Quality of Incoming Call Handling in an Emergency Dispatch Center
NCT Number: NCT06502925
Acronym: CRRAQPA
Status: NOT_YET_RECRUITING
Study Type: OBSERVATIONAL
Conditions: Medical Emergencies
Sponsor: Centre Hospitalier Universitaire de Besancon
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 800
Study Design: Observational Model: |Time Perspective: p
Start Date: 2024-07
Completion Date: 2025-07

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.

Primary Outcome Measures: 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., The quality of the incoming call will be assessed based on the agreement between the 'severity' code identified by the EM dispatchers during the call and the 'severity' code identified by the supervisor after replaying the call using the AQUA software.

There are six possible severity codes, which will be grouped into a three-category variables corresponding to the three possible referrals (emergency physician, general practitioner, 'flash' departure)., Through study completion, the anticipated duration is 1 year
Secondary Outcome Measures: The proportion of over- and under-rated calls., An over-rated call occurs when the severity level identified by the EM dispatcher is higher than that identified by the supervisor upon replay.

An under-rated call occurs when the severity level identified by the EM dispatcher is lower than that identified by the supervisor upon replay, Through study completion, the anticipated duration is 1 year|The proportion of the different training modalities received by EM dispatchers., In France, several training modalities exist for EM dispatchers such as field training, 2019 diploma training, training via tape replay, call simulation training., Through study completion, the anticipated duration is 1 year|The number of years of experience in the profession of the EM dispatchers participating in the study., Through study completion, the anticipated duration is 1 year|The rate of answered calls within 20 s (= quality of service at 20 seconds, QS20), Through study completion, the anticipated duration is 1 year|The number of calls per hour in the call centre., Through study completion, the anticipated duration is 1 year|The duration between the beginning of the EM dispatcher's shift and the time at which the incoming call occurs, Through study completion, the anticipated duration is 1 year|The proportion of incoming calls occurring during the day or night, Through study completion, the anticipated duration is 1 year|The proportion of incoming call occuring during week days or week-ends, Through study completion, the anticipated duration is 1 year