The 911 dispatch system in BC is about to get an overhaul.
The changes come as a response to an incident involving a 56-year-old woman who died in her Downtown Eastside apartment in November 2018.
First responders took 35 minutes to access her unit because they did not have the master-keys that were needed to access a locked elevator.
Only firefighters carry the master-key, but they were not initially dispatched, which is the problem.
“She wasn’t alive when they got through the door. […] Fire attendance right away could have made the difference to her life, or at least she wouldn’t have died alone”, the woman’s daughter told Global News.
An independent review by BC Health Minister Adrian Dix resulted in 14 recommended changes to the 911 dispatch system. The Health Minister has committed to implementing all of them.
BC 911 Dispatch Changes
Here they are, via the official review, in full:
- BCEHS dispatchers should always have easy and obvious access to important information related to the scene. Policy and procedures should be developed to routinely and effectively share and access information in real time known to police, fire, and ambulance dispatch centers or paramedic and first responder crews.
- All responding emergency services should have clear and robust processes to gain rapid access to a multi-unit building. Building codes should be reviewed and revised to enable such rapid access when necessary.
- The status of allied emergency services responding to medical calls should be relayed to the BCEHS dispatcher who requested the response to ensure that it is appropriate for the patient condition.
- When allied emergency services are dispatched prior to paramedics making contact with a patient and confirming their condition, they should always be dispatched with the same urgency of response as the initial call.
- Fire department should be dispatched where there is any suspicious of access delay to the particular building or at the first sign that access might be a problem.
- When communications are interrupted with a patient or caller, the assumption should be made that the patient has deteriorated and urgently requires help. This implies potential upgrading of the call, assistance with access, appropriate staging of all resuscitation equipment and dispatching additional personnel.
- Resuscitation equipment should always be carried to patient side or staged nearby initially unless it is absolutely clear that the patient will not require resuscitation.
- Each responding agency should be aware of the location and expected arrival of the other agency’s units.
- BCEHS and fire crews should routinely communicate during a combined response to ensure optimal support and teamwork.
- A linked data system should be developed that allows reliable and valid analysis of patient cohorts that includes the MPDS determinant code, CRM recommendation, and patient outcome.
- The current 6 monthly reviews should include all agencies and representatives from front life staff and members of the public. The results of the reviews should be shared with all agencies front line staff, and members of the public.
- All serious events identified by staff is PSLS have a formal review that includes all involved staff from all responding emergency services agencies and their management representatives who are responsible for the quality of care.
- Autopsies in sudden unexpected death are an essential component of a Learning Health System. They are important to understand how care can be improved in the future, through system changes or education. The Minister of Health should consult with the Solicitor General on how to ensure that the mandate for autopsies includes this important health system learning function.
- Develop regular inter-agency meetings of front line providers and management to share information on issues to improve team dynamics and agency relationships. These meetings should be case based and focus on opportunities to improve policy, process, and culture.
These recommendations look to “improve the efficiency of the dispatch process and patient management, interagency communications, and most importantly will substantially improve patient outcomes”, the official review stated.
There are no firm dates for these changes will come into effect, but there have been no public disagreements with the changes, so expect them sooner rather than later.
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