Der Anaesthesist | 2019
[Degree of implementation of structured answering of emergency calls in German emergency dispatch centers and effects of the introduction in daily practice].
Abstract
BACKGROUND\nThe emergency call-taking process is crucial for the adequate disposition of emergency vehicles and the provision of first aid instructions. Moreover, it has a\xa0direct impact on the quality of out-of-hospital emergency care. Organizations such as the European Resuscitation Council, the German Federal Association of Emergency Medical Directors and the German Association of Emergency Dispatch Centers call for the nationwide implementation of a\xa0formal call-taking process in emergency dispatching. This is required for the provision of telephone-assisted cardiopulmonary resuscitation (T-CPR).\n\n\nMETHODS\nThis article presents the results of an online survey among members of the German Association of Emergency Dispatch Centers on the implementation of structured call-taking programs. The survey comprised data on the implementation of a\xa0structured call-taking process, its effects on important quality indicators such as the frequency of T‑CPR and employee satisfaction.\n\n\nRESULTS\nOf the 100 participants who completed the survey, 49 already used formal call-taking systems and 24 (47%) of the remaining 51\xa0emergency dispatch centers intended to implement such a\xa0system. Formal call-taking systems were mainly used in the dispatch of emergency medical services (98% of emergency dispatch centers using a\xa0formal call-taking system) and fire brigades (83.7% of emergency dispatch centers using a\xa0formal call-taking system). In 42 (85.7%) of the 49\xa0emergency dispatch centers using a\xa0formal call-taking process, this process is mandatory; however, only 27 (64.3%) reported compliance rates of more than 95% in medical emergencies. Comparing the pre-post results after the introduction of a\xa0structured approach, the quality of the inquiries improved for almost all emergency dispatch centers. On the other hand, important quality indicators, e.g. mean dispatch initiation time or the necessity of subsequently alerting an advanced life support unit to the scene, were not recorded in 42.9% and 49.0% of the dispatch centers, respectively. Of the emergency dispatch centers that analyzed the frequency of T‑CPR, 94.3% could show an increase in T‑CPR. Moreover, 79.5% of the respondents reported improved employee satisfaction. Whereas the demand for dispatchers remained nearly static, 24 out of the 49\xa0dispatch centers that used a\xa0formal call-taking system set up new posts for quality management (maximum: 3\xa0posts in dispatch centers handling more than 250,000 missions annually).\n\n\nCONCLUSION\nStructured emergency call-taking has not yet been comprehensively implemented in German emergency dispatch centers. Wherever it is used consistently, important quality parameters are improved. Further investigations should aim to identify crucial factors for its implementation and to analyze additional quality parameters.