HomeMy WebLinkAboutEmergency Dispatch Protocol Implemtator Policy
Augusta Richmond GA
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1- APPROVED -19usta Richmond County 9-1-1
J 911 4th Street
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I. (706) 821-1080 FAX (706) 821-1213
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Catherine N. Walker
Assistant Director
Annette M. Brown
Training Coordinator
Phillip K. Wasson
Director
EDITION:
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AGENDA ITEM:
DATE: February 18,2002
TO: The Honorable Bob Young, Mayor
Members of the Commission
Honorable Marion Williams, Chairman, Public Safety Committee
THROUGH: George R. Kolb, Administrator
FROM: Phillip K. Wasson, Director, Augusta 9-1-1 Communications Center
SUBJECT: Emergency Dispatch Protocollmplementation Policy
CAPTION: Approve the addition of the Emergency Dispatch Protocollmplementation Policy to the
Augusta 9-1-1 Policy and Procedures Manual.
BACKGROUND: The 9-1-1 Communications Center is preparing and planning to assume the
responsibility of dispatching all calls for emergency medical assistance with a goal of midnight March 31,
2002. Currently, the Augusta 9-1-1 Policy and Procedures Manual does not address the dispatching of
calls through use of structured protocols. With the approval of the use and purchase of Dispatch Priority
Protocols by the Augusta-Richmond County Commission in December 2001, it is imperative that the 9-1-
1 Policy and Procedures Manual properly addresses the handling of these calls and to establish minimum
standards of compliance. It is also important that the Quality Assurance process be properly documented
and established.
ANALYSIS: The current Policy and Procedures Manual must be kept up-to-date.
FINANCIAL IMPACT:
100.00 for printing.
ALTERNATIVES:
(1) Approve portions of the request. (2) Disapprove.
RECOMMENDATION: The Administrator's Office and the 9-1-1 Steering Committee concur with the
recommendation of the Director of 9-1-1,
REQUESTED AGENDA DATE:
February 25, 2002 Public Safety Committee Meeting,
Augusta Richmond County 9-1-1 Communication Center
FUNDS ARE A V AII.ABLE IN THE
FOLLOWING ACCOUNTS:
216-03-7110/53.11111
FlliANCE DIRECTOR:
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DIRECTOR 9-1-1:
ADMlNISTRATOR:
Augusta 9-1-1 Center Policy and Procedure Manual
'1 13 Emergency Dispatch Protocol Implementation Policy
2
3 13.1 Policy: The 9-1-1 call taking and dispatch for assistance will be provided in a standardized
4 manner following approved Priority Dispatch System (PDS) protocols for 9-1-1 caller
5 interrogation, determination of appropriate response configurations and modes, and provision of
6 post dispatch and pre-arrival instructions.
7
8 13.2 Purpose: To provide all Communication Officers with the necessary tools and skills
9 relating to the safe and effective provision of Emergency Dispatch services. To include
10 interrogation of the caller; sending appropriate response; providing telephone assistance; and
11 communicating necessary information to Public Safety Responder personnel and other
12 responders.
13
14 13.3 Procedure: These policies regarding the implementation of the Priority Dispatch System
15 that will be adhered to in its exact format. The procedures are set out in detail and must be
16 followed precisely for the safety of all persons, as well as for liability purposes.
17
18 13.4 Implementation of Program: Priority Dispatch Systems Protocols is a flip chart card
19 system and related software, containing protocols for Emergency Dispatch shall be provided for
20 each console at the Augusta 9-1-1 Communications Center.
21
22 13.4.1 This protocol system will provide standardized key questions, post-dispatch instructions,
23 pre-arrival instructions and response-based codes.
24 13.4.2 The protocol file shall be kept on each dispatch console at all times.
25 13.4.3 The Priority Dispatch protocols have been approved by the Director and Medical Director
26 of the Augusta 9-1-1 Center and have been adopted by the Augusta 9-1-1 Steering Committee
27 and the Augusta-Richmond County Commission as the standard for this center.
28 13.4.4 The Priority Dispatch protocols shall be followed on all incoming calls. It is important not
29 to alter any information on the protocols as it may cause an unfavorable result.
30
31 13.5 Interrogation: In addition to the 9-1-1 call answering policy outlined for call processing,
32 the Communication Officer will always ask the following questions of the caller:
33
34 . What is the problem now? (The Chief Complaint)
35 . How old is the person? (approximate if necessary) (Medical Calls)
36 . Is s/he conscious? (Medical Calls)
37 . Is s/he breathing? (Medical Calls)
38
39 13.6 All attempts to obtain Case Entry and Key Question information from the caller will be
40 made by utilizing good communication techniques and reading the questions exactly as written in
41 the protocol.
42
43 13.6.1 If the initial pre-structured question is not understood, or the caller does not initially
44 provide an appropriate answer, the Communication Officer may rephrase the question in an
45 appropriately clarified form.
46 13.6.2 Questions may only be omitted if the answer is obvious or has already been clearly
47 provided; however, questions which relate to the priority symptoms of altered level of
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Augusta 9-1-1 Cente~ Policy m\d Procedure Manual
48 consciousness, breathing problems, chest pain, and severe bleeding MUST be asked in every
49 occasion in which they appear.
50 13.6.3 Communication Officers may alter the "she/he" portion of the question to "you" in the
51 event the caller is the patient (that is, for first party calls).
52 13.6.4 Status of consciousness, including "alertness" and "ability to talk" may be inferred as
53 obvious when the caller is a patient of a medical call.
54 13.6.5 Always use the Language Line System if the caller does not speak English. This gives a
55 traceable, translated record for documentation.
56
57 13.7 Response Configurations and Modes: The PDS interrogation protocols will be used to
58 select and enter the determinant codes in the PDS field of the CAD system.
59
60 13.8 Relay of Information to Responding Units: The following shall be regarded as the
61 minimum information to be passed to responding personnel upon dispatch.
62
63 13.8.1 The location of the incident
64 13.8.2 The chief complaint
65 13.8.3 The age of the patient (Medical Calls)
66 13.8.4 The PDS determinant code (Medical Calls)
67 13.8.5 The status of consciousness (Medical Calls)
68 13.8.6 The status of breathing (Medical Calls)
69
70 13.9 Due to the important nature of the information, under normal working conditions,
71 Communication Officers will relay the answers obtained to 'Key questions' to all Responders.
72 This is to include positive, negative, and unknown responses.
73
74 13.10 Should additional information become available to Communication Officers after
75 responders have been mobilized, but prior to their arrival on the scene, this will also be given to
76 responding units. Additional information may be received during administration of post-dispatch
77 instructions (PDls) and pre-arrival instructions (PAIs), or after a second call has been received.
78
79 13.11 Post-Dispatch Instructions: The Communication Officer will refer to the post-dispatch
80 instruction (PD) list for the selected chief complaint after the dispatch of responding units has
81 been initiated. The Communication Officer giving PDIs will follow the protocol, giving
82 instructions appropriate to each individual call, and avoiding free-lance information unless it
83 enhances and does not replace the written protocol.
84
85 13.11.1 PDIs will be provided to the caller whenever possible and appropriate to do so. If there
86 are unanswered 9-1 -1 calls, Communication Officer MUST apply the "emergency rule" and
87 suspend the provision of PDIs to callers at that time. This procedure is necessary to ensure that
88 9-1-1 calls are answered as soon as possible. Call takers should suspend the call and advise the
89 caller to call back if the patient's condition changes. Should a duplicate call be received by the
90 Communications Center, the Call Taker will initiate case entry protocol and follow with PDIs as
91 indicated.
