Applying Reasonableness

*To take the corresponding CDE quiz, visit the College of Emergency Dispatch.*

In the field of emergency dispatch, the Priority Dispatch System^™ offers a robust standard-setting framework designed to ensure the quality, safety, and effectiveness of interventions. Each discipline within the Priority Dispatch System is supported by performance standards that guide Emergency Dispatchers in delivering consistent, evidence-based responses. These standards are essential for maintaining operational integrity and public trust.

However, the strict and sometimes inflexible application of these standards raises important questions—particularly around the concept of reasonableness. How can we reconcile the need for compliance with the realities of clinical practice, environmental context, operational constraints, and the human nuances of each situation? This tension invites us to explore the principle of “education over deviation,” which promotes an educational rather than punitive approach to performance evaluation.

Understanding reasonableness in performance evaluation 
Reasonableness refers to the ability to interpret and apply standards with discernment, taking into account the clinical, environmental, operational, and human context of each emergency call. While Priority Dispatch System protocols are built on a rigorous framework—defined sequences of Key Questions, Determinant Codes, and DLS Instructions—their ultimate goal is the safety and effectiveness of emergency interventions.

An overly rigid application of standards can have unintended consequences. It may lead to a loss of confidence in the system, foster resentment toward quality assurance processes, and discourage Emergency Dispatchers from engaging in reflective practice. Reasonableness, therefore, becomes a critical lens through which standards can be applied without compromising service quality or professional morale.

It is essential to remember the purpose of quality reviews: They are not for identifying deviations for the sake of correction, but rather to support and empower Emergency Dispatchers in their professional development. Performance standards must be understood in an integrated and contextual manner. For example, Universal Standard 1 requires that questions or instructions be delivered as written. However, subsequent standards acknowledge that acceptable variations may exist depending on the context of the call.

Context is a vital element in emergency call management. It must be reflected in the reviewer’s assessment. Flexibility in applying standards is essential, as each situation is unique and the caller’s expression will influence the Emergency Dispatcher’s decision-making path. Reviewers must strive to see the call through the eyes and ears of the Emergency Dispatcher, recognizing the complexity and immediacy of their role.

Three guiding questions for reviewers 
Before identifying a deviation, reviewers should ask themselves three critical questions: 
1. Is it clearly an error? 
2. Does it improve the management of the call or the scene? 
3. Does it enhance the workflow of the protocol?

An Emergency Dispatcher may take a different approach than the reviewer or deviate from what is considered best practice. However, if the action does not constitute a clear error and contributes positively to the call’s outcome, it should not be classified as a deviation.

Reasonableness is especially important when evaluating exceptional cases. It reflects a commitment to meeting patient needs, clarifying complex situations, and equipping Emergency Dispatchers with refined tools. It fosters a compassionate environment where mistakes are seen not as failures but as opportunities for growth and learning.

Emergency Dispatchers operate under intense pressure, making split-second decisions with limited information. In contrast, reviewers work in calm, controlled environments with access to recordings, the ability to pause and rewind, and the opportunity to consult colleagues or reference materials. In this context, the application of reasonableness becomes not only fair but necessary. Therefore, it is legitimate to ask how we can expect Emergency Dispatchers to meet the same level of precision when they do not have the same resources or time.

Reasonableness acknowledges the limitations of the operational context and evaluates decisions based on the actual conditions under which they were made. It does not excuse errors but promotes fair and empathetic judgment, recognizing the urgency and complexity inherent in the Emergency Dispatcher’s role.

The principle of education over deviation 
The principle of education over deviation advocates for an educational approach to performance evaluation. Although not explicitly stated in quality assurance training materials, it is deeply embedded in quality management, quality improvement, and continuing education practices. It suggests that deviations should first be understood and addressed through education rather than punishment.

Instead of penalizing deviations, this philosophy emphasizes explanation, training, and skill development. It recognizes that deviations may occur in complex situations and do not necessarily indicate negligence or incompetence. The goal is to improve service quality while supporting Emergency Dispatchers—prioritizing learning over punishment and understanding over blind compliance.

Standards should be viewed not as constraints but as benchmarks that guide action. Emergency Dispatchers are encouraged to understand the rationale behind each question or instruction, contribute to its refinement, and engage in ongoing training. This approach fosters a culture of continuous improvement and professional engagement.

New employees, in particular, benefit greatly from this philosophy. Avoid overwhelming them by pointing out every minor deviation, as it may leave them feeling defeated and unsupported. Allowing small deviations during their learning phase fosters a supportive environment that encourages exploration and growth. This flexibility builds trust, enhances engagement, and promotes autonomy.

While overall quality must be maintained through documentation and monitoring of these deviations, attention should be focused on the more pressing issues. Minor imperfections—those “rough edges”—can be shaped gradually as the employee evolves and gains confidence in their role.

Education is not limited to onboarding. It is part of a continuous improvement process. The principle also applies to experienced staff when new versions, rules, or procedures are introduced. Flexibility is essential to align standards with practice, reinforce knowledge, and develop sound judgment.

Creating a culture of learning and trust 
The application of education over deviation contributes to a culture of learning and trust. Emergency Dispatchers feel supported rather than scrutinized, which enhances their sense of belonging and commitment. They are more likely to engage in reflective practice, seek feedback, and participate in professional development initiatives.

This approach also strengthens the relationship between Emergency Dispatchers and reviewers. It transforms the review process from a corrective exercise into a collaborative dialogue. ED-Qs become mentors rather than only case reviewers, and Emergency Dispatchers become active participants in their own growth.

Moreover, this philosophy aligns with broader organizational goals. It supports workforce retention and promotes a resilient and adaptive emergency dispatch system. It reflects a humanistic vision of emergency services, where each protocol is a tool for care and each deviation is an opportunity for progress.

Conclusion
Reasonableness and the principle of education over deviation are not concessions to the standards—they are its most mature expression. By recognizing that quality must be cultivated rather than imposed, the Priority Dispatch System embraces continuous improvement, interprofessional dialogue, and Emergency Dispatcher empowerment. 

This approach harmonizes safety, operational efficiency, and professional development. It reflects a compassionate and pragmatic understanding of emergency services, where standards serve as guides, not constraints, and where every Emergency Dispatcher is seen as a learner, a professional, and a vital contributor to public safety as a first, first responder.