Audrey Fraizer

Audrey Fraizer

ACE Achievers

By Audrey Fraizer

Laura Jewell is more comfortable in her role behind the scenes than a role that recently found her in front of the lens of a camera.

“The camera was much more nerve-wracking,” she said. “I felt awkward. I prefer staying in the background.”

Jewell, EMD, East Texas Medical Center – Emergency Medical Services (ETMC EMS) communications center, made her film debut in a five-minute broadcast on local CBS channel 19 during the April 24–May 1 sweeps week. The second of several Nielsen “sweeps” months planned in 2014 featured Jewell and fellow 9-1-1 EMD Laura Stanley in a behind-the-scenes look at the job of emergency dispatchers.

Sweeps week is a big deal. The rating process captures the viewing habits of “Nielsen families” across the country that, in turn, sets advertising rates and decides program scheduling. Most of the time, sweeps weeks tease viewers (and advertisers) with spectacular promotions to sweep in the numbers to support higher ad rates.

So, why did CBS 19 News Reporter Courtney Friedman choose a story about 9-1-1?

“I have been wanting to go behind-the-scenes at the call center for a while, and ETMC EMS was extremely helpful and willing to give me the time and resources to make it happen,” said Friedman, who covers a general assignment beat in East Texas. “This call center takes many of our local viewers' emergency calls, so it really does pertain directly to them.”

Friedman said the center reaches a “huge chunk of the state” and that’s probably an understatement.

ETMC EMS is one of the largest ambulance providers in Texas, covering 15 counties and more than 15,000 square miles from a central headquarters in Tyler and a smaller center that provides emergency response for the city of Pasadena, near Houston, Texas. The two communication centers—one at each location—have an annual combined call volume of more than 150,000 requests, resulting in nearly 130,000 transports.

Both centers are also Medical Accredited Centers of Excellence (ACE), which might be the reason Friedman was so taken by their operations. Although unaware of the international standing of the Medical Priority Dispatch System (MPDS) and accreditation through the IAED, the protocol’s significance figures predominantly in the sweeps reporting.

The ProQA medical screens were also center stage.

Friedman wasn’t led to a CAD and encouraged to highlight the MPDS, said Chad Richey, communications manager.

“She caught on quickly,” he said. “She realized it was the protocol that helped our EMDs work so well with our callers.”

Jewell and Stanley are shown asking Key Questions and giving Pre-Arrival Instructions (PAIs) from calls they took for a cardiac arrest and a child delivery, respectively. Although the scenes have been recreated for filming, the two calls are the actual audio recordings.

In the call involving a cardiac arrest, Jewell counts out loud over the phone to maintain the caller’s speed and rhythm during compressions. She is on the line for nearly 20 minutes. The patient survived. Stanley’s PAIs help a father safely deliver the baby, from the “baby’s head is showing,” to the infant’s entry cry into the world.

“You can hear the excitement in their voices,” Stanley said during the news interview.

But even when the calls don’t go the way she or Jewell would prefer, they agree that the process assures them of providing the best possible help for each situation.

That’s one of the reasons Jewell aspires to a dispatch position in training. She started her 9-1-1 career in 2009 and has been with ETMC EMS for the past two years. Her prior job precluded the use of the MPDS and Jewell was delighted when she began working at a center that uses the protocol.

“I was familiar with protocol and find it very thorough,” she said. “It makes more sense to learn the process than to be thrown in without any guidance. As a trainer, I can teach how important it is for everyone to do it right.”

Richey spent plenty of time personally brainstorming ideas to get the same message across during what turned out to be a double accreditation. Richey led the ACE drive at the center in Tyler—with accreditation achieved in April 2012. Quality Assurance (QA) Supervisor Michael Smith assisted, having arrived two months before the Tyler center ACE application was finalized and submitted. Smith carried the ACE project solo at the Pasadena comm. center—with accreditation achieved in May 2013.

The MPDS was introduced to ETMC EMS years before Richey took over as manager and he was instantly taken by the process.

“I’ve never seen a program better than the MPDS,” Richey said. “The protocols give our personnel peace of mind.”

ACE was a goal he assumed to support continued service contracts and sustain the same high level of performance at both centers.

“The hard part wasn’t bringing everyone on-board to achieve ACE,” Richey said. “It was getting everyone consistent in call processing, especially when giving Pre-Arrival Instructions. I needed to get us over that one big hurdle. We had to do something more in our training.”

Richey put the issue in front of the dispatchers. Literally.

He created PowerPoint presentations that were displayed 24/7 over a large projection screen typically reserved to display a map of the ETMC EMS system in real-time. PAIs for child delivery, choking, and stroke were shown repeatedly in three separate productions spread over three months.

The approach was on the order of subliminal messaging — the PowerPoint presentations placed the information strategically, infusing the data into the daily experience of dispatchers. The presentation changed screens every two to three minutes and looped to begin again once the end of the presentation was reached.

“Dispatchers were starting to quote the PAIs,” Richey said. “And that was great to hear.”

Apparently, the strategy worked. By the end of the three-month period, performance was exceeding even his expectations.

“We scored the jackpot,” Richey said. “We were ready to proceed with the ACE.”

Smith, a former ETMC EMS paramedic supervisor, keeps performance levels on track through “training, training, and more training.” He works closely with four communications training officers and four shift supervisors. While the 11 ED-Qs mostly wear headsets to take calls, the high number assures that a Q is on shift to assist when questions arise.

Call reviews are processed through AQUA and the results are sent directly to the respective dispatchers. Exceptionally good calls and non-compliant calls receive immediate attention.

“We go for real-time feedback,” Smith said.

Dispatch candidates are put through a battery of interviews and tests. New hires are required to take the ETC and EMD courses; they work one week on ProQA simulation and spend four to six weeks under the wings of a training officer before processing calls on their own.

“Ultimately, the training officer is disconnected once comfortable with the dispatcher’s progress and ability,” Smith said.

Ten percent of their calls are evaluated during the first solo month.

“We don’t allow the time for bad habits to form,” Smith said.

Stanley had been on her own for five months at the center when the PAIs she provided over-the-phone led to welcoming an infant into the world.

The timing of the call and Stanley’s “very good” handling of the call put her on Richey’s short list for the CBS 19 news program alongside Jewell.

Jewell and Stanley agreed to go on camera with one requirement. They did not want to be the focus of attention.

“They wanted the audience to understand what happens when you call 9-1-1 and the reasons we do the emergency medical dispatch,” Richey said. “We give a lot of tours, but no one sits down to chat with the dispatchers, and they didn’t want to be singled out. They’re part of a team.”

Jewell applauds the TV station’s spotlight on 9-1-1.

“I’m really glad they decided to go this route,” she said. “Courtney did a great job at explaining what we do, and I’ve heard it was eye-opening.”

Friedman seconded Jewell’s confidence.

“People in the community loved the story, and responded well to it,” she said.

To see the news report, visit http://www.yourepeat.com/watch/?v=K9mSVqB_Hgs