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Augusta 9-1-1 Center Policy ahd Procedure Manual
9~ 13,11.2 Whenever possible, the Communication Officer receiving the call will provide the PDls,
93 as opposed to transferring the call. (See Policy regarding High Priority Dispatch Chapter XX
94 Section XX)
95
96 13.12 Pre-Arrival Instructions: Pre-arrival instructions (PAIs) will be provided directly from
97 the scripted text listed on each P AI panel logic protocol script. The Communication Officer
98 giving PAIs will follow the script, avoiding free-lance information.
99
100 13.12.1 PAIs will be provided to the caller whenever possible and appropriate to do so.
10 1 13.12.2 The 'Emergency Rule" will not apply in life threatening situations, such as
102 cardiac/respiratory arrest, choking, and childbirth. In these instances, Communication Officer
103 will stay on the phone and provide PAIs to the caller until a unit arrives.
104
105 13.13 Case Entry Compliance Policy Statement: After location and call back number have
106 been obtained and verified on every case, each Communication Officer answering a request for
107 Service via 9-1-1 shall ask for and attempt to obtain all case entry-level information. It is the
108 intent of this policy that the case entry-level protocol shall be followed 100% of the time, with
109 the exception of third-party calls. The purpose of this policy is to ensure proper case entry
110 procedure and to effect an increase in protocol compliance. This will lead to more accurate
111 coding of calls, provision of the correct pre-arrival and post-dispatch instructions and unit
112 response configuration and mode assignments.
113
114 13.13.1 The case entry questions shall be asked by the Communication Officer in order and
115 phrased as shown below, to obtain the following information:
116
117 . What is the problem now? (Chief Complaint)
118 . How old is the person? (Approximate age) (Medical Calls)
119 . Is slhe conscious? (Medical Calls)
120 . Is slhe breathing? (Medical Calls)
121
122 13.13.2 Communication Officers will not assume the existence or absence of any case entry-level
123 information based on background noise or other factors that may give the impression of the
124 nature of the call or condition of persons needing a medical response. Communication Officers
125 shall not ask "is s/he alert" with the assumption that if the caller says, "yes" that they have
126 accurate information regarding status of consciousness and breathing. This is an incorrect
127 application of the protocol and can lead to serious errors.
128 13.13.3 It is recognized that a minority of callers may refuse or be unable to provide the answers
129 to case entry questions. Communication Officers will not be held accountable for this provided a
130 reasonable attempt has been made to ask these questions initially.
131 13,13.4 Communication Officers will receive regular feedback through their immediate
132 supervisor from the Quality Assurance Supervisor (QA). The shift supervisor will review the
133 compliance report with the affected employee for the purpose of correcting any non-compliant
134 action, errors or omissions.
135 13.13.5 The Augusta 9-1-1 Center expects 100% compliance in attempts to gather case entry level
136 information. Outside agency (fourth party) referrals may be the only exception to this policy.
137 With regard to first party callers (i.e. when the caller is the complainant) the Communication
138 Officer may omit questions three and four.
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Augusta 9-1-1 Cente; Policy arid Procedure Manual
139
140 13.14 Quality Improvement Process, Roles and Responsibility: The quality improvement
141 process shall follow a standardized procedure as detailed below and as required by the National
142 Academy of Emergency Dispatch (NAED) accreditation standards. The purpose oftrus policy is
143 to provide all Communication Officers with the necessary understanding and skills as they relate
144 to the efficient and effective provision of quality assurance for the Priority Dispatch Systems.
145 Such quality assurance processes shall be sufficient to meet the requirements of the NAED for
146 accreditation as a "Dispatch Center of Excellence".
147
148 13.14.1 Quality Improvement Case Review: A 10% minimum sampling of all calls shall be
149 randomly selected and reviewed monthly by the Quality Assurance Supervisor to assure
150 compliance to the PDS protocol at acceptable pre-set levels as defined within NAED
151 accreditation standards.
152
153 13.14.1.1 All cardiac arrest, choking, and emergency childbirth cases shall be reviewed and counted as a portion of
154 the] 0% of total cases required. Additionally, all cases generating a Medical Dispatch Feedback Report shall be
155 reviewed.
] 56 13.14.1.2 A minimum of 10% of calls will be reviewed on each individual Communication Officer.
157 13.14.1.3 The level of compliance required to meet NAED accreditation standards is 90% or greater for each
158 individual Communication Officer to all listed protocol components previously defined, except for Case Entry and
159 Pre-Arrival Instructions interrogation which shall be a 95% or higher compliance rate.
160
161 13.14.2 Case Review Feedback Process: Completed Case Evaluation Templates (CETs)
162 generated by the AQUA database, with either an Exemplary Dispatcher Performance Report or a
163 Dispatcher Non-compliance Report attached will be forwarded to Supervisors by the QA
164 Supervisor on a weekly basis.
165
166 13.14.2.1 Supervisors will review each CET/Perfonnance Report wit the Communication Officer on a one-to-one
167 basis. Both the Supervisor and the Communication Officer may add their comments to the fonns and both must sign
168 it.
169 13.14.2.2 If as a result of Q A review circumstances dictates the Supervisor should develop an action plan and
170 document this on the fonn. A deadline for completion of the action plan MUST be given, Action plans may be
171 appropriate if remedial training is required or if, in the case of exemplary performance, it will be beneficial to share
172 details of a case or actions of a Communication Officer.
173 13.14.2.3 Supervisors may use the fonn to request further Q A follow-up or action if required. Examples of Q A
174 action that could be suggested include requests for a particular Continuing Dispatch Education topic to be covered,
175 for a letter of commendation to be submitted, or for a problem to be raised at the Medical Dispatch Review
176 Committee meeting,
177 13.14.2.4 The Communication Officer's Supervisor must return completed fonns to the QA Supervisor within ten
178 days of receipt.
179 13.14.2.5 The QA Supervisor must be infonned of the completion of any action plan noted on the fonn.
180 13.14.2.6 A copy of the completed form will be kept by the QA Supervisor in the Communication Officer's QA
181 file.
182 13.14.2.7 Copies of the completed fonn will be distributed by the QA Supervisor to the Shift Supervisor who will
183 distribute to the Communication Officer. In addition, all exemplary and non-compliance reports will be distributed to
184 the Medical Director (Medical Calls Only) and the Director of 9-1-1.
185 13.14.2.8 Due to the subjective nature inherent in the QA Case Review Process, the possibility for non-concurrence
186 with the Review Evaluation Rating exists. When supervisors do not concur with the Case Review Evaluation Ratings
187 and these rating issues cannot be resolved to the satisfaction of the supervisor, the Director shall be notified of the
188 conflicting issues. The Director shall resolve the issues in conflict and render a decision on the proper documentation
189 of the Case Review Evaluation, The Case Review Evaluation shall reflect the findings.
190
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Augusta 9-1-1 Cente'r Policy ahd Procedure Manual
19'1 13,14,3 QA Database Individual Communication Officer Compliance Reports: Compliance
192 data for individual Communication Officers shall be generated from the PDQA database and
193 forwarded to Shift Supervisors on a monthly basis with either an Exemplary Compliance report
]94 or a Non-Compliance Action Plan attached. Data on individual Communication Officer's
]95 performance will not be discussed with their peers.
196
197 13.14.3.1 Shift Supervisors will review each Compliance Report with the Communication Officer on a one-to-one
198 basis. Both the Supervisor and the Communication Officer may add their comments to the forms and both must sign
199 it.
200 13.14.3.2 Shift Supervisors may use the form to request further QA follow-up or action ifrequired.
201 13.14.3.3 The Shift Supervisor must return completed forms to the QA within ten days of their receipt.
202 13.14,3.4 The QA Supervisor must be infornled of the completion of any action plan noted on the form.
203 13.14.3.5 The QA Supervisor will keep a copy of the completed form in the Communication Officer's QA file.
