Tuesday, May 29, 2012

Response time dissected

An important issue on my plate these days is a plan to improve Lincoln Fire & Rescue's ability to respond to life-threatening emergencies. We believe that by building four new fire stations, then repositioning our existing personnel and apparatus to those stations (while abandoning others) we can significantly improve travel time to places that are more than four minutes away from a fire station.

Travel time, however, is not the same thing as response time. Rather, it is but one component. When you dissect response time, it can be divided into three basic components: call processing time, turnout time, and travel time. I am going to write a series of posts this week to describe each of these, beginning today with call processing.

Call processing time is the interval from when the emergency call is placed to when a dispatcher notifies the emergency responders. A lot of stuff has to happen during that period: the ringing phone must be answered, the call-taker must gather and/or confirm basic information (address, nature of the emergency, level of consciousness, breathing status, etc.). Sometimes the caller must be calmed or reassured in order to gather this critical information.

In all but the smallest public safety answering points (PSAPs, commonly known as 911 Centers), the call processing is split between call-takers who handle the telephones, and dispatchers who handle the radio. Once the call-taker concludes that the event is emergent, he or she forwards it to a dispatch position. After the call has been forwarded for dispatch, the call-taker usually continues to gather and forward supplementary information, and provide instructions and assistance to the caller.

Meanwhile, the event has landed in the dispatch queue, the database of pending calls awaiting dispatch. Computer-aided dispatch software helps dispatchers deal with those queues by assigning priority rankings and colors to pending calls, and by recommending the appropriate response units based on pre-designed criteria. Nonetheless, the dispatcher must conclude any current dispatch, read and absorb the contents of the pending call in the queue, recognize it as emergent, check the availability and status of the recommended units, key the mic and get the attention of the resource to be assigned, and voice the pertinent incident details. While much of this same information is also sent electronically to a mobile data computer in the response vehicles, the voice dispatch and confirmation is still a crucial step.

All of this takes time. Even when the call processing steps proceed smoothly and quickly, those small periods of a few seconds add up. Multiple emergencies often exist at the same time, requiring call-takers, dispatchers, and responders all to multitask efficiently. Ideally we'd like to get 90% of all critical incidents dispatched within 60 seconds from the time the 911 line first rings. This doesn't mean that we will be done with the call in 60 seconds, only that we have determined that an emergency exists, forwarded the essential information to a dispatch position, and notified the assigned units to respond.


Anonymous said...

I drove big rigs for many years. Even with a highly skilled driver there is just no way a huge firetruck will be able to make it to a lo9cation as quickly as a van or a pickup( Quick Response Vehicle). I can see sending a firetruck to a location where there is a fire or a hazardous material spill reported in the 911 call. For a medical emergency like a possible heart attack, choking etc QUICK response times are especially critical. A QRV staffed with qualified EMT's and appropriate equipment could be on a scene seconds or even minutes before a HUGE truck could. IF the QRV team sees a need for the Big Rig they can ask for it. Unless fire or spills are reported to the 9/11 call center the decision to respond to a call with the firetruck should be made by the QRV team on the site.

Cross training is another issue where quicker and better responses could be achieved. The best driver should be driving the Big Rig to the scene BUT everyone on a response team should know the BASICS of driving and operating the truck, QRVs etc. The same for specialized rescue equipment. All personnel need a BASIC understanding and ability to operate MOST of the tools and equipment on the scene. I am sure my long winded spiel hasn't added anything new that you haven't already thought of. But just in case. . . .
Gun Nut

Steve said...

I curious as to the ratio of dispatchers to call takers. It would seem you'd need more people answering phones simply because not every call needs a response (at least not immediate). Maybe this is forthcoming, but I'd also like to know the frequency of 911 calls on an average and at peak periods.

Anonymous said...

Sixty seconds is a very ambitious target for dispatching such a high proportion of your calls. If you staff are getting anywhere near that target, well done to them!

Anonymous said...

Over all I think the community should be very proud of the 911 center and its staff. They sound very professional and don't let human emotion get in their way.

Now the dude that walks through the comm-center whistling need to just plain stop whistling, it is annoying to hear and rather unprofessional. Petty gripe, I know.

And we should remember too that Lincoln sort of pioneered first responder response on medical calls, using 911, LFR and Bryan Heart Team resources. It's made PSAPs what they are today.