Education Over Deviation

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

For an ED-Q in training, there is a strong focus on how to determine deviations before you’re let loose into the wild. These deviations are important aspects of protocol compliance, especially concerning an Emergency Dispatcher’s critical impact on caller and responder safety. However, inexperienced ED-Qs who are eager to have their own impact can easily fall into a pattern of providing unnecessarily punitive feedback. 

If your focus is to “make your mark” by excessively marking up your case reviews, you may neglect the overarching goal of achieving quality improvement. Instead of encouraging Emergency Dispatchers’ growth, harsh feedback breeds shame, which leads to burnout— not motivation. With each heavy-handed evaluation, you can create an environment of crippling anxiety instead of empowerment. 

Usually, as you gain experience as an ED-Q, you start to make better decisions, trusting Emergency Dispatchers to make their own good decisions. That’s the sweet spot where case review becomes effective. 

Weighing decisions 

When you evaluate an Emergency Dispatcher’s decision, the litmus test is to ask whether that decision favored patient care or responder safety. Ultimately, the Emergency Dispatcher must forge ahead based on the information they’re given and the protocol in their hands. 

Using that tool effectively shouldn’t feel like a barrier to doing their job. Unfortunately, QA/QI can be feared as a foundation for writing performance improvement plans, documenting a struggling Emergency Dispatcher’s first steps out the door. But the last thing our profession needs is more empty seats. 

As an ED-Q completing evaluations, consider your mindset. Are you aiming to provide criticism or credit? Though you may be surrounded by recordings and screens, you cannot forget you’re dealing with human beings on both ends of the call—often in high stress. 

Reviewing calls with regularity can cause common complacency. You may forget the weight of serving as a lifeline for a caller who may not have ever called 911 before. It’s easier to listen to a call with every playback tool at your disposal rather than act as the Emergency Dispatcher, having one second to choose a path and a lifetime to live with it. 

You have the opportunity to be an evaluator of calls or a mentor of people. Which do you think is more effective in creating change? When an Emergency Dispatcher’s fear of judgment is replaced with guided support, they begin to trust themselves with freedom to “fail forward.” 

If you can encourage your team to own and learn from mistakes—instead of ruminating on them—you carve out a healthier, more effective path for growth. The Emergency Dispatcher can then develop an inner voice of confidence that you, as an ED-Q, can help build. 

One protocol element that is wildly underutilized is the ability to override. It’s an option. It’s intentionally there for those moments when the Emergency Dispatcher’s “spidey senses” are tingling and something doesn’t feel right. If it seems the situation may be more critical than what has been assigned, the override button is there to help, but it’s dusty because Emergency Dispatchers don’t trust themselves—even when their internal alarms are blaring. With fear of reprimand, they turn off their own minds and defer to what is dictated. 

This is where you may need to do some evaluation of your role as an ED-Q. Are you effectively training, educating, and believing in your Emergency Dispatchers? Do you see yourself as a key to their success—their mentor, cheering squad, and champion support? Or are you the deviation detective, tearing down their confidence in their career and the service they provide? 

Investing in impact 

If your own improvement is needed, it’s time to lead the charge with positivity. This does not mean turning a blind eye to critical case review components, but it should intentionally include “catching them doing it right,” as Dr. Clawson says. 

Try encouraging your team by recognizing exemplary performance along with their areas for improvement. If you hear empathy in an Emergency Dispatcher’s voice as they calm a distraught caller, give them a pat on a back for their human connection. If they helped deliver a baby over the phone, don’t ding them for forgetting the word “Okay.” Emergency Dispatchers need to hear that they’re rockstars for showing up, facing the mental toll, meeting endless queues, and doing their best every day to help others. 

Your recognition doesn’t always have to be formal. You can simply meet them on the dispatch floor with a fist bump to let them know they crushed it. Notice the difference when your steps around the comm. center carry an ongoing boost of morale. The big picture comes together when praise and education go hand in hand. 

Your new best friend is that green employee who started this job when all they knew about 911 was the number. Invest in their success, be present through the struggles, and watch their growth through three months, six months, and even a year as that light bulb grows brighter. Like a proud parent, help grow their confidence until you see a professional you’d be relieved to have answer your own emergency call. 

Fine-tuning 

Perhaps one of the hardest parts of the ED-Q’s role is walking the line between subjective judgments and clearly defined guidelines. It can feel frustrating when the ED-Q Performance Standards give guard rails instead of defined paths, but this leeway is by design, with freedom to pick a lane and continue forward. 

We trust ED-Qs to not only know the ins and outs of protocol but to understand the underlying objectives. Deviations are measured in the categories of CRITICAL, MAJOR, MODERATE, and MINOR intentionally to indicate their potential impact on the service rendered. 

If an Emergency Dispatcher’s error could clearly impact the safety of the caller or responders by deviating from the protocol or using it incorrectly, your role is important in correcting that action for future cases. But if the action is unclear or does not meet any of the specified deviations, it’s fair to keep up the momentum and freedom to make good decisions as needed.

No protocol Rule, Axiom, manual, or standard could conceivably direct every decision the Emergency Dispatcher is tasked to make. But in the ED-Q world, we remind ourselves that moving forward with the information we have is reasonable. Whether reviewing an Emergency Dispatcher’s decisions or your own, remember, if it looks like a duck and acts like a duck, it’s probably not a chicken. If you get hung up on trying to legislate logic or common sense, you get off the road completely. 

Conclusion 

ED-Qs can have a huge impact not only in ensuring compliance but in empowering Emergency Dispatchers to trust themselves while improving their performance. As you weigh decisions, consider impact, and fine-tune your own evaluations, you can become a trusted guide to striving for excellence—one case review at a time.