204 13.14.3.6 Copies of the completed form will be distributed by the QA Supervisor to the Shift Supervisor for
205 distribution to the Communication Officer. In addition, all exemplary and non-compliance reports will be distributed
206 to the Medical Director (Medical Calls Only) and the 9-1-1 Director,
207
208 13.14.4 Due to the subjective nature inherent in the QA Case Review Process, the possibility for
209 non-concurrence with the Review Evaluation Rating exits. When Supervisors do not concur with
210 the Case Review Evaluation Ratings and these ratings issues between the QA and the Supervisor
211 cannot be resolved the Director shall resolve the issues. and the Director shall render a decision
212 on the proper documentation of the Case Review Evaluation. The Case Review Evaluation shall
213 reflect the Director's findings.
214
215 13.14.5 QA Database Shift Compliance Reports
216
217 13.14.5.1 Compliance data for each shift overall shall be generated from the PDQA database and posted on the
218 bulletin board in dispatch at monthly intervals by the QA Supervisor.
219 13.14.5.2 The QA Supervisor and the Director will review the compliance data for each shift with the relevant
220 supervisor on a one-to-one basis each month. Copies of any action plan required should be forwarded to the QA
221 Supervisor for record keeping.
222 13.14.5.3 The QA Supervisor must be informed of the completion of any action plan.
223 13,14.5.4 A copy of each Shift Compliance Report will be kept by the QA Supervisor in the Shift's QA file.
224 13.14.5.5 Copies of the Shift Compliance Report will be distributed by the QA Supervisor to the Director, the
225 Medical Director, 9-1-1 Steering Committee, and Dispatch Review Committee, for the life of the implementation
226 contract, to Dispatch Priority Consultants (DPe).
227
228 13.14.6 QA Database Dispatch Summary Compliance Reports
229
230 13.14.6.1 A Communication Officer Sununary Compliance Report will be generated from the PDQA database and
231 copied to each member of the DRC at weekly intervals and to the 9-1-1 Steering Committee with a Summary report
232 at quarterly intervals. The Summary report will also be copied to the membership of the DRC at monthly intervals.
233 13.14.6.2 The DRC will review the Dispatch Summary Compliance Report and the QI Data Summary report at
234 monthly intervals and develop an action plan if appropriate. Copies of any action plan formulated should be
235 forwarded to the QA Supervisor for record keeping,
236 13.14.6.2.1 The 9-1-1 Steering Committee will review the Dispatch Summary Compliance Report, the Data
237 Summary report, and any associated action plan(s) at quarterly intervals, The 9-1-1 Steering Committee may require
238 of the DRC that an action plan is formulated (if it wasn't previously accomplished), or is modified.
239 13.14.6.2.2 The QA Supervisor the DRC and the 9-1-1 Steering Committee membership must be informed of the
240 completion of any action plan,
241 13.14.6.2.3 The QA Supervisor will keep a copy of each Dispatch Summary Compliance Report and QI Data
242 Summary report in the Communication Officer's QA file,
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Augusta 9-1-1 Center Policy arid Procedure Manual
243' 13.14.6.2.4 Copies of the Dispatch Summary Compliance Report and QI Data Summary report will be distributed
244 by the QA Supervisor to the Director, the Medical Director (Medical Calls Only), the membership of 9-1-1 Steering
245 Committee, and DRC for the life of the implementation contract, to Dispatch Priority Consultants.
246
247 13.14.6.3 Medical Dispatch Feedback Reports
248
249 13.14.6,3.1 These forms will be made available to all field personnel dispatched by Augusta 9-1-1 who respond to
250 EMS calls, They will be utilized to provide feedback from the field to dispatch in the event of exemplary
251 Communication Officer performance or if a case proves problematic.
252 13.14.6.3.2 Completed forms will be written and sealed and forwarded directly to the Augusta 9-1-1 QA Supervisor,
253 13.14,6.3.3 On receipt of a fonn the QA Supervisor will review the tape of the relevant call and discuss it with the
254 Communication Officer's Supervisor, in the event of non-compliance, The Shift Supervisor will then review with the
255 involved Communication Officer and take any other action that is deemed appropriate.
256 13.14.6.3.4 The QA Supervisor will provide a reply to the initiator of the query or feedback within fourteen days of
257 receipt of the form. In the first instance and where feasible this will be in the form of a telephone call to the initiator.
258 13.14.6.3.5 The completed Medical Dispatch Feedback Report will be returned to the initiating ambulance service
259 Supervisor.
260 13.14.6.3.6 Copies of the completed Medical Dispatch Feedback Report will be kept by the QA Supervisor in the
261 relevant Communication Officer's file and in a file dedicated to completed Medical Dispatch Feedback Reports.
262 13.14.6.3.7 Copies of the completed Medical Dispatch Feedback Report will be distributed by the QA Supervisor to
263 the Director, the Medical Director, and for the life of the implementation contract, to Dispatch Priority Consultants
264 (DPe),
265 13.14.6.3.8 Medical Dispatch Feedback Reports must be completed in a professional manner. Reports submitted
266 which contain aggressive or abusive language, or otherwise unprofessional behavior, will be returned to the initiator
267 via appropriate channels, A copy of such forms will be forwarded by the QA Supervisor to the Director.
268
269 13.15 Continuing Dispatch Education Process, Roles and Responsibilities: The Continuing
270 Dispatch Education (CDE) process shall follow a standardized procedure as detailed below and
271 as required by the National Academy of Emergency Dispatch (NAED) to meet accreditation
272 standards.
273
274 13.15.] Purpose: To provide all dispatch personnel with the necessary understanding and skills
275 as they relate to the efficient and effective provision of Continuing Dispatch Education for the
276 Priority Dispatch Systems. Such Continuing Dispatch Education processes shall be sufficient to
277 meet the requirements of the NAED for accreditation as a "Dispatch Center of Excellence".
278
279 13.15.2 CDE Program Management The DRC (in conjunction with the QA Supervisor) shall
280 be responsible for defining the topics that the CDE program will address.
281 13.15.2.] Once defined, these topics shall be submitted to the Training Coordinator for approval, prior to
282 implementation.
283 13.15.2.2 Appropriate CDE topics may be identified in a number of ways:
284
285 . As a result of the DRC'S recommendations (based on the QA's findings)
286 . Supervisor's action plans or requests for further action by the QA,
287 . Via requests from Communication Officers,
288
289 13.15.2.3 The QA Supervisor shall be responsible for scheduling educational opportunities in conjunction with the
290 Training Coordinator, as necessary to address the needs identified above, The QA Supervisor shall be responsible for
291 ensuring that necessary educational opportunities are:
292 13,15,2.4 Delivered by appropriately qualified personnel (Must be related to the topic chosen, does not necessarily
293 have to be a Dispatcher Instructor)
294 13.15.2.5 Adequate in their content and format to address the identified learning objective
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Augusta 9-1-1 Center Policy and Procedure Manual
29'5 13.15.2.6 Relevant to Communication Officers and the associated work
296 13.15.2.7 Attended by all Communication Officers.
297 13.15.2.8 The QA Supervisor shall be responsible for ensuring that appropriate records are maintained regarding the
298 CDE program in the QA filing system and for Communication Officer individually.
299 13.15.2.9 The QA Supervisor shall be responsible for ensuring that a CDE Lesson Plan is completed with adequate
300 standards for all classroom-based education.
301
302 13.15.3 Meeting NAED Re-Certification Requirements
303
304 13.15.3.1 The QA Supervisor shall be responsible for ensuring that all Call Takers/Dispatchers are given adequate
305 opportunity to meet NAED re-certification requirements.
