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County introduces E-911 Nurse Triage program

Posted On: December 2, 2019

Emergency medical service (EMS) systems are experiencing increased calls for ambulances for situations that are not true medical emergencies. These low-acuity calls unnecessarily occupy ambulances while burdening emergency departments with patients needing only urgent, but not emergent care. Volusia County EMS has engaged in a forward effort to implement the E-911 Redirect Nurse Triage program to better optimize resource utilization for ambulance deployment.

The program, which starts Dec. 9, is part of the comprehensive service level update approved by the Volusia County Council on Feb. 5. Its implementation is a tremendous effort, requiring intense collaboration with the Volusia Sheriff’s Office emergency communications staff and through a multidisciplinary partnership with area hospitals, urgent care clinics and a myriad of community partners.

“This initiative is really a communitywide effort,” said Dr. Peter Springer, the county’s EMS medical director. “Our overarching goal is to better ensure that our county’s ambulances are being utilized for true medical emergencies.”

A new clinical library of medical emergency dispatch protocols (medical conditions) were collaboratively developed through an interdisciplinary team of clinicians and EMS medical direction. The effort also simultaneously improves the county’s computer-aided dispatch technology through the building of new interfaces, allowing dispatchers and clinicians to share and transmit vital information in rapid time. 

When a person calls 911, the call is initially screened to determine emergency or non-emergency priority. Using E-911 Nurse Triage, after ruling out emergency priority, non-emergency callers would be seamlessly routed to an emergency medicine-trained registered nurse who interviews the patient to find out the nature of the problem and to facilitate appropriate treatment facilities and transportation options. Low-acuity patients may be redirected to urgent care facilities, walk-in clinics or primary care physician offices. Low-acuity patients may also still be directed to a hospital emergency department but in a non-emergency manner.

“Today’s ambulances are mobile emergency rooms on wheels with clinicians highly trained to care for life-threatening emergencies,” said Joe Pozzo, Volusia County’s director of public protection. "Appropriately redirecting the mode of transport and destination of non-emergent patients to more appropriate facilities improves the availability of our clinicians and ambulances for those time/life critical emergencies and reduces unnecessary congestion in our emergency departments.”

Other EMS systems that have adopted similar programs exist in Reno, Las Vegas, Fort Worth and in areas throughout Canada.

For more information, call 386-822-5062, ext. 15637.

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