Hosseini Seyyed Mohammad Reza, Maleki Mohammadreza, Gorji Hasan Abolghasem, Khorasani-Zavareh Davoud, Roudbari Masoud
Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran,
Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Multidiscip Healthc. 2018 Aug 22;11:391-398. doi: 10.2147/JMDH.S159593. eCollection 2018.
Prehospital emergency medical service dispatchers should make prompt and appropriate decisions to save the life of victims. The complexity of timely and reasonable decision-making in life-threatening conditions has driven researchers to investigate varying aspects of the emergency medical dispatch (EMD) process. The purpose of this study was to explore the contributors to appropriate and prompt decision-making among dispatchers.
A qualitative study through thematic analysis was designed. Data were collected using observation and semistructured interviews with 16 authorities and dispatchers in seven EMDs across Iran.
The study found "responsiveness" as the main category contributing to improved decision-making in EMD. The components introduced in this study for dispatchers' responsiveness consisted of two categories. The first was "personal values" including faith and belief, eagerness to help, service excellence, altruism, respect, and impartiality in clinical judgment. The second was "professional attitudes" resulting from education and experience, including the recognition of emergency as a threat to health, sensitivity in triage, response to all requests for help, care for early warnings, commitment to organizational goals and standards, attention to the emergency medical service social support responsibility, and professional temperance.
In this study, responsiveness was identified as a main category in improving the decision-making process among dispatchers. To attain responsiveness, institutionalization of its values and establishment of EMD-specific professional attitudes in dispatchers should be taken into consideration.
院前急救医疗服务调度员应迅速做出恰当决策以挽救受害者生命。在危及生命的情况下及时且合理决策的复杂性促使研究人员对紧急医疗调度（EMD）过程的各个方面展开调查。本研究旨在探究调度员做出恰当且迅速决策的影响因素。
设计了一项通过主题分析进行的定性研究。采用观察法以及对伊朗七个紧急医疗调度中心的16名负责人和调度员进行半结构化访谈来收集数据。
该研究发现“反应能力”是有助于改善紧急医疗调度决策的主要类别。本研究为调度员的反应能力引入的组成部分包括两类。第一类是“个人价值观”，包括信念与信仰、乐于助人的热忱、卓越服务、利他主义、尊重以及临床判断中的公正性。第二类是由教育和经验所产生的“职业态度”，包括将紧急情况视为对健康的威胁、分诊时的敏感性、对所有求助请求做出回应、关注早期预警、致力于组织目标和标准、重视紧急医疗服务的社会支持责任以及职业节制。
在本研究中，反应能力被确定为改善调度员决策过程的主要类别。为实现反应能力，应考虑将其价值观制度化，并在调度员中确立特定于紧急医疗调度的职业态度。