306 13.15.3.2 If it appears likely that a Communication Officer will not meet NAED re-certification requirements, the
307 QA Supervisor must infonn that individual's supervisor at the earliest opportunity.
308
309 13.15.4 Types of CDE: The following are acceptable formats and their associated maXImum
310 hours for CDE.
311
312 . Workshops and seminars (16 hours minimum/maximum)
313 . Attendance at planning and management meetings, such as the DRC (8 hours maximum)
314 . Quality assurance and case review (8 hours maximum)
315 . Review of related audio, video and written materials (4 hours maximum)
316 . Public education (4 hours maximum)
317 . PDS Protocol review (4 hours maximum)
318 . Miscellaneous, such as ride-along and work experience 4 hours maximum)
319
320 13.15.4,1 The minimum CDE requirement in any given year shall be twelve hours Communication Officer, at least
321 eight hours of which shall be didactic in nature. In addition to the CDE hours, types, and topics discussed above,
322 Communication Officer must maintain current CPR certification equal to those established by the American Heart
323 Association standards, The bulk of the subject matter accepted as fulfilling NAED requirements will be directly
324 related to the science of Emergency Dispatch and the use of the PDS; however, other related material will be
325 considered for its educational relevance.
326
327 13.15.5 CDE Program Objectives
328
329 13.15.5.1 Development of a better understanding of telecommunications and of the Communication Officer's
330 specific roles and responsibilities,
331 13.15.5.2 Enhancement of on-line skills in the use of PAIs and in all emergency telephone procedures within the
332 practice of Communication Officer,
333 13.15.5.3 Improving skill in the use or application of all component parts of the PDS, including interrogation and
334 prioritization.
335 13.15.5.4 Providing opportunities for discussion, practice of skills, and for constmctive feedback of perfonnance.
336
337 13.16 Press Information Policy: All concerned personnel will follow the procedure
338 described below to alert the Communications Center Administration of cases of potential
339 interest to the press. In no case will any information be released regarding criminal
340 investigation by the Augusta 9-1-1 Center, except for statements made through the
341 investigating unit or other member at the RCSO. The purpose of this policy is to provide
342 Augusta 9-1-1 Center personnel with a procedure which will ensure that cases potentially
343 providing opportunities for positive publicity are identified in a timely manner.
344
345 13.16.1 Pre-Arrival Instruction Cases
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346
347 13.16.1.1 By definition this will include all cardiac arrest, choking, and childbirth cases,
348 13.16.1.2 The QA Supervisor will review the previous day's (or weekends) cases at the beginning of the shift to
349 identify those calls for which PAIs were given,
350 13.16.1.3 The QA Supervisor will then briefly review the audio recording of each of these calls for examples of
351 exemplary perfonnance, unusual or interesting circumstances, or significant impact and patient outcome.
352 13.16.1.4 The audio tapes of cases that are identified as being of special interest will then be taken immediately to
353 the Augusta 9-1-1Director, After personally reviewing the tapes, a joint decision will be made on what details of
354 those calls are suitable for release to the Public within the limits of the Georgia State Statute regarding the
355 confidentiality of9-1-1 calls and any other investigative restrictions.
356 13.16.1.5 The QA Supervisor will handle initial contacts with the press and coordinate any further related activity.
357
358 13.16.2 Calls of Potential Press Interest other than PAIs
359
360 13.16,2.1 Supervisors should make a special attempt to identify any call that may be of interest to the press that does
361 not fall into the category of PAl administration. The involvement and support of all concerned personnel will be
362 essential in this endeavor.
363 13.16.2.2 Supervisors should promptly pass the infonnation regarding the call to the Director.
364 13.16.2,3 The Director will then follow the same steps as identified in Section 13,16.1.2 above.
365
366 13.16.3 Problematic Cases
367
368 13.16.3.1 Supervisors must make every attempt to identify problematic cases that may attract
369 adverse press interest. Details of these cases must be passed to the Director immediately, This will
370 allow adequate time for preparation of a response.
371 13.16.3,2 If a Communication Officer receives a call that is considered to be of interest to the
372 press, the call must be referred to the Director of the Augusta 9-1-1 Center immediately, in an effort
373 to allow adequate time for preparation of a response. If you are unsure, refer calls to your
374 supervisor and the supervisor will make the decision.
375 13.16.3.3 Examples of problematic cases:
376
377 . Delay in entry of a request for service
378 . Incorrect triagingluse of protocol
379 . Discrepancies in the location of the incident, that results in delayed response time.
380
381 13.17 Certification Policy: Staff employed in the position of Conununication Officer are
382 required to gain initial certification in all three disciplines of Public Safety Dispatch (Law
383 Enforcement, Fire and EMS) and to maintain these qualifications via the relevant re-certification
384 process. The Purpose of the policy is to inform all Conununication Officers of the requirements
385 for certification and re-certification.
386
387 13.17.1 Emergency Dispatcher Certification
388
389 13.17.1.1 All current and future personnel employed in the position of Communication Officer are required to
390 obtain Emergency Dispatcher Certification (Law Enforcement, Fire, EMD) with the National Academy of
391 Emergency Dispatch (NAED) within 180 days of employment.
392 13.17.1.2 The Augusta 9-1-1 Center will provide the necessary training and retraining opportunities to facilitate
393 acquisition of this qualification.
394 13.17.1.3 In the event that an employee does not pass the certification examination on the first attempt, they will be
395 provided with supportive retraining based on feedback received from the NAED regarding areas of poor
396 perfonnance. They will then be invited to take a retest conducted by the NAED via telephone.
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397 13.17.1.4 Should the Communication Officer still be unsuccessful in passing the retest, the employee will be
398 scheduled for further training. The employee may then take the certification examination and, if necessary, the retest
399 on one further occasion.
400 13.17.1.5 Failure to successfully pass the certification or re-certification tests required to obtain NAED Certification
40 I in anyone discipline will be cause for dismissal.
402
403 13,17.2 Re-certification
404
405 13.17,2.1 Communication Officers are required to maintain current certification as mandated by the NAED. This
406 currently requires completion of a minimum of twenty-four hours of Continuing Dispatch Education per two-year
407 period, achieving a passing mark in an open-book examination every two years, and maintaining current CPR
408 certification.
409 13.17.2.2 The Augusta 9-1-1 Center will provide all necessary opportunities for completion of the continuing
410 Dispatch Education requirement and CPR re-certification. It will also maintain records of CED and certification
411 status to assist in meeting the qualifications,
412 13.17.2.3 Details ofCDE requirements are contained in a separate specific policy.
413
414 13.18 Language Translation Policy: Call receiving and dispatch for medical assistance shall be
415 provided in a standardized manner following approved Priority Dispatch Systems (PDS) protocol
416 scripts for 9-1-1 caller interrogation and provision of post dispatch and pre-arrival instructions,
417 regardless of the language used by the caller.
418
419 13.18.1 Purpose: To provide all Communication Officers with the necessary understanding of
420 the requirements for use of the PDS when the caller utilizes a language other than American
421 English.
422
423 13.18.2 Priority Dispatch Foreign Language Protocols
424
425 13.18.2.1 Use of the Language Line Services is mandatory when the caller does not speak American English, If the
426 Language Line Services line is not functioning, and the caller is unable to understand or converse in English, then the
427 Communication Officer must make ever reasonable effort to obtain the minimum information necessary to effect a
428 dispatch to the victim's location.
429 ]3.18.2,2 In the event the Language Line Services line is not functioning and Communication Officer has the
430 appropriate language skills, the Communication Officer may translate the protocols into another language. However,
431 any translation made must result in a precise translation of the meaning, tense, and phrasing of the American English
432 language version of the PDS.
