Audrey Fraizer

Audrey Fraizer

Best Practices

By Audrey Fraizer

Don’t expect smooth sailing when implementing state-level protocol and training standards but if you listen to someone who has “been there, done that,” the trip can be a lot less bumpy.

Stephan Bunker is a primary force in “how it’s done” and readily admits that failure was nothing he expected the first go-around with Maine’s legislators.

But that’s just what happened.

“It took me two times in the fishbowl with them,” said Bunker, at that time director of Maine’s Emergency Services Communications Bureau (ESCB). “The first time I failed miserably. The second time I came prepared.”

“Failed miserably” is an overexaggeration. Bunker was prepared, having studied the legislative process and arranged his talking points in order when he approached the legislative committee responsible for public services in February 2002. He described the purpose of standardized protocol, the importance of training and certification, and the gaps existing in Maine’s 9-1-1 system. He explained how the lack of standards affected the quality of response and, in some cases, led to litigation.

“A majority of Maine’s PSAPs were providing emergency medical dispatch, but the point was getting every PSAP to provide the same, consistent response,” he said. “I also wanted more attention paid to quality assurance across the state.”

Bunker’s presentation might have been well received, but it did not make the impression he intended.

“I hadn’t rallied the troops,” he said. “I didn’t have stakeholders lined up to come in to testify on my behalf. I came across as another speaking head from the state wanting more money and more authority.”

Getting his ducks in a row

Bunker did not make the same mistake in 2003. He amended his strategy to emphasize standard of care. He talked about the impact on community and how standards were the right thing to do. He built consensus, enlisting the aide of public service employees prior to meeting with legislators. He brought in heavy hitters like the American Heart Association as an ally.

“Their emphasis on caller safety and increased survival due to Pre-Arrival and Post-Dispatch Instructions sent a strong message,” he said. “Their credibility with the legislators was very influential as a true stakeholder organization.”

At the public service committee meeting, each individual—and there were 15—gave testimony different from the last person.

“It’s unmercifully painful to watch 15 people come up and say the same thing,” he said. “Figure out your presentation and arrange testimony in an order that supports your argument.”

He suggested a funding strategy and calculated an appropriate estimated expense since “unfunded mandates tend to be the kiss of death for public policy approach.”

The second time around won the committee’s serious consideration, with one caveat. His proposal to increase the state surcharge would not fly since the ESCB was already asking for a 20-cent subscriber increase over the next 18 months to cover the cost of Next Generation 9-1-1 technology.

“Timing is everything,” he said. “The committee suggested waiting until the downside slide of the surcharge increase and asking the ESCB to take 15 cents instead of the entire 20 cents. The extra pennies would be saved for our request.”

The legislation, enacted in 2005, mandates, with funding support, the statewide implementation and ongoing evaluation of Emergency Medical Dispatch™ commencing on Jan. 1, 2007. Although the ESCB remains a critical partner, the Maine Emergency Medical Services bureau coordinates oversight.

The state’s approximately 700 public safety telecommunicators in 26 PSAPs are certified EMDs and in August 2010, the Maine Board of Emergency Medical Services approved the use of Priority Dispatch® as an option for Maine’s licensed EMS services, in accordance with board-approved standards.

The bureau also mandates the NAED’s Emergency Telecommunicator Course (ETC) for all newly hired full-time dispatchers, the Emergency Medical Dispatch Quality Assurance (ED-Q) program for those responsible for a center’s QA, and ProQA and AQUA training. An online training schedule lists additional coursework in MapStar, crisis communications, and supervisor/manager/lead dispatcher training. Bunker doesn’t plan to stop there and, although he claims to be retired, he has plenty to keep him busy after 40 years in Maine’s public services.

Bunker is chair of the Board of Selectmen for the Town of Farmington, firefighter with the Farmington Fire Department, and president of the Maine Municipal Association Executive Committee.

A report currently in front of Maine 9-1-1 describing added QA standards and implementation of police and fire protocols would, he said, add momentum to his goals for the coming legislative session. This time he plans to bring in people to tell their personal stories in support of standardized police and fire protocols, training, and certification. He won’t be the “talking head” and he will persist.

“If at first you don’t succeed, try, try again,” he said. “Change comes hard. Don’t be disillusioned. You can be the catalyst for this if you get the right people and the right foundations behind you.”

Tips from the pro:

Devise a plan

Create a model through ideas available from other sources, such as the NAED

• Make an argument for implementation

Callers have certain expectations and if you’re not meeting the expected standard of care, what does the public think of you? And, who wants to be known as the person who could have made a difference, but chose not to?

• Seek communications center support

Don’t take for granted your philosophy is understood; spend time talking to dispatchers, managers, and supervisors to help them understand what state policy could mean for them

• Put together a stakeholders group

• Review existing policies and procedures

Know what’s in place since the lack of documentation or ignorance of existing practices is a recipe for disaster

• Learn about state policymaking and get to know legislators, office staff, and committee powerbrokers

• Develop a funding plan

• Don’t give up

“If you fail the first time, that’s not reason to stop,” Bunker said. “Regroup. There are a lot of resources out there. You don’t have to struggle alone.”