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What is ProQA™?
ProQA™ is a premier Emergency Dispatch (ED) software package for medical,
fire, and law enforcement agencies. It offers you the automated tools you need
to provide the very best public service and patient care. During the course
of an emergency call, ProQA guides you through the process of collecting vital
information from the caller, obtaining victim status, choosing an appropriate
dispatch level, and instructing the caller with industry approved protocols
until the dispatched units arrive at the scene.
ProQA is an expert system designed to help you provide the very best in service
and speed. Correct dispatch levels are usually determined in less than one minute.
ProQA additionally provides you with Dispatch Life Support (DLS) protocols which
meet or exceed the international standards for emergency dispatching. ProQA
is built on a foundation of empirical literature and industry experience relevant
to all fields of public emergency care.
It purposely takes into account the unique, non-visual nature of the dispatch
environment, where both victims and the scene must be assessed and treated by
remote control.
ProQA is based on the Emergency
Priority Dispatch System™ (EPDS™) and provides a standardized
format for carrying out the practice of priority dispatching. It is an automated
system which operates by evaluating incoming information according to logical
rules built on expert industry knowledge. Those using this system must have
the very best in dispatch training, must have a firm understanding of the Priority
Dispatch systems, and must operate within a quality assurance and improvement
environment.
The use of ProQA software by dispatchers trained and certified by the National
Academies of Emergency Dispatch™ (NAED™) results in state-of-the-art
emergency dispatching. Training is also available for communication center supervisors,
medical directors, and EMS administrators in the form of an Executive
Certification Course, or Communications Center Manager
Course. These seminars are designed to provide upper level training relevant
to center management and dispatcher supervision issues and will give attendees
a general understanding of the ProQA software system.
ProQA, along with its companion software package AQUA™
(Advanced Quality Assurance), provides a superb quality
assurance platform designed specifically for the needs of center directors,
quality improvement coordinators, and dispatch supervisors.
What
is the MPDS™?
At the core of ProQA is the Medical Priority Dispatch System (MPDS). The MPDS
has been developed and refined over the last two decades under the direction
of Jeff J. Clawson, M.D. The MPDS EMD protocols are supported and continually
validated by a scientific, international body of medical experts.
The MPDS is simple, yet complete. It includes Chief Complaint/incident type
protocols which help EMDs quickly obtain vital information about patient status
and scene conditions. The EMD then uses this information to send the appropriate
response configuration as determined by local medical and EMS control. The MPDS
also includes DLS treatment sequence protocols covering arrest, choking, and
childbirth. These protocols enable a trained and certified EMD to assist the
caller in immediately helping the patient.
The MPDS protocols ensure that trained and certified EMDs properly carry out
the following four important activities:
1. Structured and rapid caller interrogation and patient evaluation
2. Accurate selection of the appropriate EMS unit response
3. Relay of important patient and scene information to field responders
4. Provision of essential Dispatch Life Support
In order for EMDs to be patient advocates, they must also be system advocates.
EMS agencies must maintain a reasonable level of staffing and unit availability,
so when calls come in, EMDs can make the most efficient use of available resources.
Emergency Medical Dispatch
For many years the EMS dispatcher was without a system to ensure accurate decision-making
based on sound medical principles. Historically, the interrogations conducted
by these ill-equipped medical dispatchers resulted in subjective evaluations
of the pre-hospital responses required for each call. Inconsistencies in medical
dispatch policies, procedures, and practices have led to major legal disasters
that could easily have been avoided if the dispatchers had been provided with
the training and protocol tools necessary to perform their job properly.
One of the primary purposes of the MPDS protocols is to enable EMDs to determine
the appropriate response to send to a given emergency. The protocols help EMDs
quickly obtain the patient status and scene information necessary to determine
the appropriate dispatch determinant code. The EMD then sends the response configuration
that has been assigned to the code by local medical and EMS control. In short,
the MPDS helps dispatchers send the right thing, at the right time, in the right
way.
In several implementation studies of agencies with both BLS and ALS capabilities,
the MPDS reduced the number of ALS responses by 30 percent. The MPDS also produced
commensurate decreases in emergency medical vehicle accidents and unit maintenance
costs. This happens because the MPDS protocols enable EMDs to make safe response
choice decisions based on well-established medical principles, as opposed to
making dangerous decisions based on subjective, unstructured interrogations.
Another primary purpose of the MPDS is to enable EMDs to assist callers in
aiding the patient prior to on-scene arrival of field personnel. This is accomplished
through uniform, medically approved, DLS protocols. All of the MPDS DLS protocols
meet or exceed the international standards for emergency medical dispatching.
It has long been believed that emergency medical care begins when the pre-hospital
care providers arrive at the scene. However, when EMDs are properly trained
and equipped, emergency medical care can begin the moment the dispatcher answers
the phone. This makes properly trained and equipped EMDs a critical link in
the EMS chain of patient care.
The National Academy of Emergency Medical Dispatch
One of the most important functions of the National Academy of Emergency
Medical Dispatch, now the National Academies of Emergency Dispatch following
the creation of the Fire and Police protocol systems, is the consideration,
research, and adoption (or rejection) of proposed revisions to the MPDS protocols.
