Risk Negotiation in Critical Care Teams
Ambulance services need to balance the large volume of emergency calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis.
The risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision.
There are two areas where research is urgently needed:
- the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and,
- the role of national, regional and organisational policy frameworks, protocols and regulations which directly influence how the different teams and professionals need to negotiate risk vis-a-vis institutional priorities, resource allocation and performance indicators.
We are launching two project to address those agendas. 999 R.E.S.P.O.N.D. and P.A.R.S.E. 999
emerRgEncy diSPatch decisiONs in coviD-19 (999 R.E.S.P.O.N.D.)
policy frAmewoRkS for 999 ResponsE (P.A.R.S.E. 999)