The Second Opinion Dispatch- Evaluating Decisions Made by an Ambulance Dispatch Center

BACKGROUND: The efficacy and precision of dispatching right ambulance to right patient demands a proper decision-making. Wrong decisions may lead to overloading of emergency departments and shortage of ambulances. The aim of this study was to evaluate and improve the process of prehospital resource allocation conducted by a Swedish ambulance dispatch center.

METHODS: A team of three experienced ambulance and dispatch nurses evaluated the decisions made by the dispatch center. The method chosen was “Action Research” divided into five actions during 76 days. In the first action, the team listened passively to the calls. The team gradually increased its involvement in the process of decision-making during the actions.

RESULTS: During the actions, specific keywords indicating a need for evaluation were identified. The results showed a need to change the primary decisions in 486 cases out of 24,800 calls (2%). The most common measure after an evaluation was to change an ordinary ambulance transportation to an assessment vehicle staffed by a nurse or a physician who would select an appropriate care level (hospital vs. primary healthcare).

CONCLUSION: This model not only optimized the prehospital resources but also changed the process of decision-making at the dispatch center and improved their staffs’ ability to optimize the allocation of emergency resources.