ASTM F1560-00(2006)
(Practice)Standard Practice for Emergency Medical Dispatch Management
Standard Practice for Emergency Medical Dispatch Management
SCOPE
1.1 This practice covers the function of the emergency medical dispatcher (EMD). This function is the prompt and accurate processing of calls for emergency medical assistance. The training and practice through the use of a written or automated medical dispatch protocol is not sufficient in itself to ensure continued medically correct functioning of the EMD. Their dispatch-specific medical training and focal role in EMS has developed to such a complexity that only through a correctly structured and appropriately managed quality assurance environment can the benefits of their practice be fully realized. The philosophies of emergency medical dispatch have established new duties to which the emergency medical dispatch agency must respond. It is important that their quality assurance/quality improvement (QA/QI) activities, including initial hiring, orientation, training and certification, continuing dispatch education, recertification, and performance evaluation be given appropriate managerial attention to help ensure the ongoing safety in the performance of the EMD. This practice establishes functional guidelines for these managerial, administrative and supervisory functions.
1.2 The scope of this practice includes:
1.2.1 The entry level selection criteria for hiring emergency medical dispatchers;
1.2.2 The orientation of new emergency medical dispatchers;
1.2.3 Development of QA/QI mechanisms, management strategies and organizational structures for use within a comprehensive emergency medical dispatch system;
1.2.4 Performance evaluation as a component of a comprehensive and ongoing quality assurance and risk management program for an emergency medical dispatch system;
1.2.5 Development and provision of continuing dispatch education activities for the emergency medical dispatcher;
1.2.6 Requirements for initial certification and recertification of the emergency medical dispatcher;
1.2.7 Provision for comparative analysis between different EMD program approaches available to the EMS community that conform to established EMD practice standards prior to implementation of an emergency medical dispatch program; and
1.2.8 Guidelines for implementation of an emergency medical dispatch program.
1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.
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Designation: F1560 − 00(Reapproved 2006)
Standard Practice for
Emergency Medical Dispatch Management
This standard is issued under the fixed designation F1560; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
INTRODUCTION
The emergency medical dispatcher (EMD) is the principal link between the public caller requesting
emergencymedicalassistanceandtheemergencymedicalservice(EMS)resourcedeliverysystem.As
such, the EMD plays a fundamental role in the ability of the EMS system to respond to a perceived
medical emergency.With proper training, program administration, supervision, and medical direction,
the EMD can accurately query the caller, select an appropriate method of response, provide pertinent
information to responders, and give appropriate aid and direction for patients through the caller.
Through careful application and reference to a written, medically approved, emergency medical
dispatch protocol, sound decisions concerning EMS responses can be made in a safe, reproducible,
and non-arbitrary manner. These benefits are realized by EMS systems when appropriate
implementation, sound medical management, and quality assurance/quality improvement (QA/QI) at
dispatch are provided within the EMD/EMS system. This practice assists in establishing these
management and administrative standards.
1. Scope 1.2 The scope of this practice includes:
1.2.1 The entry level selection criteria for hiring emergency
1.1 This practice covers the function of the emergency
medical dispatchers;
medical dispatcher (EMD). This function is the prompt and
1.2.2 The orientation of new emergency medical dispatch-
accurate processing of calls for emergency medical assistance.
ers;
The training and practice through the use of a written or
1.2.3 Development of QA/QI mechanisms, management
automatedmedicaldispatchprotocolisnotsufficientinitselfto
strategies and organizational structures for use within a com-
ensure continued medically correct functioning of the EMD.
prehensive emergency medical dispatch system;
Their dispatch-specific medical training and focal role in EMS
1.2.4 Performance evaluation as a component of a compre-
has developed to such a complexity that only through a
hensive and ongoing quality assurance and risk management
correctly structured and appropriately managed quality assur-
program for an emergency medical dispatch system;
ance environment can the benefits of their practice be fully
1.2.5 Development and provision of continuing dispatch
realized.Thephilosophiesofemergencymedicaldispatchhave
education activities for the emergency medical dispatcher;
established new duties to which the emergency medical dis-
1.2.6 Requirements for initial certification and recertifica-
patch agency must respond. It is important that their quality
tion of the emergency medical dispatcher;
assurance/quality improvement (QA/QI) activities, including
1.2.7 Provision for comparative analysis between different
initial hiring, orientation, training and certification, continuing
EMD program approaches available to the EMS community
dispatch education, recertification, and performance evaluation
that conform to established EMD practice standards prior to
be given appropriate managerial attention to help ensure the
implementation of an emergency medical dispatch program;
ongoing safety in the performance of the EMD. This practice
and
establishes functional guidelines for these managerial, admin-
1.2.8 Guidelines for implementation of an emergency medi-
istrative and supervisory functions.
cal dispatch program.
