IS YOUR EMERGENCY SYSTEM IN CRISIS?

IS YOUR EMERGENCY SYSTEM IN CRISIS?

BY FRANCIS X. HOLT

By now, the scenario has become frighteningly repetitious: A solemn newscaster is expressing righteous anger and confusion over a “bungled 911 call.” The tape is playing while a graphic transcript is showing on the screen over a graphic of slowly winding tape reels. In case after case, a dispatcher is portrayed as cold, unfeeling, incompetent, and generally not up to the task. The next day, headlines continue the story: “Ambulance Delay Linked to Errors in Dispatching,” “Handling of Emergency Calls Criticized.” Often, the story comes back in the headlines years later: “$3 Million Awarded in Ambulance Dispatch Suit.”

I have spoken with emergency communications managers throughout the United States and Canada, and all have said they consider themselves lucky that their operations have not been the subjects of similar headlines. For those whose operations have experienced such an unfortunate event, it no doubt is the worst thing they ever experienced professionally. How does it happen that systems in which hundreds of thousands (and sometimes millions) of dollars have been invested come apart? Can it be that so many municipalities have done a poor job of hiring emergency communications personnel? What can be done to decrease the likelihood that your department will ever have to live through such a traumatic event?

HOW DO EXPENSIVE SYSTEMS COME APART?

Clearly, the emergency communications system component that catastrophically fails most frequently is not the hardware, the software, or the lines or relays. It is the human operator. In many systems, the human operator is the least costly critical component of the system because the pay for emergency communications personnel–telecommunicators, call takers, radio dispatchers–often is not commensurate with the demands made on the individual. At this point, many managers may say, “They knew the pay when they took the job, so I have no sympathy for the argument that lower than desirable pay leads to dispatcher error.” While the first portion of that statement may be true, it is hard to ignore the practical consequences of paying dispatchers poorly.

These dispatchers usually find that the only way they can raise a family with minimum comfort is to work overtime and/or work another job–leaving them with less family time, more fatigue, and increased frustration associated with their jobs. Many emergency communications managers will admit off the record that they can “get away with” lower salaries for their personnel because so many of them are female and that many of the male decision makers in their jurisdictions have an antiquated view of the implications of this policy. Many, for example, see the female dispatchers as holding the “second job” in the family, notwithstanding the evidence to the contrary (think a moment about how many single mothers you know working in the field) and the illogicality of the premise that any “second job” should pay less simply because it is a second job. (Imagine a 911 call taker saying, “I`ll get you help as soon as I can, but not too fast, since my husband is also employed.” Sound silly? So does the idea of paying a woman less than the work is worth because she has the option of marrying a working man.)

The origins of these attitudes are traceable. For years, dispatch centers in many localities have been thought of as the “Elephants` Burial Ground” for “defective” field personnel. Do you have a police officer with a drinking problem? Send him to dispatch. A firefighter whose arthritis keeps him from climbing the ladder? Have him answer phones. The star of NYPD Blue, David Caruso, gets written out of the hit series not in a hail of bullets but under threat of transfer to communications. He gives up his beloved job, pension, and benefits rather than go to that land of “disrespected misfits,” home of “The Rubber Gun Squad” (a demeaning term describing light-duty officers whose superiors do not trust them to carry weapons)–dispatch.

Even so, after a recent incident in Philadelphia, Pennsylvania, where a call taker`s actions were questioned, a city councilwoman wanted to know why pensioned officers instead of civilian personnel could not be used for these jobs. A few things can be said about this idea:

If dispatchers are paid an amount equal to their salary plus a police officer`s or firefighter`s pension, you are likely to attract a larger pool of applicants for the job (thus increasing the likelihood of acquiring more qualified personnel) and to hold on to your hires longer (increasing average years of experience on the job–and thus proficiency).

Just as a good ballplayer does not necessarily make a good coach or referee, a good firefighter, EMT, or police officer does not necessarily make a good dispatcher.

In any case, it is clearly time to reexamine the rationale for emergency communicator pay scales and for decision makers to begin investing as much in the human component of their systems as they do in the hardware. Also, it is well past time to acknowledge the complexity and demands of call-taker and dispatcher jobs. This leads us to the next question.

CAN IT BE THAT SO MANY MUNICIPALITIES HAVE DONE A POOR JOB OF HIRING EMERGENCY COMMUNICATIONS PERSONNEL?

A key factor often overlooked in the public agonizing in the aftermath of a tragic dispatch error is training. It certainly is possible, for example, that a good firefighter, EMT, or police officer could make a good dispatcher; but, obviously, the individual would have to undergo a considerable amount of training. And, we`re talking here about people who already have been in the service.

When looking for answers to why emergency communications systems fail, it is enlightening to examine what happens to the personnel after they are hired. In most centers, it amounts to on-the-job training (OJT).

