Factors affecting emergency medical dispatchers’ decision-making: a qualitative study

Seyyed Mohammad Reza Hosseini,1 Mohammadreza Maleki,1 Hasan Abolghasem Gorji,1 Davoud Khorasani-Zavareh,2–4 Masoud Roudbari5 1Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran; 2Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Department of Health in Disaster and Emergency, School of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 4Department of Clinical Sciences and Education, Karolinska Institute, Södersjukhuset (KI SÖS), Stockholm, Sweden; 5Antimicrobial Resistance Research Center, Rasoul-e-Akram Hospital, Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Introduction: 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. Methods: 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. Results: 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. Conclusion: 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. Keywords: emergency medical services, emergency medical dispatch, response time, decision-making, prehospital, dispatche