Samu 44, Department of Emergency Medicine, University Hospital of Nantes, Nantes, France.
Department of Medical Evaluation and Epidemiology, Nantes University Hospital, Nantes, France.
Scand J Trauma Resusc Emerg Med. 2019 Oct 28;27(1):94. doi: 10.1186/s13049-019-0667-6.
Access to an Emergency Medical Communication Centre is essential for the population in emergency situations. Handling inbound calls without delay requires managing activity, process and outcome measures of the Emergency Medical Communication Centre to improve the workforce management and the level of service. France is facing political decisions on the evolution of the organisation of Emergency Medical Communication Centres to improve accessibility for the population. First, we aim to describe the variation in activity between Emergency Medical Communication Centres, and second, to explore the correlation between process measures and outcome measures.
Using telephone activity data extraction, we conducted an observational multicentre study of six French Emergency Medical Communication Centres from 1 July 2016 to 30 June 2017. We described the activity (number of incoming calls, call rate per 1000 inhabitants), process measure (agent occupation rate), and outcome measure (number of calls answered within 20 s) by hourly range and estimated the correlation between them according to the structural equation methods.
A total of 52,542 h of activity were analysed, during which 2,544,254 calls were received. The annual Emergency Medical Communication Centre call rate was 285.5 [95% CI: 285.2-285.8] per 1000 inhabitants. The average hourly number of calls ranged from 29 to 61 and the call-handled rate from 75 to 98%. There are variations in activity between Emergency Medical Communication Centres. The mean agent occupation rate was correlated with the quality of service at 20 s (coefficient at - 0.54). The number of incoming calls per agent was correlated with the mean occupation rate (coefficient at 0.67). Correlation coefficients varied according to the centres and existed between different process measures.
The activity dynamics of the six Emergency Medical Communication Centres are not identical. This variability, illustrating the particularity of each centre, must be accurately assessed and should be taken into account in managerial considerations. The call taker occupation rate is the leverage in the workforce management to improve the population accessibility.
在紧急情况下，民众需要能够及时获得紧急医疗通讯中心的服务。为了能够及时处理呼入电话，需要对紧急医疗通讯中心的活动、流程和结果指标进行管理，以改善劳动力管理并提高服务水平。法国正面临着有关紧急医疗通讯中心组织演变的政治决策，以提高民众的可及性。首先，我们旨在描述各紧急医疗通讯中心之间活动的变化，其次，探讨流程指标与结果指标之间的相关性。
我们使用电话活动数据提取，对法国六个紧急医疗通讯中心（2016 年 7 月 1 日至 2017 年 6 月 30 日）进行了一项观察性多中心研究。我们按小时范围描述了活动（呼入电话数量、每千居民的呼入率）、流程指标（座席占用率）和结果指标（20 秒内接听的电话数量），并根据结构方程方法估计了它们之间的相关性。
共分析了 52542 小时的活动，期间共接听了 2544254 个电话。紧急医疗通讯中心的年呼叫率为每千居民 285.5 [95%CI：285.2-285.8]。每小时呼入电话数量范围从 29 到 61，电话处理率从 75 到 98%。紧急医疗通讯中心之间的活动存在差异。平均座席占用率与 20 秒服务质量相关（相关系数为-0.54）。每位座席的呼入电话数量与平均占用率相关（相关系数为 0.67）。相关系数因中心而异，且存在于不同的流程指标之间。
六个紧急医疗通讯中心的活动动态并不相同。这种可变性，说明了每个中心的特殊性，必须进行准确评估，并在管理考虑中予以考虑。呼叫接听员的占用率是改善民众可及性的劳动力管理中的关键因素。