433
434 13.19 Request for Clarification/Review Policy: Supervisors shall review all new and previous
435 requests, that have not been reviewed, for clarification and their associated answers, as found in
436 the PDS folder, with Communication Officers during every shift. The purpose of the policy is to
437 provide all Communication Officers with the opportunity to enhance their skills in the use of the
438 PDS by reviewing the questions (and the associated answers) raised by their peers regarding the
439 use of this system.
440
441 13.] 9.] PDS Folder: A folder is provided in the Communications Center that allows
442 Communication Officers to raise questions regarding the use of the PDS.
443
444 ]3.19.2 This folder is regularly reviewed by the Quality Assurance Supervisor for new questions
445 to which the QA Supervisor will promptly provide a written response by placing it in the folder.
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446' 13.19.3 It is recognized that questions raised by Communication Officers and the associated
447 answers provided are likely to provide an excellent learning opportunity for all Communication
448 Officers using the system.
449
450 13.20 Supervisor's Responsibility
451
452 13.20.1 At least once during each shift, supervisors will review the contents of the PDS folder for
453 new and previous requests, which have not been reviewed, for clarification.
454 13.20.2 At least once during each shift, supervisors will review these clarification requests with
455 each Communication Officer under their supervision, either in a group format or on a one-to-one
456 basis, to ensure that all staff understand the implication of each query raised and its associated
457 answer.
458 13.20.3 Supervisors shall record in the log that this review has taken place, noting which
459 clarification requests have been reviewed and with which members of staff.
460 13.20.4 The Requests for Clarification will then be routed through the office of the Director.
461
462 13.21 Answering of 9-1-1 Call: Communication Officer shall answer 9-1-1 calls for
463 emergency assistance using a standardized format. This may be clarified and enhanced when
464 necessary but may not be altered or abandoned. If a Communication Officer applies all
465 relevant techniques but the caller still refuses to cooperate, the Communication Officer will not
466 be considered to be at fault.
467
468 13.21.1 The purpose of this policy is to provide all Communication Officers with a standardized
469 methodology for establishing and maintaining control of the data gathering and interrogation
470 process during the receipt of 9-1-1 calls. Communication Officers are expected to accurately
471 gather all appropriate information and to give PDIs and PAIs when possible, appropriate, and
472 necessary.
473
474 13.21.2 Initial Receipt of a 9-1-1 Call: "Augusta 9-1-1, where is your emergency?" (Have
475 the caller repeat the address for confirmation and check it against the CAD). If they do not match,
476 say, "Can you repeat that address back to me so that I can be sure I've got it right?" (Do not
477 repeat the address back to the caller always have them repeat it to you.) If the address still does
478 not match, ask them, "That is not the address you originally gave me, could you repeat it once
479 more please?" it is your responsibility to be sure they match.
480
481 13.21.2.1 What telephone number are you calling from? As the caller gives you the number, actively compare it
482 to the number on the ANI/All Display or CAD Screen. If the numbers match, you may accept this as confirmation.
483 If the numbers do not match, say to the caller, "Could you repeat that number again, so I can make sure I've go it
484 right?" (Do not repeat the number back to the caller, always have them repeat it to you.) If the number still does not
485 match, ask them, "That is not the number you originally gave me, could you repeat it once more please?" it is your
486 responsibility to be sure they match.
487 13.21.2.2 What is the problem? What happened? (If emergency help is determined; go to 'C'; if non-emergency,
488 transfer to a lower priority queue.
489
490 13.21.2.2.1 If the caller starts to give a long history, rephrase and repeat the question as "What's the problem now?
491 What's happening now?"
492 13.21.2.2.2 If the caller's response does not enable selection of a Chief Complaint, seek clarification of the chief
493 complaint, if possible.
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494 13.21.2.2.3 If still unable to identify the correct Chief Complaint card, select either card 26 (second party callers) or
495 card 32 (third party callers).
496 13.21.2.2.4 Ask the remaining questions on the Case Entry card in the correct order.
497 13.21.2.2.5 Politely but firmly focus the caller on answering all questions as asked. Do not allow callers to offer
498 additional information until they have answered all scripted questions. If callers lose their focus and do not
499 concentrate on answering questions asked, say "SirlMadam, I need you to answer this question so that I can get help
500 to you as quickly as possible." Repeat this as often as necessary using exactly the same phrasing.
501
502 13.21.3 Chief Complaint Cards (At this point the call can be dropped in the CAD using the
503 QENT or IQ Command)
504
505 13.21.3.1 Go to the appropriate Chief Complaint card after gathering all Case Entry information.
506 13.21.3.2 Say to the caller "Help is on the way to you now. Please stay on the line. I need to ask you a few more
507 questions so that I can tell you what to do to help the patient."
508 13.21.3.3 Ask all of the Key Questions in the order they appear on the card following the script.
509 13.21.3.4 Politely but firmly focus the caller on answering all questions in order. Do not allow callers to offer
510 additional information until they have answered all scripted questions. If callers lose their focus and do not
511 concentrate on answering questions as asked, say "SirlMadam I need you to answer this question so that I can tell
512 you exactly what to do to help." Repeat this as often as necessary using exactly the same phrasing.
513
514 13.21.4 Coping with Distressed, Hysterical, Aggressive, and Abusive Callers.
515
516 13.21.4.1 It is recognized that callers who fall into these categories represent a great challenge to the
517 Communication Officer. However, all of these callers (especially those who are aggressive or abusive) behave in
518 this way because they are frightened and feel that they have no control of the situation. The following techniques
519 will help to calm them but require a very professional demeanor from the Communication Officer. Do not let the
520 caller affect the way the call is handled.
521 13.21.4:2 Remain calm and courteous at all times, regardless of how the caller behaves, or what is said or done.
522 13.21.4.3 Keep your voice level and even at all times. Do not shout at the caller, or even raise your voice, unless
523 necessary to get their attention.
524
525 . Never display irritation with the caller.
526 . Never threaten the caller.
527
528 13.21.4.4 Give an explanation with a motive for everything you do or ask the caller to do. For instance, explain why
529 you are asking key questions (so that you can tell them how to help the patient) or why you need to put the caller on
530 hold (so that you can get help on the way to them).
531 13.21.4.5 Tell them that help is on the way. Repeat this as often as is necessary.
532 13.21.4.6 Use the first name of children. This may also be a helpful technique for hysterical adults.
533 13.21.4.7 Use "repetitive persistence." This works for many abusive and aggressive callers as well as those who are
534 hysterical. Give the caller an action, followed by a reason for complying with this action. Repeat this, using exactly
535 the same phrasing, and in a calm level voice, as often as is necessary until the caller listens and cooperates. Be
536 prepared to use this technique more than once.
537 13.21.4.8 Use "positive ambiguity". Do not lie to the caller, even if motivated by kindness. Do not make promises
538 that are not within your ability to keep. Examples follow:
539
540 . The caller asks "How long will the an1bulance be?" You should reply "Help is on the way. They will be with
541 you as soon as possible." Do not give an exact time of arrival.
542 . The caller asks, "The patient is going to be all right, isn't s/he?" You should reply "Everyone will do the best
543 they can to help."
544 . The caller asks, "Will this save him/her?" You should reply "This will help give him/her the best possible
545 chance.
546 . Give the caller firm but gentle encouragement. If the caller says "Nothing's working!" say, "Don't give up.
547 You've got to keep doing it. This will keep him/her going until help arrives."
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548' . If a hysterical calJer stilJ can't be calmed, ask if there is someone else you can speak to. This should only be
549 used as a last resort, as you will no longer be in a position to calm the caller.
550 . Always use repetitive persistence, positive ambiguity, and a calm, reassuring, professional demeanor.
