Nurses’ Line Ease Hospital Crowding and EMS Dispatches

This story is about a new 911 dispatch program that is hoping to ease overcrowding. Now we’ve talked about this in the news on several different occasions but every time a new system starts utilizing something like this, I like to bring it up because I think this is really the standard by which we should all be using and moving certainly in very busy systems in suburban and metropolitan areas. This is a 911 program that will be instituted by Louisville Metro Emergency Medical Services and this a program under which the low priority calls- somebody calling in with ear ache or a nosebleed or whatever the case may be, they call in to 911, they get the low priority call but usually we dispatch an ambulance to them. How can we change that?

Well, they’ve instituted a program where this call will be diverted to a nurse line and the nurse on the other end of the line would talk to the patient, find out more information, make an over-the-phone assessment on that patient and then direct them to more appropriate medical care that would be more appropriate than an expensive trip to the emergency room. It might be an urgent care center, it might be directing the patient to take analgesic medication, sleep through the night and get up in the morning and call their primary care provider or come in to a local clinic. The great news is this is something that can be handled over the phone without any diversional resources and without a trip to the emergency room.

So we’re going to see more and more programs like this because it’s just a more efficient use of resources. You can have 1 nurse or 1 or 2 nurses answering phone calls, depending on how busy your service is but they can be using these calls, going ahead and maybe following up with the patients at a later date, the next morning or later in the evening to see how they’re doing but by doing that, you don’t divert an entire ambulance and an entire crew to a non-emergency call, saving those resources for patients that really need it. I think that this is going to be a standard by which we all operate in the near future and is really going to be part of a whole program where we’re going to see changes in the way we dispatch units; changes in the way we utilize resources, whether its chase cars or ambulances or helicopter transport, fixed wing aircraft; and of course programs like community paramedicine programs fit in perfectly with this. You have a chase vehicle with a supervisor who’s trained as a community paramedic, maybe that individual follows up with some of these frequent calls, follows up with patients who called in the night before with an ear ache, stopping in to visit them, seeing if they need any additional information or resources and maybe even putting them back in touch with the nurse line.

There’s a lot of different ways to implement this and there’s no right or wrong way, it’ll be part of your system and you’ll build it the way you need to build it but I think this is just a great look at what one community is doing to solve this problem of hospital overcrowding and overuse of EMS resources. I applaud them, I think this is really forward thinking program in their case. Check out this link and you’ll be able to follow up and read this article for yourself but I definitely urge you to talk to your supervisors, talk to people in your area. What are they doing at the dispatch level to try to take some of the calls out of the EMS system?

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This article has been featured in the news segment of the MedicCast podcast episode Asthma for EMS and Episode 227