Dispatch Decision Making in an Air Medical Transport System

Abstract

Air medical transport relies on effective dispatching of air and land vehicles to provide the fastest and best care possible for patient transfers. These difficult dispatch decisions are characterized by high time pressure, uncertainty, and the dynamic and complex environment of medical transportation. This paper describes a preliminary study of the decision making processes that occur during dispatch decisions at Ornge, the air medical transportation system in Ontario, Canada. We drew upon the Critical Decision Method and the structured data analysis approach to understand the major decision points faced by Ornge’s dispatchers, and the cues and sources of information attended to in those situations. We found that the decision points deal with three main goals: maintain situation awareness, match resource to transfer, and plan logistics of transfer. Furthermore, we found that time estimation might play an important role in helping dispatchers coordinate within the dispatch team and with their external partners. These findings may help improve the design of computer aided dispatch software to better support the goals of the dispatchers.

Developing NWO Navigate: An App for Navigating Stroke Care

“…A coordinated system of regional care is essential for providing timely access to treatment for patients who present with a suspected acute stroke. It is estimated that for every minute of delay in treating an ischemic stroke 1.9 million brain cells die, 13.8 billion synapses are damaged, and 12 km of axonal bers are lost [1].Patients who are eligible for time-sensitive therapies should still be transported to the closest hospital capable of providing services for the diagnosis and treatment of stroke [11]. To facilitate transportation in NWO, direct transportation protocols for six regional hospital locations have been established and implemented to support access to care.…”

Medical dispatch decision support for transfer time estimation: Individual operator differences in system use

“…In this research, we provide a preliminary investigation into the role of individual differences, in particular, the role of numeracy, impulsiveness, and venturesomeness on how operators use a dispatch tool built on historical data to support time estimation. Previously, we found that dispatchers consider a variety of contextual factors when estimating transfer times (Giang, Hui, Donmez, Ahghari, & Macdonald, 2016). We hypothesize that individual differences would influence how operators use contextual information when estimating transfer times using a support tool that displays historical dispatch times.…”

“…Medical dispatchers are responsible for the allocation of medical resources in response to incoming patient transfer requests, however, dispatch decision making is a difficult task due to high time pressure and complexity (Wong, Hayes, & Moore, 2005). Dispatch decisions are especially difficult for large-scale air medical transport systems, such as Ornge in Ontario, Canada (Giang, Hui, Donmez, Ahghari, & MacDonald, 2016). Ornge is the sole provider of air medical transport within the province and completes the majority of air and land interfacility transfers using a fleet of fixed and rotary wing aircraft and land ambulances based throughout the province.…”

“…Ornge's dispatchers often rely on estimates of time to definitive care, the time from when a patient request is received to when the patient is handed off to the receiving hospital, to make dispatch decisions (Giang, Donmez, Fatahi, Ahghari, & MacDonald, 2014;Giang, Hui, Donmez, Ahghari, & MacDonald, 2016). However, dispatchers have been found to be susceptible to misestimating times (Giang et al, 2014), which can lead to inefficient dispatch decisions with adverse effects on patient outcomes.…”

“…However, time estimation strategies can vary between different dispatchers, due to elements such as experience and knowledge of the situation (Giang, Donmez, Zakir, Ahghari, & MacDonald, 2015;Giang, Hui, Donmez, Ahghari, & Macdonald, 2016). Thus, it is also possible that individual dispatchers may use a tool meant to support and standardize time estimation in different ways.…”