Scripted protocols have become a mainstay of public-safety dispatching. Produced by a number of vendors, scripted protocols enumerate questions to be asked of and advice to be given to emergency callers. As such, variants exist for all services. Emergency fire dispatch (EFD), emergency medical dispatch (EMD) and emergency police dispatch (EPD) routines are utilized in thousands of facilities nationwide in both computerized and manual flip-card form. As with any policy or procedure, there are supporters and detractors. This debate rose to the forefront last year when one major city announced that it would discontinue the use of scripted protocols.
In August 2019, the city of Minneapolis made public its decision to abandon programs that were developed by is its chosen vendor. This came after employee complaints and concerns over processing time. Regarding the anticipated benefits of this change for callers, Minneapolis’ emergency communications director, Kathy Hughes, said that callers to 9-1-1 are “not only going to get a better response time, they’ll get a better response from the dispatcher.” Still, the city didn’t rule out adopting other technology. According to Minneapolis’ city coordinator, Nuria Rivera-Vandermyde, “With new software coming on the market every day, it could be that we find a different solution in the future.”
The decision to drop scripted protocols was applauded by some as enabling dispatchers to think for themselves, but this support was far from universal. Although not questioning the need for telecommunicators to utilize skill and common sense in managing calls, some were quick to point out the benefits of standardization. Lake County, MN, for one, successfully uses the same product that was abandoned by Minneapolis. Unlike Minneapolis, where employee dissatisfaction seemed to have an influence on the decision to stop asking scripted questions, Lake County call-takers, such as Brian Dempsey, see the good in what they’re doing. Although expressing some reservations about the police component, he stated in an article in the Minneapolis Post-Tribune that, currently, “everyone is on the same page” and “the positives far outweigh the negatives.”
How many questions?
Even though time is of the essence, firefighters should expect to routinely receive basic information as part of dispatch. In addition to the location and type of call, there are pieces of data that are critical to response and safety. The presence of victims, hazardous materials, type of cargo involved, exposures and patient vital signs all are included here. These and other factors have a bearing on our actions. Every question that’s asked by a telecommunicator prolongs caller contact time and potentially delays dispatch, but some questions need to be asked. Ensuring that they are is the crux of the discussion.
Regardless of whether scripted protocols or in-house guidelines are used, it’s clear that certain facts must be gathered. Although this might be accomplished by vigorous training alone, the current turnover in telecommunicator ranks begs for the most reliable method of ensuring compliance. That method is to provide the call-takers with a list of pertinent questions as a reference to assure standardization across the organization.
As a former director of emergency communications, I supported the use of these protocols, but my support didn’t inhibit me from discussing with my local medical directors or fire chiefs questions that I felt were superfluous. Nor did my support keep us from cooperatively developing routines that allowed for the dispatch of critical emergencies when sufficient information was gathered and for the completion of triage once help was on the way. Conditions also were agreed upon—such as major disasters or weather emergencies—where interrogation could be bypassed to process the outstanding number of pending events more expeditiously.
Agencies that require their call-takers to systematically ask every question in order, even if the reporting party already provided the information, need to re-evaluate this practice. It certainly doesn’t speed up processing, and it can irritate the caller who now believes that 9-1-1 isn’t listening. Overall, I find protocols to be beneficial when properly used, properly trained and properly administered. With some states now requiring pre-arrival CPR instructions, at least a portion of public contact there will be scripted, even if a full-fledged EMD program isn’t in place.
The clock’s ticking
Perhaps the most frequent criticism that’s heard concerning protocols is that they take too much time. This is voiced by both citizens who fail to understand that, in many cases, help already is underway during their call and by firefighters who believe that the protocols delay dispatch. NFPA 1221: Standard for the Installation, Maintenance, and Use of Emergency Services Communications Systems calls for the processing of 90 percent of calls within a minute but identifies several conditions that can extend this window. However, the majority of high-priority events fall within that specified 60-second target.
This brings us to the issue of true response time, which begins when the citizen sees the problem and ends when the first unit arrives on scene. Many departments instituted limited response policies for certain classes of calls (such as fire units that respond only to life-threatening medical emergencies). These rules can’t be enforced unless the dispatcher knows the exact nature of the complaint, which requires a degree of caller interrogation. Secondarily, it has become accepted practice to stop at red lights during runs, with some agencies situationally restricting lights and sirens altogether. These delays all are made in the name of safety. Is there not a similar degree of safety that’s derived from having an accurate description of what you’re rolling to and where? Even slight nuances can change the appropriate response level, and, again, this can’t be determined without some questions being asked.
The second criticism stems from the so-called dumbing down of dispatchers. If this absence of independent thinking occurs at all, it occurs when training and quality assurance are lacking. Scripted protocols must be taught as part of a complete system, with telecommunicators having a firm grasp of how their actions mesh with the needs of first responders. With the continued turnover in the dispatcher ranks, it’s imperative that strong guidance be provided to assure that less-seasoned employees consistently obtain critical information. (According to the Association of Public-Safety Communications Officials, 19 percent of dispatch personnel leave the profession every year.)
EFD/EMD can help. Starting with the prepackaged vendor list of questions, local fire departments and EMS providers should be involved in the customization of the decision tree. This engagement transfers field knowledge into the scripts and continues as part of an ongoing review of the effectiveness of the protocols. The questions and advisements remain dynamic, with adjustments made based on local experience and lessons learned in other communities. For example, several years ago, instructions for handling sinking vehicles were upgraded nationwide as a result of incidents that ended in tragedy.
Dispatch, like every other aspect of the fire service, requires a combination of training and tools to get the job done. Scripted protocols are designed to augment—not replace—the human factor and are best placed only in the hands of those who are educated on their proper maintenance and use.
Barry Furey
BARRY FUREY, who is a Firehouse Contributing Editor, provides consulting and training services in emergency communications. He is the former director of the Raleigh-Wake Emergency Communications Center in North Carolina. During his 50-year public safety career, he has managed 9-1-1 centers and served as a volunteer fire officer in three other states. In 2005, Furey received a life membership in the Association of Public-Safety Communications Officials (APCO) International for his continued work in emergency communications. Furey was inducted into the Firehouse Hall of Fame in 2017.