1.3 This standard does not purport to address all of the
This practice is under the jurisdiction ofASTM Committee F30 on Emergency
Medical Services and is the direct responsibility of Subcommittee F30.04 on
safety concerns, if any, associated with its use. It is the
Communications.
responsibility of the user of this standard to establish appro-
Current edition approved March 1, 2006. Published March 2006. Originally
priate safety and health practices and determine the applica-
approved in 1994. Last previous edition approved in 2000 as F1560 – 00. DOI:
10.1520/F1560-00R06. bility of regulatory limitations prior to use.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1560 − 00 (2006)
2. Referenced Documents planning, EMD program selection, proper system
implementation,employeeselection,training,andcertification,
2.1 ASTM Standards:
QA/QI, performance evaluation, continuing dispatch
F1258 Practice for Emergency Medical Dispatch
education, recertification, and risk management activities.
F1552 Practice for Training Instructor Qualification and
These functions must be designed and implemented to assist
Certification Eligibility of Emergency Medical Dispatch-
the medical director, dispatch supervisor, and emergency
ers
medical dispatcher in monitoring and modifying EMD perfor-
3. Terminology
mance found deficient by QA/QI to protect the public against
incompetent practitioners, as well as modify organizational
3.1 Definitions of Terms Specific to This Standard:
structure, resource, or protocol deficiencies that exist in the
3.1.1 case review template—a structured performance
emergency medical dispatch system.
evaluation document containing all necessary input and output
4.1.1 Entry Level Selection—The selection and evaluation
actionsrequiredofdispatchersthatparallelstheEMDs’on-line
protocols, policies, and procedures related to call-taking and of new dispatchers must include clearly written objective
standards to be adopted for qualifying candidates, interviewing
processing. It contains check-off lists and compliance scoring
mechanisms that objectively rate the EMDs’ performance on a applicants and pre-employment aptitude and skill testing pur-
suant to the hiring of dispatchers.
single call.
4.1.2 Orientation—A pre-planned process of events focus-
3.1.2 dispatch life support—the knowledge, procedures, and
ing on the development and acclimation of an employee who
skills used by trained EMDs in providing care through pre-
will function within the organization’s standards, practices,
arrival instructions to callers. It consists of those BLS andALS
policies, and procedures.
principles that are appropriate to application by medical
dispatchers. 4.1.3 Quality Assurance/Quality Improvement—Within a
physician medically directed emergency medical dispatch
3.1.3 emergency medical dispatch agency—any organiza-
system, the development and implementation of employee
tion or a combination of organizations working cooperatively,
performance thresholds, concurrent evaluation of compliance
that routinely accepts calls for emergency medical assistance
to these thresholds through on-line supervision, retrospective
and facilitates the dispatch of prehospital emergency medical
evaluation of non-edited logged recordings of requests for
resources/personnel and provides medically oriented pre-
emergencyservicemeasuringcompliancewithpolicy,practice,
arrival instructions pursuant to such requests.
andproceduretovalidatethatthepracticesareappropriate,and
3.1.4 performance evaluation—the documented, objective,
to correct the employee and practice if they are found to be
quantitative measure of an individual emergency medical
deficient.
dispatcher’s performance based upon compliance with depart-
4.1.4 Performance Evaluation—Each EMD in an emer-
mental protocols, policies and procedures.
gency medical dispatch agency must regularly and routinely be
3.1.5 pre-arrival instructions—telephone-rendered, medi-
evaluated with respect to his or her adherence to policy,
cally approved written instructions provided by trained EMDs
protocol, and procedure through the QA/QI process. This
through callers which help to provide aid to the victim and
determines conformance to these elements and measures how
controlofthesituationpriortoarrivalofprehospitalpersonnel.
this performance affects the efficiency and effectiveness of the
3.1.6 quality assurance/quality improvement (QA/QI)—the
emergency medical dispatch agency. The evaluation must be
comprehensive program of prospectively setting standards,
quantitative and qualitative.
concurrently monitoring the performance of clinical, opera-
4.1.5 Continuing Education—Each emergency medical dis-
tional and personnel components, and retrospectively improv-
patchagencymustprovideforthedevelopmentandimplemen-
ing these components in the emergency medical dispatch
tation of a continuing dispatch education program for the
agency when compared with these standards.