OJT leaves no lines of accountability. It offers no quality-assurance opportunities. It enhances the likelihood of institutionalizing poor work habits. (“This is the way we`ve always done it.”) It leaves to chance whether a fresh and enthusiastic new hire will be allowed to grow professionally or will become contaminated by cynicism.

Do not confuse OJT with acquiring supervised experience. The concept of OJT is defined in different ways in different places. There are scholarly explanations and defenses for doing things on the cheap that rely heavily on the high-minded concept of OJT. However, in most dispatch centers I have visited, OJT usually implies “no formal training.”

A formal documented orientation program and certification in emergency dispatching should be considered a minimum competency for emergency communications personnel; they should be accomplished within six months of hire. The concept of changing standards of care is widely accepted in the fire rescue service. Perhaps, the idea of a changing minimum standard for call takers and dispatchers should be explored as well.

In addition, training should not stop after orientation and certification. I entered the emergency communications field more than 25 years ago, and I have been writing, consulting, and lecturing about various aspects of this field for the past 14 years. No one has ever asked me, “Where do you get the ideas that enable you to keep writing about the same field all these years?” The answer is obvious: Talk to dispatchers, firefighters, and police officers. Read the paper. Watch CNN. Listen to your scanner. The field is dynamic, not static. The degree of attention paid to continuing professional training should reflect this reality. The idea of maintaining dispatcher certification through a minimum number of training hours is hardly far-fetched.

If you are thinking in terms of how much it will cost to do this, start thinking about how much it might cost not to do it. Having had the experience of serving as an expert dispatching witness and of having been deposed for hours and hours by a plaintiff`s attorney, reviewing hours of videotaped testimony, listening to hours of dispatch center tapes, and reviewing thousands of pages of transcripts, I can tell you that lack of training in today`s emergency communications center is very costly. I don`t come cheap; but by the time we get to depositions, I`m the least expensive person in that room.

WHAT STEPS CAN BE TAKEN TO DECREASE THE LIKELIHOOD THAT YOUR DEPARTMENT WILL EXPERIENCE A DISPATCH DISASTER?

In addition to the obvious action of instituting the training standards outlined above, several other steps can be taken:

Dispatch center managers must listen to their personnel. This means keeping an ear out for what`s going on in and around the operations room as well as periodically reviewing tapes. If you pick up on increasing anger, impatience with callers, frustration, increased error rates (yes, that means you are measuring such things), cynicism, sarcasm, or racism, it`s time to speak with the person involved. If you don`t have a mechanism by which coworkers can report their concerns about colleagues` performances, establish at least an informal channel for that purpose. If you see an increase in sick time or lateness or if physical presentations suggest alcohol or other drug abuse, it`s time to speak with that dispatcher.

Provide support systems. For dispatchers experiencing difficulty in coping with the stresses of life, an employee assistance program can be very effective. If an adjustment in attitude or sensitivity training is warranted, several good courses and training programs are available. Responding to these situations in a remedial instead of vindictive fashion is best for the individual (affords the opportunity to stay on as a productive and experienced team member) and the department (provides documentation that the individual was given every opportunity to improve performance–an important consideration should the question of termination arise).

Be open to the possibility that a primary reason for poor job performance may be poor management of the organization. Centers that routinely rely on overtime to fill dispatching schedule spots instead of hiring additional personnel, for example, may be contributing to burnout.

Systematically monitor operations. Postincident communications critiques, for example, afford dispatchers and field personnel the opportunity to assess their performance. Another method for assessing day-to-day operations is to establish fixed monitors of critical dimensions of the dispatching function–keeping track of the number of foreign language calls handled each week or tracking verbal address errors by each shift, for example. The results of such monitoring can be used to demonstrate productivity as well as identify operational weaknesses.

Establish a regular means of providing positive and negative feedback to line personnel. One vehicle for doing this is a monthly in-house newsletter (especially easy to do with today`s desktop publishing options), noting particular problems and successes of your dispatch center and other centers of which you may be aware.

Develop a public relations policy wherein the press is regularly provided with reports of your dispatchers` good performance. In addition to getting this information to the public, this program conveys to the line troops that the organization values and takes pride in the quality of their performance.

All these things may seem to be common sense, but common sense often isn`t common practice. What we see becoming more common is that dispatcher and call taker errors no longer are being swept under the rug. Perhaps this change is due to the increasing notoriety afforded emergency communications personnel through television shows such as Rescue 911. What also is becoming more common is litigation involving dispatcher performance. Perhaps it is time for systematic dispatcher improvement and appreciation programs to become more common as well. n

FRANCIS X. HOLT, R.N., served as a dispatcher with the City of New York (NY) Fire Department for almost 10 years. For half that time, he was president of the union that represented fire alarm dispatchers and supervisors. He holds bachelor`s degrees in social studies and nursing and a master`s degree in counseling and is the author of Emergency Communications Management, published by Fire Engineering Books. He currently is traveling throughout the United States and Canada for the PowerPhone dispatcher training company, conducting seminars in emergency medical dispatching, fire service dispatching, and stress identification and management.

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