551
552 13.21.5 Pre-Arrival Instructions
553
554 13.21.5.1 Do not ask for permission to give pre-arrival instructions. Do not say "Would you like me to tell you
555 how to do CPR.
556 13.21.5.2 If the caller refuses to follow PAIs, say, "Help is on its way, but it is important to give the patient the best
557 possible chance until it arrives." Repeat as necessary.
558 13.21.5.3 If the caller stills refuses to administer aid, ask if there is someone else you can speak to. Remember this
559 is your last resort, attempt to calm this caller first!
560
561 13.21.6 Third Party Calls
562
563 13.21.6.1 Do not assume that third party callers know nothing, even ifthey say they know nothing.
564 13.21.6.2 Always ask all Case Entry and Key Questions.
565 13.21.6.3 Always ask the caller if they will go back to the scene to render aid. If they agree, give POI's and PAl's as
566 possible, appropriate, and necessary.
567
568 13.21.7 Useful Phrases to Remember
569
570 13.21.7.1 First Contact With Caller:
571
572 . "AUGUSTA 9-1-1, Where is your emergency?"
573
574 13.21.7.2 CONFIRMING THE ADDRESS:
575
576 . "Can you repeat that address back to me so that I can be sure I've got it right?"
577 . "That is not the address you originally gave me. Could you repeat it once more, please?"
578
579 13.21.7.3 Confirming the Call-Back Number:
580
581 . "What telephone number can I call you back on, if necessary?"
582 . "That is not the same as the number given to me by the operator. Could you repeat it once more, please?"
583
584 13.21.7.4 Case Entry
585
586 . "What's the problem? What happened?"
587 . "What's the problem now? What's happening now?"
588 . "Sir/Madam I need you to answer this question so that 1 can get help to you as quickly as possible."
589
590 13.21.7.5 Key Questions
591
592 . " SirfMadam I need you to answer this question so that I can tell you exactly what to do to help."
593 . Help is on the way to you now. Please stay on the line. I need to ask you a few more questions so that I can tell
594 you what to do to help the patient."
595
596 13.21.7.6 Positive Ambiguity
597
598 . "Fire Rescue has been advised. They will be with you as soon as possible."
599 . "Everyone will do the best they can to help."
600 . "This will help give him/her the best possible chance."
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60"[
602 13.21.7.7 Encouragement to Follow Instructions
603
604 . "Don't give up. You've got to keep doing it. This will keep him/her going until help arrives."
605
606 13.21.7.8 PAIs
607
608 . "Help is on its way, but this is important to give the patient the best possible chance until it arrives."
609
610 13.22 Obvious Death Policy: The following defines the meaning of the term "obvious death"
611 for dispatch purposes and provides a protocol to be followed by Communication Officer in the
612 event they identify a patient as being a victim of "obvious death." It also defines the actions to be
613 taken in the event that the caller identifies the patient as having signed a "Living Will" or is
614 subject to a "Do not resuscitate" order.
615
616 13.22.1 Purpose: The purpose of this policy is to provide Communication Officer with a
617 protocol to follow with regard to confirming obvious death or in the event that a Living Will or
618 Do Not Resuscitate is identified, and the subsequent actions they should take.
619
620 13.22.2 Obvious Death Definition For dispatch purposes "Obvious Death" is defined as meaning
621 that a patient's condition can be identified, as the sole result of information being provided by a
622 9-1-1 caller and without doubt or fear of error, as being incompatible with life. This information
623 would in turn indicate that it would be inappropriate for Communication Officer to offer
624 pre-arrival instructions.
625
626 13.22.2.1 The Medical Director has agreed that the following conditions may be considered by emergency medical
627 dispatchers to constitute "Obvious Death" in the event that the patient is confirmed as being both without pulse and
628 not breathing and at least one of the following eight conditions is unquestionable:
629
630 . Decapitation
631 . Explosive gunshot wound to the head
632 . Decomposition
633 . Non-recent traumatic death (confirmed as being greater than six hours, with rigor mortis or lividity present)
634 . Non-recent expected death (confirmed as being greater than six hours, with rigor mortis, or lividity present)
635 . Severe injuries obviously incompatible with life (massive crush injury)
636 . Incineration
637 . Submersion (confirmed as being greater than twenty-four hours)
638
639 13.22.2.2 The Communication Officer must be sure that the presence of at least one of the above eight conditions
640 is unquestionable.
641 13.22.2.3 Communication Officer will not routinely question callers about the presence or absence of the above
642 listed conditions. Communication Officer will only attempt to identify the existence of these conditions in the event
643 that the caller suggests that the patient is not salvageable.
644
645 13.22.3 Action in the Event of Identification of Unquestionable "Obvious Death"
646
647 13.22.3.1 Re-code the call as 9-B-I, and infom1 all responders of your reason for doing so.
648 13.22.3.2 Do not provide Pal's.
649 13.22.3.3 Ifpossible, keep the caller on the line and provide emotional support until the first of the responding units
650 arrive on the scene.
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65'1 13.22.3.4 If none of the conditions listed in 13.22.2.1 are present, the Communication Officer must provide CPR
652 pre-arrival instructions as per protocol.
653
654 13.22.4 Living Wills and Do Not Resuscitate Orders: If the caller identifies that the patient has
655 signed a Living Will or is subject to a "Do Not resuscitate" order, the Communication Officer
656 must still provide pre-arrival instructions as per protocol. This is to avoid CPR instructions being
657 withheld in the event that the caller is in error about the presence of such an order or document.
658
659 13.22.5 Refusal by Caller to Act on Pre-Arrival Instructions
660
661 13.22.5.1 It is not the Communication Officer responsibility to attempt to force callers to participate in actions
662 against that individual's will.
663 13.22.5.2 Do not ask for permission to give pre-arrival instructions. Do not say "Would you like me to tell you how
664 to do CPR?"
665 13.22.5.3 If the caller refuses to follow PAIs, say "Help is on the way, but this is important to give the patient the
666 best possible chance until it arrives." Repeat as necessary.
667 13.22.5.3.1 If the caller stills refuses to administer aid, ask if there is someone else you can speak to.
668 13.22.5.4 If no one else is available, attempt to keep the caller on the line and provide emotional support. Make it
669 clear that if you change their mind about providing patient care, you will tell them exactly what to do.
670 13.22.5.5 If the caller stated the patient is subject to a "Do Not Resuscitate Order" (ONR), tell the caller to have the
671 order ready to present to the medical personnel upon their arrival.
672 13.22.5.6 Remain polite and courteous at all times.
673
674 13.23 Priority Dispatch Incremental Compliance Policy: It is the policy of Augusta 9-1-1
675 Center to comply with the Priority Dispatch Systems (PDS) protocols.
676
677 13.23.1 Purpose: The purpose of this policy is to achieve and retain accreditation from NAED,
678 all Communication Officers shall maintain the average compliance scores as required by that
679 organization.
680
681 13.23.2 It is necessary for each individual Communication Officer to meet the following average
682 PDS compliance scores in order to meet the NAED Dispatch Center of Excellence Accreditation
683 requirements, which are as follows:
684
685 . 95% Case Entry compliance
686 . 90% Key Question compliance
687 . 90% Post-Dispatch Instruction compliance
688 . 95% Pre-Arrival Instruction compliance
689
690 13.23.3 CERTIFICATION REQUIREMENTS: Realizing that achievement of these
691 compliance rates is not immediately feasible for newly qualified Communication Officers, the
692 below listed procedures outline a systematic approach to reach that objective:
693
694 13.23.3.1 All new Communication Officers shall (within six months of hire date) be certified as Emergency
695 Dispatchers.
696 13.23.3.2 All existing dispatchers shall be subject to this policy as of their certification date for each discipline.
