Clinical trial NCT06502925: Quality of Incoming Call Handling in an Emergency Dispatch Center
Official title: Evaluation of the Quality of Incoming Call Handling Assisted by the proQA Software in the Emergency Dispatch Center of Besançon.
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Medical Emergencies
Lead sponsor: Centre Hospitalier Universitaire de Besancon
Sponsor class: OTHER
First posted: 2024-07-16
Enrollment: 800
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: We will study incoming calls in the EMD of Besançon University Hospital. These calls must be handled by a professional EM dispatcher and must have a 'severity' code that is not unfounded.

During the replay and evaluation, it can happen that the supervisor is unable to assign a severity code with certainty. This occurs when a decisive question regarding the severity code has not been asked, and the information has not been provided spontaneously by the caller. In such cases, the supervisor considers the code obtained by the EMD to be unfounded

Brief summary: The aim of Emergency Medical Dispatch (EMD) is to ensure prompt access to medical care for all at all times, initiate appropriate responses quickly, arrange suitable hospital facilities, and coordinate patient transport and hospitalization.

In France, care begins with an incoming call managed by the EM Dispatchers, who collect the patient's details and assess the seriousness of the situation. This severity assessment is essential for triggering the appropriate resources: direct dispatch of first-aiders in extreme emergencies, or transfer of the call to an emergency or general practitioner.

Under- or over-assessment will necessitate redirection, resulting in a loss of time and opportunity for the patient, or emergency channel congestion. Errors at this stage can impact the entire care pathway.

To assist EM dispatchers, aids have been developed. Firstly, In France, a diploma course was created in 2019. Various training methods exist. Their contribution to the quality of incoming calls handling remains unevaluated. Secondly, EM centers use regulation protocols designed to guide dispatchers in call handling and identifying the seriousness of the situation.

The regulation protocol used at Besançon University Hospital is ProQA (Priority Dispatch Corporation, Salt Lake City, UT, US). It uses standardized questions and records EM Dispatchers' decisions and the responses they obtain from callers. These responses are considered by ProQA, which then assigns a "severity" code to the call.

The assistance provided by regulation protocols, however useful, remains insufficient. Contextual factors can complicate compliance with regulation protocols, making matching resources to needs challenging.

AQUA is a software package dedicated to quality control, enabling EM Dispatcher's supervisors to rate the quality of all stages of the call-taking process. This ensures that all key questions have been asked and that they have been asked correctly. In addition, the 'severity' code obtained by the EM Dispatcher can be compared with the 'severity' code obtained by the supervisor, using a qualifying analysis method and data entry software. The calls are replayed under optimal conditions, in a calm environment and allowing supervisors to listen multiple times to ensure no information is missed. the supervisors' code is therefore the reference code.

CRRAQPA study's aim is to assess the quality of incoming call handling and to identify the factors that influence this quality.


Eligibility criteria: Inclusion Criteria:

* Calls handled by a professional EM Dispatcher during the study period.

Exclusion Criteria:

* Calls handled by a medical student functioning as an EM Dispatcher.
* Calls for which the "severity" code is unfounded.

Primary outcomes:
measure: The proportion of incoming calls for which the 'severity' code identified by the EM dispatchers during the call and the 'severity' code identified by the supervisor after replaying the call are in agreement.
timeFrame: Through study completion, the anticipated duration is 1 year
Secondary outcomes:
measure: The proportion of over- and under-rated calls.
timeFrame: Through study completion, the anticipated duration is 1 year
measure: The proportion of the different training modalities received by EM dispatchers.
timeFrame: Through study completion, the anticipated duration is 1 year
measure: The number of years of experience in the profession of the EM dispatchers participating in the study.
timeFrame: Through study completion, the anticipated duration is 1 year
measure: The rate of answered calls within 20 s (= quality of service at 20 seconds, QS20)
timeFrame: Through study completion, the anticipated duration is 1 year
measure: The number of calls per hour in the call centre.
timeFrame: Through study completion, the anticipated duration is 1 year
measure: The duration between the beginning of the EM dispatcher's shift and the time at which the incoming call occurs
timeFrame: Through study completion, the anticipated duration is 1 year
measure: The proportion of incoming calls occurring during the day or night
timeFrame: Through study completion, the anticipated duration is 1 year
measure: The proportion of incoming call occuring during week days or week-ends
timeFrame: Through study completion, the anticipated duration is 1 year
Other outcomes:
Locations:
city: Besançon
country: France
facility: Centre Hospitalier Universitaire de Besancon
state: Franche Comté
city: Besançon
country: France
facility: University Hospital of Besançon
state: Franche Comté
Study officials:
affiliation: University Hospital of Besançon
name: Antoine Leclerc
role: PRINCIPAL_INVESTIGATOR
References: