 We hold quarterly operational meetings and monthly meetings focused on Emergency Medical Dispatch issues. 3 We have monthly meetings with our 911 Advisory Board and ambulance is on this board. Any issues have always been discussed at these meetings unless it is something more urgent. 4 Our county has monthly emergency service resource meetings. All ambulance services are welcome to attend. This affords opportunities for communication and discussion. 5Semi-annually for rural BLS 6 Complaints are submitted by EMS as needed, so they can be responded to in a timely manner. Ambulance Services have met with Dispatch for training, and as needed. Quarterly meetings are held between all Ambulance Services, Hospital member, 911 Coordinator and a community member. Needs and opportunities are addressed. Question 29