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Impact of two-level filtering on emergency medical communication center triage during the COVID-19 pandemic: an uncontrolled before-after study.
Scand J Trauma Resusc Emerg Med. 2020 Aug 14; 28(1):80.SJ

Abstract

BACKGROUND

Rapid access to emergency medical communication centers (EMCCs) is pivotal to address potentially life-threatening conditions. Maintaining public access to EMCCs without delay is crucial in case of disease outbreak despite the significant increased activity and the difficulties to mobilize extra staff resources. The aim of our study was to assess the impact of two-level filtering on EMCC performance during the COVID-19 outbreak.

METHODS

A before-after monocentric prospective study was conducted at the EMCC at the Nantes University Hospital. Using telephone activity data, we compared EMCC performance during 2 periods. In period one (February 27th to March 11th 2020), call takers managed calls as usual, gathering basic information from the caller and giving first aid instructions to a bystander on scene if needed. During period two (March 12th to March 25th 2020), calls were answered by a first-line call taker to identify potentially serious conditions that required immediate dispatch. When a serious condition was excluded, the call was immediately transferred to a second-line call taker who managed the call as usual so the first-line call taker could be rapidly available for other incoming calls. The primary outcome was the quality of service at 20 s (QS20), corresponding to the rate of calls answered within 20 s. We described activity and outcome measures by hourly range. We compared EMCC performance during periods one and two using an interrupted time series analysis.

RESULTS

We analyzed 45,451 incoming calls during the two study periods: 21,435 during period 1 and 24,016 during period 2. Between the two study periods, we observed a significant increase in the number of incoming calls per hour, the number of connected call takers and average call duration. A linear regression model, adjusted for these confounding variables, showed a significant increase in the QS20 slope (from - 0.4 to 1.4%, p = 0.01), highlighting the significant impact of two-level filtering on the quality of service.

CONCLUSIONS

We found that rapid access to our EMCC was maintained during the COVID-19 pandemic via two-level filtering. This system helped reduce the time gap between call placement and first-line call-taker evaluation of a potentially life-threatening situation. We suggest implementing this system when an EMCC faces significantly increased activity with limited staff resources.

Authors+Show Affiliations

Samu 44, Department of Emergency Medicine, University Hospital of Nantes, Nantes, France. yann.penverne@chu-nantes.fr.Department of Medical Evaluation and Epidemiology, Nantes University Hospital, Nantes, France. MiHAR lab, University of Nantes, Nantes, France.Samu 44, Department of Emergency Medicine, University Hospital of Nantes, Nantes, France.Samu 44, Department of Emergency Medicine, University Hospital of Nantes, Nantes, France.Samu 44, Department of Emergency Medicine, University Hospital of Nantes, Nantes, France.Samu 44, Department of Emergency Medicine, University Hospital of Nantes, Nantes, France. MiHAR lab, University of Nantes, Nantes, France.Samu 44, Department of Emergency Medicine, University Hospital of Nantes, Nantes, France. MiHAR lab, University of Nantes, Nantes, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32799911

Citation

Penverne, Y, et al. "Impact of Two-level Filtering On Emergency Medical Communication Center Triage During the COVID-19 Pandemic: an Uncontrolled Before-after Study." Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 28, no. 1, 2020, p. 80.
Penverne Y, Leclere B, Labady J, et al. Impact of two-level filtering on emergency medical communication center triage during the COVID-19 pandemic: an uncontrolled before-after study. Scand J Trauma Resusc Emerg Med. 2020;28(1):80.
Penverne, Y., Leclere, B., Labady, J., Berthier, F., Jenvrin, J., Javaudin, F., & Montassier, E. (2020). Impact of two-level filtering on emergency medical communication center triage during the COVID-19 pandemic: an uncontrolled before-after study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 28(1), 80. https://doi.org/10.1186/s13049-020-00775-0
Penverne Y, et al. Impact of Two-level Filtering On Emergency Medical Communication Center Triage During the COVID-19 Pandemic: an Uncontrolled Before-after Study. Scand J Trauma Resusc Emerg Med. 2020 Aug 14;28(1):80. PubMed PMID: 32799911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of two-level filtering on emergency medical communication center triage during the COVID-19 pandemic: an uncontrolled before-after study. AU - Penverne,Y, AU - Leclere,B, AU - Labady,J, AU - Berthier,F, AU - Jenvrin,J, AU - Javaudin,F, AU - Montassier,E, Y1 - 2020/08/14/ PY - 2020/05/12/received PY - 2020/08/05/accepted PY - 2020/8/18/entrez PY - 2020/8/18/pubmed PY - 2020/8/25/medline KW - Accessibility KW - Emergency medical communication center KW - System KW - Triage SP - 80 EP - 80 JF - Scandinavian journal of trauma, resuscitation and emergency medicine JO - Scand J Trauma Resusc Emerg Med VL - 28 IS - 1 N2 - BACKGROUND: Rapid access to emergency medical communication centers (EMCCs) is pivotal to address potentially life-threatening conditions. Maintaining public access to EMCCs without delay is crucial in case of disease outbreak despite the significant increased activity and the difficulties to mobilize extra staff resources. The aim of our study was to assess the impact of two-level filtering on EMCC performance during the COVID-19 outbreak. METHODS: A before-after monocentric prospective study was conducted at the EMCC at the Nantes University Hospital. Using telephone activity data, we compared EMCC performance during 2 periods. In period one (February 27th to March 11th 2020), call takers managed calls as usual, gathering basic information from the caller and giving first aid instructions to a bystander on scene if needed. During period two (March 12th to March 25th 2020), calls were answered by a first-line call taker to identify potentially serious conditions that required immediate dispatch. When a serious condition was excluded, the call was immediately transferred to a second-line call taker who managed the call as usual so the first-line call taker could be rapidly available for other incoming calls. The primary outcome was the quality of service at 20 s (QS20), corresponding to the rate of calls answered within 20 s. We described activity and outcome measures by hourly range. We compared EMCC performance during periods one and two using an interrupted time series analysis. RESULTS: We analyzed 45,451 incoming calls during the two study periods: 21,435 during period 1 and 24,016 during period 2. Between the two study periods, we observed a significant increase in the number of incoming calls per hour, the number of connected call takers and average call duration. A linear regression model, adjusted for these confounding variables, showed a significant increase in the QS20 slope (from - 0.4 to 1.4%, p = 0.01), highlighting the significant impact of two-level filtering on the quality of service. CONCLUSIONS: We found that rapid access to our EMCC was maintained during the COVID-19 pandemic via two-level filtering. This system helped reduce the time gap between call placement and first-line call-taker evaluation of a potentially life-threatening situation. We suggest implementing this system when an EMCC faces significantly increased activity with limited staff resources. SN - 1757-7241 UR - https://www.unboundmedicine.com/medline/citation/32799911/Impact_of_two_level_filtering_on_emergency_medical_communication_center_triage_during_the_COVID_19_pandemic:_an_uncontrolled_before_after_study_ L2 - https://sjtrem.biomedcentral.com/articles/10.1186/s13049-020-00775-0 DB - PRIME DP - Unbound Medicine ER -