697
698 13.23.4 INCREMENTAL COMPLIANCE REQIDREMENTS
699
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700 13.23.4.1 Within 2 months of becoming certified all Communication Officer shall achieve a 50% compliance rate.
701 Any Communication Officer not achieving a minimum 50% compliance rating as listed above shall receive five
702 on-line training sessions by a TO, totaling 40 hours. These sessions shall be based on the problems demonstrated
703 during the QA process.
704 13.23.4.2 Within 3 months of becoming certified, all Communication Officers will achieve a 65% minimum
705 compliance rate. Any Communication Officer not achieving a 65% compliance rate as listed above shall receive five
706 more on-line training sessions, based on the problems identified in the QA process.
707 13.23.4.3 Within 4 months of becoming certified all Communication Officer shall achieve an 80% minimum
708 compliance rate. Any dispatcher not achieving an 80% compliance rate as listed above shall receive five on-line
709 training sessions. These sessions shall be based on the problems demonstrated during the QA process.
710 13.23.4.4 Within 5 months of becoming certified all Communication Officer shall achieve the NAED accreditation
711 compliance rates as identified above. Any Communication Officer not achieving these compliance rates shall
712 receive 5 on-line training sessions. These sessions shall be based on the problems demonstrated during the QA
713 process.
714 13.23.4.5 After 6 months of becoming certified all Communication Officers shall maintain the NAEO compliance
715 rates detailed above. Any Communication Officer not achieving these compliance rates shall receive five more
716 on-line training sessions. These sessions shall be based on the problems demonstrated during the QA process.
717
718 13.23.5 This policy does not exclude the need for discipline when considering individual cases
719 of gross negligence or gross improper behavior, or cases of persistent failure to apply PDS
720 protocols, nor does it exclude any other existing disciplinary process.
721
722 13.23.6 Discipline versus Quality Assurance:
723
724 13.23.6.1 All quality improvement reviews shall be handled by the QA.
725
726 13.23.6.2 When compliance becomes a disciplinary versus a quality assurance problem, the quality assurance
727 supervisor will identify the individual to the Shift Supervisor and the Director. The Shift Sergeant will handle all
728 on-line remedial training. All discipline cases shall be handled by the immediate Supervisor (according to the
729 current disciplinary policy) and via the chain of command.
730
731 13.23.7 Trilw:er Points for Disciplinary Action
732
733 13.23.7.1 During the first six months after certification Progressive discipline shall begin for Communication
734 Officers who are in noncompliance;
735 13.23.7.2 After the initial 3 months;
736 13.23.7.3 Fail to achieve the required compliance levels as detailed above during two out of three months.
737
738 13.23.8 Following a six month period of certification Progressive discipline shall begin for
739 Communication Officers who:
740
741 13.23.8.1 Fails to achieve 95% Case Entry compliance in two out of three months;
742 13.23.8.2 Fails to achieve 90% Key Questions compliance in two out of three months;
743 13.23.8.3 Fails to achieve 90% Post-Dispatch Instruction compliance in two out of three months;
744 13.23.8.4 Fails to achieve 95 % Pre-Arrival Instructions compliance in two out of three months.
745
746 13.24 Emergency Mental Health Services Center: Calls received by the Augusta 9-1-1 Center
747 that involve patients who are in an emotional crisis will be dispatched through the PDS system
748 and will be transferred to the Emergency Mental Health Services Center after the appropriate
749 response determinants have been activated. Emergency Mental Health Services will refer any
750 caller who they feel needs emergency medical assistance back to the Augusta 9-1-1 Center
751 immediately.
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752'
753 13.24.1 The purpose of this policy is to provide all Communication Officers with an additional
754 resource for handling emotional patients prior to or instead of sending an EMS response,
755 dependent upon the emergency.
756
757 13.24.2 Communications Technology and Protocols
758
759 13.24.2.1 The Emergency Mental Health Service will always have the ability to distinguish Augusta 9-1-1 Center
760 calls from others, prioritize answering calls from the Augusta 9-1-1 Center within 3 rings, and not place Augusta 9-1-
761 I Center calls on hold. In an emergent situation, Emergency Mental Health Service (EMHS) operators will always
762 contact Augusta 9-1-1 Center Call Taker by calling 821-1080.
763 13.24.2.2 When handling calls, Augusta 9-1-1 Center Call Takers will transmit their identification number to
764 Emergency Mental Health Operators, so that the EMHS operator responses to the Augusta 9- I -I Center can be
765 directed to the respective Call Taker who contacted them.
766
767 13.24.3 Quality Control
768
769 13.24.3.1 The Emergency Mental Health Service will participate in Augusta 9-1-1 Center Quality Improvement by
770 informing Augusta 9-1-1 Center of any suggestions for change or any problems through use of the "Medical
771 Dispatch Feedback Report" fom1s which will be stationed in a designated place in the Emergency Mental Health
772 Service Center. Augusta 9-1-1 Center Quality Improvement Supervisor (QA) should be notified immediately upon
773 completion of the form by calling 821-1080, then faxing the form to 821-1243.
774
775 13.24.4 Training/Implementation
776
777 13.24.4.1 In the process of implementing EMO, the Emergency Mental Health Service will participate in joint
778 training with Augusta 9-1-1 Center.
779
780 13.24.5 Psychiatric/Suicide Attempt (protocol 25)
781
782 13.24.5.1 Post Dispatch Instructions The Communication Officer will conduct the "Post-Dispatch Instructions"
783 (unless the Emergency Rule is invoked), after which the Call Takers will bring Emergency Mental Health Service
784 into the call for any call wherein a violent and/or suicidal threat or gesture is reported.
785 13.24.5.2 First Party Callers: In the case of a first party caller (patient is the caller), Post Dispatch Instruction "a"
786 and "e" apply, and the Emergency Mental Health Service will be contacted after "a".
787 13.24.5.3 Second Party Callers: In the case of second party callers, if any explanation of the Post-Dispatch
788 Instruction is requested, the Emergency Mental Health Service will be consulted immediately upon completion of the
789 Post-Dispatch Instructions.
790
791 13.25 GEORGIA POISON CONTROL CENTER: Calls received by Augusta 9-1-1 Center
792 that involve patients who have accidentally or intentionally inhaled, ingested, injected or
793 absorbed poisons (or drugs, alcohol, etc.) into their bodies will be dispatched through the PDS
794 system. After the appropriate response determinants have been activated the call will be
795 transferred to the Georgia Poison Control. The Georgia Poison Control Center will refer any
796 caller whom they feel needs emergency medical assistance back to the Augusta 9-1-1 Center
797 immediately.
798
799 13.25.1 The purpose of this policy is to provide all Communication Officers an additional
800 resource for handling overdose/poisoning patients prior to or instead of sending an EMS
801 response, dependent upon the emergency.
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802
803 13.25.2 Communications Technology and Protocols
804
805 13.25.2.1 The Georgia Poison Control Center (GPCC) will dedicate a land line to tI1e Augusta 9-1-1 Center to
806 access the GPCC without delay, and to communicate without subsequently being placed on hold.
807 13.25.2.2 In an emergent situation, the GPCC will contact the Augusta 9-1-1 Center by calling 821-1080.
808 13.25.2.3 If at any time the GPCC determines that an EMS response is needed on a call that was not previously
809 reported to a Public Safety Answering Point (PSAP), they will instruct the caller to hang up and call 9-1-1. This will
810 ensure capture of the ANI/ALl information or they will call the Augusta 9-1-1 Center themselves if they determine
811 that there is a question about the caller's ability to call.
812 13.25.2.4 When handling calls, the Augusta 9-1-1 Center will transmit their identitication number to the GPCC
813 Operator so that GPCC responses to the Augusta 9-1-1 Center can be directed to the respective Call Taker who
814 contacted the G PCC.