The NAEMD College of Fellows consists of internationally recognized experts
in EMS, public safety telecommunications, and emergency medical dispatching.
Just as the American Heart Association establishes the standards for CPR, BLS,
and ACLS, the College of Fellows maintains the standards and integrity of all
aspects of DLS, including MPDS protocols and curriculum.
This orderly process provides a legally defensible national medical standard
in addition to maintaining a unified protocol and curriculum. The MPDS uniform
coding system is similar to the U.S. National Fire Protection Administration's
Uniform Fire Incident Reporting System (UFIRS) or the ICDM-9 Medical Coding
System. Only through the use of a unified coding system can national and international
standards be maintained and comparative research be carried out.
EMS responders should be able to expect a reasonable correlation between response
level and scene findings. Significant problems, discovered through the use of
your agency's designated Medical Dispatch Feedback Report (or equivalent), should
be reported through the prescribed channels. This field responder feedback assists
in the developing science of EMD by helping to improve the MPDS.
Field responder observations should be carefully and systematically researched
and reported. These reports should not attack the MPDS or accuse the EMD, but
should include all of the relevant facts. A thorough case review should be completed
regarding any seemingly problematic dispatch case. Judgment on these cases should
be reserved until the case review has been completed.
Significant findings or trends observed by field personnel and verified by
protocol compliance case reviews should be forwarded to the NAEMD College of
Fellows. The College of Fellows will evaluate the information and take the necessary
action.
What
is the FPDS™?
The Fire Priority Dispatch System™ (FPDS™) is the result of years
of work structuring a set of protocols based upon the same format as the logic
driven medical protocols. The National Academy called together center advisors,
dispatch supervisors, managers, first responders and other experts from fire
safety agencies, combining decades of experience, to create the new system.
The FPDS protocols ensure that trained and certified EFDs properly carry out
the following four important activities:
1. Structured and rapid caller interrogation and scene evaluation
2. Accurate selection of the appropriate fire/EMS unit response
3. Relay of important victim and scene information to field responders
4. Give standardized, measurable care for every call that comes into the center
In order for EFDs to be public care advocates, they must also be system advocates.
Fire dispatch agencies must maintain a reasonable level of staffing and unit
availability, so when calls come in, EFDs can make the most efficient use of
available resources.
What
is the PPDS™?
Following closely on the heels of the fire protocol, the Police Priority Dispatch System™ (PPDS™) follows the same logic-structured format for this set of protocols available to law enforcement dispatch centers worldwide. The police protocol has been designed by a group of experts nationwide who have spent hours structuring the question and instruction sequences to effectively help the public in just about any scenario that may present itself. The protocol system is designed to increase officer safety, improve knowledge of the scene, and activate an appropriate response to the incident.
The PPDS protocols ensure that trained and certified EPDs properly carry out
the following four important activities:
1. Structured and rapid caller interrogation and scene evaluation
2. Accurate selection of the appropriate police unit response
3. Relay of important victim and scene information to field responders
4. Give standardized, measurable care for every call that comes into the center
In order for EPDs to be public care advocates, they must also be system advocates.
How
ProQA and the Protocols Work
As a dispatcher using ProQA and/or the cardsets in any of the systems, your
first step with every incoming call is Case Entry (equivalent to the field responder's
primary survey). In Case Entry, you verify the location and callback number
for the incident. The protocols are designed to ask questions clearly and concisely
to gather information on the the patient's age, status of consciousness, status
of breathing, and Chief Complaint or main emergency that is occurring. These
questions together constitute the "Four Commandments" of emergency
dispatching.
During the initial interrogation the dispatcher is directed through a series
of yes or no diagrams that will direct them to the next step of the questioning
process depending on the answers that the caller is giving them. The dispatcher
is directed to either proceed with the questions or in acute emergency situations
to dispatch help immediately. For instance, if you receive information that
the patient is unconscious and not breathing (for any reason), before continuing
with any further interrogation or instructions, you immediately send a maximal
response. In fire and police protocols information about the scene is collected,
as well as any victim information and eye witness testimony that might describe
what happened on the scene, for instance a description of a gunman. Questioning
sequences have been designed to assist first responders and to gather the initial
picture of what is occurring at the incident site.
After Case Entry, the next task is to complete the Key
Questions from the appropriate protocol (Chief Complaint or Incident Type).
The Key Questions are equivalent to the field responder's secondary survey.
They provide you with a more orderly and much closer view of the scene or victim
status so the response provided is appropriate and in keeping with the severity
of the incident.
If you are using the ProQA software, the program then
takes the information obtained through Case Entry and the Key Questions and
automatically determines the appropriate dispatch determinant code. Your task
as a dispatcher is then to dispatch the response configuration (emergency vehicles
and mode of response) assigned to the code. If using a cardset then responses
are assigned according to severity and are listed on the protocol card itself.
The protocols have been designed with some flexibility in the response method
area so that individual centers can configure responses based on their needs
and resources.
The EPDS protocol systems have been developed to provide exact, sound advice
which increases the quality of public care, provides a measurable standard for
dispatch center quality control officers, and insures that no matter what the
situation the caller will have access to the same level of care as every other
caller.
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