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Great Expectations

Art Braunschweiger

Art Braunschweiger

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Art Braunschweiger

Most of my co-workers would be very surprised to learn that I have several tattoos, including a fairly large one. (No, it’s not the Priority Dispatch® logo.) Tattoos are common nowadays, but most people who know me wouldn’t expect me to have one. One of my co-workers even said once, “That would be a bit extreme for you.”

Our expectations channel our actions. If we don’t expect to find something, we rarely go looking for it or put much energy into the search. That’s a problem in 911, where we have to rely entirely on information from remote sources. It’s especially problematic with third-party callers, who make up a significant percentage of our call base. Many of these callers are quick to tell us that there’s no point asking questions because “I’m not there, I don’t know anything.” Some calltakers accept this all too readily, assuming that if a caller isn’t at the scene with the patient, he can’t provide any information.

Our use of the Medical Priority Dispatch System (MPDS®) Protocol is governed by Performance Standards established by the International Academies of Emergency Dispatch®. One of those standards says, in part, “Anytime a caller is not in direct contact with those needing assistance, the calltaker will continue interrogating the caller according to protocol.”[i] This standard is in place for a good reason: Callers usually know more than they think! The person who drove by the motor vehicle accident and isn’t there anymore might have slowed down as he passed and took a good look at the scene. I’ve had callers like that insist they don’t know anything and then proceed to give me definitive answers to four of the five Key Questions when asked. Or consider the person calling about a relative in another town. That caller might have talked to the patient and can tell you whether he’s alert, breathing normally, and what medical history is involved. You won’t know unless you ask!

There’s no question that third-party callers require special handling because of the resistance they frequently project to questioning. That’s reflected in the performance standard above, which allows us to preface our questions with a statement such as “It’s very important that I get as much information as I can for the responders. I’m going to ask you some questions; I know you’re not there, but do the best you can.” On my calls, if the caller says “I don’t know,” I go one step further by saying, “That’s okay, you’re doing fine, I appreciate the help.” These enhancements go a very long way toward minimizing callers’ frustrations and gaining their cooperation. On occasion I’ll get pushback from the caller anyway. I respond by saying “I understand, but you might know one piece of information that will help us out. This will only take a minute.” As with all difficult callers, I view them as a challenge, not an aggravation.

We need to remember that third-party callers have their own expectations. Often they expect to tell us nothing more than an ambulance is needed and what address it needs to go to. They’re ready to hang up and move on since they have nothing further to tell us.

When we keep them on the phone and start asking questions, our needs conflict with their expectations. It’s easy to label them as uncooperative and, over time, expect all such callers to be that way—but that’s doesn’t help us do our job. Don’t just ask questions because you have to. Broaden your expectations instead and develop some good third-party management skills. We’re all about information processing, and the more we get, the better we—and our responders—can do our job.

1 Performance Standards, 10th Edition (Interrogation of Third-Party Callers)