815
816 13.25.3 Quality Control
817
818 13.25.3.1 The Georgia Poison Control Center will participate in Augusta 9-1-1 Center Quality Improvement by
819 informing the Augusta 9-1-1 Center of any suggestions for change or any problems through the use of tI1e "Medical
820 Dispatch feedback Report" forms. These forms will be provided by Augusta 9-1-1 Center and stationed in a
821 designated place in the Georgia Poison Control Center. The Quality Assurance Supervisor should be notified
822 immediately upon completion of the form by calling 821-1080, then faxing it to 821-1243.
823
824 13.25.4 TraininglImplementation
825
826 13.25.4.1 In the process of implementing the EMD, the Georgia Poison Control Center will participate in joint
827 training with the Augusta 9-1-1 Center.
828
829 13.25.5 PROCEDURE ISSUES:
830
831 13.25.5.1 Carbon Monoxide/Inhalation HazMat (Protocol 8)
832 13.25.5.2 Concerning "a", of the Post-Dispatch Instructions, Call Takers should always notify the Georgia Poison
833 Control Center, if information from the caller indicates that someone is ill/injured in association with a gas or liquid
834 chemical exposure. This should always be done as soon as possible after dispatch of the appropriate units so that all
835 responding units (Police, Fire, and EMS) can be alerted to scene hazards as soon as they are discovered.
836 ]3.25.5.3 If no ill/injured victims are reported, or if further information about the offending chemical is needed
837 beyond that given the GPCC, CHEMTREC should be contacted and their information also passed on to the
838 responders.
839
84013.25.6 Overdose/Ingestion/Poisoning (protocol 23)
841
842 13.25.6.1 for the dispatch decision and the call disposition on callers in the "Omega" category, the Georgia Poison
843 Control Center must be contacted.
844 13.25.6.2 If the GPCC and/or the caller desire a physical response to the scene, the call should be dispatched as a
845 23-B-1, unless the condition of the victim worsens. This will require that the Call Taker remain on the line with both
846 the caller and the GPCC until a response is agreed upon.
847 13.25.6.3 Regarding "Post-Dispatch Instructions" listed in "c", the GPCC must be contacted and should advise the
848 Call Taker on giving this instruction.
849 13.25.6.4 For any caller reporting a victim who has, or may have ingested an anti-psychotic medication, the GPCC
850 must be notified after tI1e call Taker has given Post-Dispatch Instructions.
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13.23.4.1 Within :2 months of becoming certified all Communication Officer shall achieve a 50% compliance rate.
Any Communication Officer not achieving a minimum 50% compliance rating as listed above shall receive five
on-line training sessions by a TO, totaling 40 hours. These sessions shall be based on the problems demonstrated
during the QA process.
13.23.4.2 Within 3 months of becoming certified, all Communication Officers will achieve a 65% minin1Um
compliance rate. Any Communication Officer not achieving a 65% compliance rate as listed above shall receive five
more on-line training sessions, based on the problems identified in the QA process.
13.23.4.3 Within 4 months of becoming certified all Communication Officer shall achieve an 80% minimum
compliance rate. Any dispatcher not achieving an 80% compliance rate as listed above shall receive five on-line
training sessions. These sessions shall be based on the problems demonstrated during the QA process.
13.23.4.4 Within 5 months of becoming certified all Communication Officer shall achieve the NAED accreditation
compliance rates as identified above. Any Communication Officer not achieving these compliance rates shall
receive five on-line training sessions. These sessions shall be based on the problems demonstrated during the QA
process.
13.23.4.5 After 6 months of becoming certified all C~mmunication Officers shall maintain the NAEO compliance
rates detailed above. Any Communication Officer not achieving these compliance rates shall receive five more
on-line training sessions. These sessions shall be based on the problems demonstrated during the QA process.
13.23.5 This policy does not exclude the need for discipline when considering individual cases
of gross negligence or gross improper behavior, or cases of persistent failure to apply PDS
protocols, nor does it exclude any other existing disciplinary process.
13.23.6 Discipline versus Quality Assurance:
13.23.6.1 All quality improvement reviews shall be handled by the QA.
13.23.6.2 When compliance becomes a disciplinary versus a quality assurance problem, the quality assurance
supervisor will identify the individual to the Shift Supervisor and the Director. The Shift Sergeant will handle all
on-line remedial training. All discipline cases shall be handled by the immediate Supervisor (according to the
current disciplinary policy) and via the chain of command.
]3.23.7 Trigger Points for Disciplinarv Action
13.23.7.1 During the first six months after certification Progressive discipline shall begin for Communication
Officers who are in noncompliance;
13;23.7.2 Afterthe initial 3 months;
13.23.7.3 Fail to achieve the required compliance levels as detailed above during two out of three months.
13.23.8 Following a six month period of certification Progressive discipline shall begin for
Communication Officers who:
13.23.8.1 Fails to achieve 95% Case Entry compliance in two out of three months;
13.23.8.2 Fails to achieve 90% Key Questions compliance in two out of three months;
13.23.8.3 Fails to achieve 90% Post-Dispatch Instruction compliance in two out of three months;
13.23.8.4 Fails to achieve 95 % Pre-Arrival Instructions compliance in two out of three months.
13.24 Psychiatric/Suicide Attempt (Protocol 25)
13.24.1 Post Dispatch Instructions: The Communication Officer will conduct the
"Post-Dispatch Instructions" (unless the Emergency Rule is invoked). The Communication
Officer will bring Emergency Mental Health Service into the call for any call wherein a violent
and/or suicidal threat or gesture is reported.
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13.24.2 First Party Callers: In the case of a first party caller (patient is the caller), Post Dispatch
Instruction "a" and "e" apply, and the Emergency Mental Health Service will be contacted after
"a".
13.24.3 Second Party Callers: In the case of second party callers, if any explanation of the
Post-Dispatch Instruction is requested, the Emergency Mental Health Service will be consulted
immediately upon completion of the Post-Dispatch Instructions.
13.25 ACCIDENTAL INGESTION: Calls received by Augusta 9-1-1 Center that involve
patients who have accidentally inhaled, ingested, injected or absorbed poisons (or drugs, alcohol,
etc.) into their bodies will be dispatched through the PDS system. After the appropriate response.
determinants have been activated, the call 'Yill be transferred or referred to the Georgia Poison
Control. The Georgia Poison Control Center will refer any caller whom they feel needs
emergency medical assistance back to the Augusta 9-1-1 center immediately.
13.25.1 The purpose of this policy is to provide all Communication Officers an additional
resource for handling overdose/poisoning patients before or instead of sending an EMS response,
dependent upon the emergency.
. 13.25.2 PROCEDURE ISSUES:
13.25.2.1 Carbon Monoxide/Inhalation HazMat (Protocol 8)
13.25.2.2 Concerning "a", of the Post-Dispatch Instructions, Call Takers should always notify the Georgia Poison
Control Center, if information from the caller indicates that someone is iIVinjured in association with a gas or liquid
chemical exposure. This should always be done as soon as possible after dispatch of the appropriate units so that all
responding units (Police, Fire, and EMS) can be alerted to scene hazards as soon as they are discovered.
13.25.2.3 If no ill/injured victims are reported, or if further information about the offending chemical is needed
beyond that given then contact Fire/Rescue & EMA.
THE AUGU~TA 9-1-1 CENTER MEDICAL DIRECTOR, THE AUGUSTA 9-1-1
CENTER DIRECTOR, AND REPRESENTATIVES OF DISPATCH PRIORITY
CONSUL TANTS HAVE REVIEWED THESE POLOCIES AND PROCEDURES AND
GIVEN THEIR RESPECTIVE APPROVAL.
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