benefit of that agency’s EMD personnel. This program must
3.1.7 risk management—a sub-component of the quality provide the EMD with applicable educational topics designed
assurance/quality improvement program designed to: identify
to enhance their general knowledge and skill in the philosophy
problematic situations and assist EMS medical directors, dis- and application of the EMD program used within the emer-
patch supervisors, and EMDs in modifying practice behaviors
gency medical dispatch agency.
found to be deficient by quality assurance procedures; protect
4.1.6 Risk Management—A written practice and procedure
the public against incompetent practitioners; and modify
shall be established for each agency that provides guidelines
structural, resource, and protocol deficiencies that may exist in
for physician medical directors, EMS system administrators,
the emergency medical dispatch system.
agencysupervisors,and/orQA/QIpersonneltofollowwhenan
EMD is identified as failing to meet or follow established
4. Summary of Practice
protocols. These may be acts of omission or commission
4.1 A comprehensive plan for managing the quality of care
identified through concurrent or retrospective review. This
in an emergency medical dispatch system must include careful
practice and procedure shall provide guidelines for proper
investigative criteria relative to the medical or administrative
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
nature of the perceived infraction, and the proper progressive
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
disciplinary procedure to be followed in order to provide the
Standards volume information, refer to the standard’s Document Summary page on
the ASTM website. EMD due process.
F1560 − 00 (2006)
4.1.7 Certification, Recertification—All EMDs working in a professional, it is necessary to establish sound medical man-
medical dispatch agency shall be certified as competent in the agementprocessesthroughamulti-componentQA/QIprogram
use of the medically approved emergency medical dispatch administered by the EMD’s agency in conjunction with the
priority reference system (EMDPRS) used within the medical physician medical director. Prompt, correct, and appropriate
dispatch center. Initial certification and recertification stan- patient care can be enhanced through the use of a standardized
dards shall be established by each certifying entity associated approach to quality assurance, especially the component of
withtheirEMDPRSprotocolsinaccordancewithASTM-EMD EMD performance assessment. This practice is intended for
standards that validate the individual EMD’s knowledge and use by agencies, organizations, and jurisdictions having the
competency in their use. responsibility for providing such services and assurances to the
4.1.8 Reciprocal Certification—Reciprocal certification public through the correct management of the nation’s emer-
gency medical dispatchers.
shall be established between certifying agencies and organiza-
tions having programs that meet the standards contained in this
6. EMD Entry Level Selection Criteria
practice.
4.1.9 Registration and Maintenance of Certification
6.1 Each emergency medical dispatch agency shall adopt a
Records—All certifying entities, agencies, or organizations
formal written policy delineating the selection procedures for
shall maintain records for all certified individuals and shall
individuals to be employed as emergency medical dispatchers.
provide documents and reports regarding testing and certifica-
It must address the ability to:
tion status as required by using agencies, states, or governmen-
6.1.1 Read and write at a high school graduate or GED
tal units.All records shall be maintained for a minimum period
level;
of ten years from initial certification, recertification or testing
6.1.2 Perform those clerical skills as delineated by the
of the individual.
employing agency;
4.1.10 Revocation of Certification—This practice shall set 6.1.3 Perform verbal skills in a clear and understandable
forthguidelinesforassessinggroundsforapossiblesuspension
manner, in the required language or languages established as
or termination of certification when questionable situations necessary to that emergency medical dispatch agency;
arise in EMD conduct or performance.
6.1.4 Perform alphanumeric transcription skills necessary to
correctly record addresses, locations, and telephone numbers;
4.1.11 Program Selection and Implementation—This is in-
and
tended to assist the EMS administrator in the selection of the
6.1.5 Demonstratecompetencyinbasictelecommunications
program that best suits the dispatch agency’s needs from a
skills as required by the employing or training agency.
medical, legal, and operational perspective and provide for
comparative analysis between different EMD program ap-
6.2 Selection criteria should also include the following:
proaches available to the EMS community that conform to
6.2.1 A clear attribute of helpfulness and compassion to-
established EMD practice standards.
ward the sick or injured patient and the caller advocate;
4.1.12 Physician Medical Director—Each emergency medi-
6.2.2 The ability to clearly guide callers in crisis through
cal dispatch agency shall have a physician medical director,
application of necessary interrogation procedures and the
who shall assist in evaluation and review of the EMD program
provision of telephone pre-arrival instructions;
under consideration. The physician medical director shall
6.2.3 The ability to learn and master the skills, philosophy
approve the selected EMD program written protocol. The
and knowledge required to successfully complete the training
physician shall be responsible for all medical aspects of the
process;
EMD program.Additional responsibilities include the medical
6.2.4 The ability to efficiently and effectively organize
oversight of the EMD t
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