The role of the emergency medical dispatch centre (EMDC) and prehospital emergency care safety: results from an incident report (IR) system

Abstract

Introduction: The role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives. Methods: An ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010. Results: During the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population. Conclusions: Despite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a "learning organization" and improve both efficacy and safety of first aid care.

How safe is prehospital care? A systematic review

“…The studies used data from incident reporting systems or a record review (see Online Supplementary Material 2 for more information). All the incident reporting systems were for use by staff, with four anonymous reporting systems [ 37 , 41–43 ], and in two systems, the person submitting the report was identifiable [ 25 , 36 ].…”

Medical emergencies at sea: an analysis of ambulance-supported and autonomously performed operations by lifeboat crews

“…Collecting this information is primarily a task of the JRCC, which dispatches the lifeboat crews and decides whether an ambulance crew on board is indicated. Studies show that emergency dispatch centres play an important role in improving the quality of pre-hospital care [ 11 – 15 ]. Furthermore, the use of standardized protocols results in faster identification, faster arrival at the scene and better recommendations to bystanders [ 16 – 18 ].…”

The pre-hospital care and the patient safety: contributions to the safe practice / O atendimento pré-hospitalar móvel e a segurança do paciente: contribuições para prática segura

“…A Canadian study showed that most errors (78%) were due to human elements, stressing the need to implement specific training on prehospital care protocols. 12 A specific course on communication skills and relationships for the medical emergency team was carried out aimed at overcoming these educational gaps experienced by PHC professionals.…”