The use of structured protocols in emergency call centres is widely recognised as an essential tool and critical to achieving a quality-centric organisation. In this session, you will hear from experts who have implemented structured protocols and the benefits that this has brought. Chair: Demetrios Pyrros, President, EENA

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The Evidence Base for the
AMPDS
Advanced Medical Priority Dispatch System

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Christian
Laucher
Notruf Niederösterreich
Head of Process Management
email:
christian.laucher@notrufnoe.at
fulltime employment
1999 start working in a Emergency Center in
Tirol
2001 start working with the EMD Protocol
2008 change to Notruf Niederösterreich
2009 Accredited Center of Excellence
2015 EENA Certificate of Quality Standard
112
… - a lot of changes and innovations
- ReAccreditations, -certifications,
Dispatchers of
the year
part time job
2004 start working for Priority Dispatch (PDC)
2006 my first Protocol Implementations for PDC
in a Center
2008 First European Navigator in Berlin
… - Teaching Medical, Police, QM
- Implementations
- Consulting

3. The Evidence base for the
Advanced Medical Priority Dispatch System
(AMPDS)
The protocol himself
Evidence Based Practice
How changes migrate to the protocol
Proposal for Change
Clinical Expertise
Examples
1
2
3
4

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The protocol himself

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What is Evidence-Based Practice?
1) EBM Evidence Based Practice Matters
1

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AMPDS Protocol Evolution as Evidence-Based Practice
PFCs1
Councils of Standards
Expert Opinion
Practitioner-Engaged Research
Published Research
Continuous Data Analysis
Council of Research
University/IAED2 Partnerships
Community-Engaged Research
EMD3 Training
1) PFC Proposal for Change
2) IAED International Academies of Emergency Dispatch
3) EMD Emergency Medical Dispatch
4) EBM Evidence Based Practice Matters
4

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Proposal for Change (PFC)
every center who use the protocol can submit a change
• „Readers of the Council“
• subcommittee reviews and evaluates all PFC’s
• formulate the finaly proposals
• forwards Proposals to Voting Council
• commission research or request clinical data, ...
before a new version is coming …
• „Cultural Meeting“
• in every language a group of users verify the protocol again, so that it works for this language

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Why Evidence-Based Practice Matters
• Improves patient care and reduces unnecessary errors/negative outcomes
• Reassures practitioner, patient, and family members that the best care was provided,
even if outcome is negative
• Increases community and patient confidence in care providers when they know EBP1 is
being applied
• Practitioners/clinicians feel more prepared for situations—more confidence and less
stress
• Reproducible care and reduced bias: all callers receive the same standard of care
1) EBP Evidence Based Practice

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Best Research Evidence: Examples

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Individual Clinical Expertise: Examples
Aspirin (ASA Diagnostic Tool and Instructions):
• Input from George M. Rodgers, MD, PhD, Professor of Medicine at University of Utah, on
differences between Aspirin and blood thinners
• Tool developed in collaboration with Joseph Ornato, MD, FACP, FACC, FACEP; Chairman of Dept.
of Emergency Medicine at Virginia Commonwealth U and Medical Director of Richmond
Ambulance Authority
Not Alert (in progress)
• Practitioner/clinicial (EMD and Medical Director) input has to led to the development of three
studies with international scope (Brazil, Australia, UK, USA, involved)
• Testing varied phrasings of “not alert” to determine is most accurate
• Individual EMD input/evaluation is a key metric in at least one of the studies, along with
hospital/EMS outcomes

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Individual Clinical Expertise: Practitioner-Engaged Research
Practitioner-Engaged Research assumes that individual professionals (in this case, EMDs)
have clinical and hands-on knowledge that is important to generating and making sense of
research findings.
To increase practitioner-engaged research in EMD, the IAED is running an annual research
workshop (soon to be online and available for international attendees!)
Three practitioner (EMD/EMD-Q) studies already published from it:

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Patient Values and Expectations: Examples
Ongoing study:
Caller Expectations of Emergency Dispatch in Diverse Communities
• Focus group methodology
• Working with 6 different communities in Utah—including Pacific Islander, American
Indian, Hispanic, refugee (mostly African), African American, and LGBTQ
• Better understanding their expectations, needs, and values, as well as their experiences
calling for emergency services and their barriers to calling
• Creating training for EMDs and may integrate some of the findings into protocol to
reflect the needs of communities we serve
• Developing a toolkit so others can do similar studies in their own communities

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Recommendations
• First of all, use a protocol, because you should never forget anything – you only have
one change to make it right
• Do not make mistakes again that have already been discovered and eliminated
somewhere in the world
• Pay attention to which workgroups working behind a protocol, to make sure that it is
not a one man show
• Use an Evidence Based Protocol, because this is the only way to do the really right
things

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Conclusions and Recommendations
• The MPDS absolutely meets all three elements of the definition of evidence-based
practice
• EBP makes the protocol not only the standard of care, but gives both EMDs and our
communities faith in the service they are being provided
• The IAED continues to deepen our work in all three areas of EBP and will continue to
publish and report on our findings