Karolinska Institutet, Department of Clinical Science and Education and Section of Emergency Medicine Södersjukhuset, Södersjukhuset, Stockholm, Sweden.
Scand J Trauma Resusc Emerg Med. 2011 Mar 31;19:19. doi: 10.1186/1757-7241-19-19.
There is a great variety in how emergency medical communication centers (EMCC) are organized in different countries and sometimes, even within countries. Organizational changes in the EMCC have often occurred because of outside world changes, limited resources and the need to control costs, but historically there is often a lack of structured evaluation of these organization changes. The aim of this study was to evaluate if the performance in emergency medical dispatching changed in a smaller community outside Helsinki after the emergency medical call centre organization reform in Finland.
A retrospective observational study was conducted in the EMCC in southern Finland. The data from the former system, which had municipality-based centers, covered the years 2002-2005 and was collected from several databases. From the new EMCC, data was collected from January 1 to May 31, 2006. Identified performance indicators were used to evaluate and compare the old and new EMCC organizations.
A total of 67,610 emergency calls were analyzed. Of these, 54,026 were from the municipality-based centers and 13,584 were from the new EMCC. Compared to the old municipality-based centers the new EMCC dispatched the highest priority to 7.4 percent of the calls compared to 3.6 percent in the old system. The high priority cases not detected by dispatchers increased significantly (p<0.001) in the new EMCC organization, and the identification rate of unexpected deaths in the dispatched ambulance assignments was not significantly (p=0.270) lower compared to the old municipality-based center data.
After implementation of a new EMCC organization in Finland the percentage and number of high priority calls increased. There was a trend, but no statistically significant increase in the emergency medical dispatchers' ability to detect patients with life-threatening conditions despite structured education, regular evaluation and standardization of protocols in the new EMCC organization.
不同国家的紧急医疗通讯中心（EMCC）的组织形式多种多样，有时甚至在一个国家内也是如此。EMCC 的组织变革通常是由于外部世界的变化、有限的资源以及控制成本的需要而发生的，但历史上往往缺乏对这些组织变革的结构化评估。本研究的目的是评估在芬兰实施紧急医疗调度中心组织改革后，位于赫尔辛基以外较小社区的紧急医疗调度性能是否发生了变化。
在芬兰南部的 EMCC 进行了回顾性观察研究。前一个系统的数据来自基于市政府的中心，涵盖了 2002-2005 年，是从多个数据库中收集的。新的 EMCC 从 2006 年 1 月 1 日至 5 月 31 日收集数据。使用确定的绩效指标来评估和比较新旧 EMCC 组织。
共分析了 67610 个紧急电话。其中，54026 个来自基于市政府的中心，13584 个来自新的 EMCC。与旧的基于市政府的中心相比，新的 EMCC 将最高优先级分配给 7.4%的电话，而旧系统为 3.6%。新的 EMCC 组织中调度员未检测到的高优先级病例显著增加（p<0.001），而在调度员分配的救护车任务中意外死亡的识别率与旧的基于市政府的中心数据相比没有显著降低（p=0.270）。
在芬兰实施新的 EMCC 组织后，高优先级电话的百分比和数量有所增加。尽管在新的 EMCC 组织中进行了结构化教育、定期评估和标准化协议，但在检测有生命危险的患者的能力方面，出现了一种趋势，但没有统计学意义上的显著提高。
