Effect of a comprehensive quality management process on compliance with protocol in an emergency medical dispatch center.
OBJECTIVE
Modern emergency medical dispatch provides appropriate resource responses with the use of an emergency medical dispatch priority reference system (EMDPRS). The EMDPRS is a systematic protocol for all aspects of the dispatch process, including interrogating the caller, matching responses with severity, and providing pre-arrival care. We tested the hypothesis that appropriate performance feedback would increase dispatcher compliance with the protocol.


METHODS
We examined how emergency medical dispatchers complied with the protocols contained in the Advanced Medical Priority Dispatch System, a commercially available EMDPRS. Six key areas and overall compliance were studied. Dispatchers performed for 2 months without feedback and for a further 2 months with performance feedback. We used statistical methods to compare the dispatchers' compliance with the protocols each month.


RESULTS
The mean overall compliance score improved from 76.4%+/-10.2% (mean+/-SD) in the absence of performance feedback to 96.2%+/-4.0% (n=217; P <.001) when performance feedback was provided. Five of 6 key areas showed similar improvements.


CONCLUSIONS
Providing emergency medical dispatchers with regular and objective feedback regarding their performance dramatically improves how rigorously they follow a systematized dispatch protocol.
Clawson
J J
JJ
Medical Priority Consultants, Inc, and National Academy of Emergency Medical Dispatch, Salt Lake City, UT, USA.
Cady
G A
GA
Martin
R L
RL
Sinclair
R
R
D004631:Emergency Medical Service Communication Systems / Q000458:organization & administration*; D004650:Employee Performance Appraisal; D019983:Guideline Adherence; D006266:Health Education; D006801:Humans; D017749:Total Quality Management