Art Braunschweiger

Art Braunschweiger


By Art Braunschweiger

As a whole, dispatchers are a pretty outspoken group of people. We have opinions on most things and aren’t hesitant to criticize what we don’t like. We also have some definitive ideas when there’s room for improvement. I have yet to meet a dispatcher who didn’t, at one time or another, have an idea on how something could be done better.

This is particularly true for the Medical Protocols. The problem is, we can’t change them, right? Well, if that’s what you thought, you’re mistaken. You and your staff can submit ideas for improvement and should do so. After all, who knows the protocols better?

The Academy is always looking to build a better mousetrap. That expression is uniquely American, and it is part of a quotation by Ralph Waldo Emerson that has turned into a metaphor about the power of innovation. The analogy, as I’ve used it here, is particularly appropriate since the protocols are designed to catch things we can’t see.

In its 143-year history, the United States Patent and Trademark Office has issued more than 4,400 patents for new and improved mousetraps. The Academy has made more than 4,000 changes to the Medical Protocols since their inception in 1979. It surprises many people to find out that the majority of changes come from protocol users: us, the dispatchers. Yet most of us have never heard of how to suggest one of those changes. It’s through a document called a Proposal For Change (PFC for short). It’s the means by which a specific idea for improving the protocols is formally submitted to the Academy. There are PFCs for curriculum changes and other areas; a PFC for protocol change is the focus of this article.

What types of changes are submitted through this process? You can submit anything you think will make the protocols more effective. It might be a different way to word a Key Question, a better way of scripting a Pre-Arrival Instruction, or even adding a new Dispatch Life Support pathway. Your proposal might be based on your experience with a particular aspect of the protocols over time, or you might have had an unusual call that you felt the protocols didn’t adequately handle.

The Academy requires that PFCs go through a formal review and sign off process within your agency, starting with your Dispatch Review Committee and proceeding to your Dispatch Steering Committee. (If you’re not sure who or what these are in your agency, find out.) Then they’re submitted by a designated contact person within your agency (frequently the head of your Quality Improvement Unit). You’ll need to include some supporting documentation, but you don’t need reams of case studies; in many cases, a simple explanation of what you’re proposing and why you feel it will be beneficial is all that’s needed.

The process by which a PFC turns into a protocol change is a multi-step process of review and evaluation within the Academy, followed by beta testing. And it doesn’t happen overnight. Throughout the process, your agency will receive periodic updates. (This is new; in the past an agency typically would not receive any further communication once a PFC had been submitted.)

So start taking ownership of the protocols. The next time you have an idea for making them better, the Academy wants to hear it. Get together as a group. Talk to a member of your Quality Improvement Unit about writing a Proposal For Change and how to submit it within your agency. We can always build a better mousetrap. Who knows, the next one might have your name on it.

The PFC form is available at