title: Protocol: simulation training to improve 9-1-1 dispatcher identification of cardiac arrest.
abstract: BACKGROUND
  9-1-1 dispatchers are often the first contact for bystanders witnessing an out-of-hospital cardiac arrest. In the time before Emergency Medical Services arrives, dispatcher identification of the need for, and provision of Telephone-CPR (T-CPR) can improve survival. Our study aims to evaluate the use of phone-based standardized patient simulation training to improve identification of the need for T-CPR and shorten time to start of T-CPR instructions.
  
  
  METHODS
  The STAT-911 study is a randomized controlled trial. We will recruit 160 dispatchers from 9-1-1 call-centers in the Pacific Northwest; they are randomized to an intervention or control group. Intervention participants complete four telephone simulation training sessions over 6-8 months. Training sessions consist of three mock 9-1-1 calls, with a standardized patient playing a caller witnessing a medical emergency. After the mock calls, an instructor who has been listening in and scoring the dispatcher's call management, connects to the dispatcher and provides feedback on select call processing skills. After the last training session, all participants complete the simulation test: a call session that includes two mock 9-1-1 calls of medium complexity. During the study, audio from all actual cardiac arrest calls handled by the dispatchers will be collected. All dispatchers complete a baseline survey, and after the intervention, a follow-up survey to measure confidence. Primary outcomes are proportion of calls where dispatchers identify the need for T-CPR, and time to start of T-CPR, assessed by comparing performance on two calls in the simulation test. Secondary outcomes are proportion of actual cardiac arrest calls in which dispatchers identify the need for T-CPR and time to start of T-CPR; performance on call-taking skills during the simulation test; self-reported confidence in the baseline and follow-up surveys; and calculated costs of the intervention training sessions and projected costs for field implementation of training sessions.
  
  
  CONCLUSIONS
  The STAT-911 study will evaluate if over-the-phone simulation training with standardized patients can improve 9-1-1 dispatchers' ability identify the need for, and promptly begin T-CPR. Furthermore, it will advance knowledge on the effectiveness of simulation training for health services phone-operators interacting with clients, patients, or bystanders in diagnosis, triage, and treatment decisions.
  
  
  BACKGROUND
  ClinicalTrials.gov
  
  
  BACKGROUND
  NCT01972087 . Registered 23 October 2013.
authors.affiliation: University of Washington, Northwest Center for Public Health Practice, 1107 NE 45th St. Suite 400, Seattle, WA, 98105, USA. hendrika@uw.edu.
authors.forename: Hendrika
authors.initials: H
authors.lastname: Meischke
authors.affiliation: University of Washington, Northwest Center for Public Health Practice, 1107 NE 45th St. Suite 400, Seattle, WA, 98105, USA. ipainter@uw.edu.
authors.forename: Ian
authors.initials: I
authors.lastname: Painter
authors.affiliation: University of Washington, Northwest Center for Public Health Practice, 1107 NE 45th St. Suite 400, Seattle, WA, 98105, USA. amturner@uw.edu.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Turner
authors.affiliation: University of Washington, Institute for Health Metrics and Evaluation, 2301 Fifth Ave, Room 436, Seattle, WA, 98121, USA. mweaver@uw.edu.
authors.forename: Marcia R
authors.initials: MR
authors.lastname: Weaver
authors.affiliation: Public Health- Seattle and King County, Division of Emergency Medical Services, 401 5th Ave Suite 1200, Seattle, WA, 98104, USA. carol.fahrenbruch@kingcounty.gov.
authors.forename: Carol E
authors.initials: CE
authors.lastname: Fahrenbruch
authors.affiliation: Department of Family Medicine, University of Washington, 4225 Roosevelt Way NE, Suite 308, Seattle, WA, 98105, USA. bike2@uw.edu.
authors.forename: Brooke R
authors.initials: BR
authors.lastname: Ike
authors.affiliation: University of Washington, Northwest Center for Public Health Practice, 1107 NE 45th St. Suite 400, Seattle, WA, 98105, USA. stangs@uw.edu.
authors.forename: Scott
authors.initials: S
authors.lastname: Stangenes
mesh_terms: D016887:Cardiopulmonary Resuscitation; D004631:Emergency Medical Service Communication Systems; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis* / Q000628:therapy; D000066908:Simulation Training / Q000379:methods*; D013689:Telephone; D013997:Time Factors
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