From my previous posting:
I have to agree with Todd Allen, hands down. Especially:
"Unfortunately, many dispatch centers do not consult the users. The people that are often making the decisions, approving of the product demonstrations have (sorry to say) no idea what the dispatchers need or do. The system that you have has been seen, has been tested and has been approved by your "powers that be". It is easy to put the blame on others than to take responsibility for ones own actions."
"I am sorry to hear if your site is having problems, but it is not the CAD, it is your center. Poor management, lack of training to dispatchers, short staffing, etc.. There is not a CAD out there that can fix these issues."
I have worked with many CAD systems, and TriTech, VisiCAD Command in my opinion, is the best. Of course again, this is my opinion and my paradigm based on my user agencies needs (I have worked with multiple).
But in light of recent events, let me elaborate on a few things.
I have 13 years experience providing communications, customer service, and support services to various police, fire, EMS, and other public safety agencies. I have worked with Interact, Tritech VisiCad Command, Compudyne/Tiburon 2000, Extensity/GEAC Enroute, Zoll Data RightCad/Rescuenet, Northup-Grumman, Motorola PinTrak, EDS, and Positron. I am currently a communications Supervising System Status Controller (dispatcher) in the EMS communications/control center of the largest hospital based EMS agency in the nation, and the largest public hospital in the Southeast with a renowned Burn Unit, Level 1 Trauma Center, and state Poison Control Center; Grady Health System EMS in Atlanta, GA… where we dispatch fleet of 35 ALS, and 2 Neonatal-Angel’s, Bike Medics, and Tactical Medics ambulances in a 9-1-1 zone inside the mere 174 Sq. miles of the city limits of Atlanta, Fulton County (exclusive provider); responding to more than 100,000 calls annually. We do no IFT or NET, nor do we provide venue coverage.
In 2003 the county gave up dispatch operations to our newly started communications and control center (CAC). They took the 9-1-1 calls and used AMPDS to triage the call on their Interact CAD and it was linked to our “Ivory Tower” (literally on the 11th floor overlooking Underground Atlanta, Midtown, and Buckhead) via T1 to our CAD. We chose VisiCAD because of its capabilities with EMS dispatch that are 2nd to none. When the county dispatched, they used zones (beats) to allocate resources and the CAD recommended the closest unit. Our system, utilizing AVL/GPS and street-corner posting uses dispatcher training and judgment. Our response compliance went from 50% to 80% immediately when we took over. Combined with more training, more accountability, and more quality improvement processes, we are now holding in the 90% percentile on perhaps one of the most rigorous high performance EMS contracts in the nation, shying away from a 12:59 or 10:59 life-threatening emergency response contract time to 7:59. Our average response time is just under 6 minutes and only have 1st responder fire accompaniment on Echo and Delta level calls (and we still get to the scene faster than the FD).
In June of this year, rather than the City of Atlanta answering the 9-1-1 calls at their police department, transferring them to the county to triage and then to us to dispatch, the COA transfers the 9-1-1 calls directly to us. We increased our staff, double what the county was providing, and while our goal was to answer calls within 15-seconds 90% of the time, we do it in less than 10-seconds, 94% of the time – and we don’t have ACD. Part of our response time includes the call-taking process as we quick-start/pre-alert ambulances to calls as soon as we have an address. While the unit is starting toward an incident location non-emergency, the call is being triaged using AMPDS ProQA (works seamlessly with VisiCAD). Once the determinant is complete, the chief complaint and call priority automatically updates and upgrades the incident and unit via MST and pager (the SSC will provide verbal confirmation of receipt). We are doing better because we were provided with a tool and I myself have invested the blood, sweat, and tears, to do a good job and train everyone how to use what we have to the best of our ability. I do it because I am passionate about my career and job, and because patient care is my pinnacle priority. This is why we all should be here. As well, the team of management in place made it important to put those processes in place that would make the greatest impact on the community, not for the sake of the contract, but for the constituents. Some polices and procedures aren’t flawless, make no mistake, but they are protocols nevertheless.
There isn’t a CAD in this world that won’t crash, there isn’t always a CAD that will provide the integration needed to sustain multi-jurisdictional user agencies and different types of public safety groups with their own codes, response configurations, priorities and services obligations, big or small. I have worked PD channels with as many as 50 units doing special details and traffic stops, ice storms with multiple TAC channels running 100s of incidents simultaneously; but the key was a management team that had simultaneous incident plans, contingency plans, emergency response plans, training programs… in place to effectively enhance the capabilities of their human capital when they needed it most..
HennepinEMS440 has an excellent understanding and makes a lot of good points; and it sounds like your agency is awesome.
Inter-agency cooperation and collaboration. The EMD workload has been decreased and the radio traffic has dropped since implementing mobile data computers in the field. We are 60% silent dispatch now.
Closest car dispatching, whether ambulance, fire apparatus or squad, has many configuration elements. Each unit and personnel in VisiCAD has attached capabilities. If any of the configuration is wrong, it effects recommendations. That is not the fault of any CAD system. The CAD Administrator has the ability to control configurations.
How much is as designed by configuration? Just because the dispatcher does not agree with the recommendation does not mean that the agency doesn't want it that way by policy. I have certain policy in place and I know my staff do not 100% agree, but that's not a reason to not follow the recommendation and blame the CAD for a bad recommendation. This is also not the fault of any CAD system.
My suggestion is for those who have issues, problems, and concerns – bring solutions to the table, not just complaints. The CAD can do anything you want it to, or not do what you don’t want it to do. Talk to the CAD Administrator within the agency and determine the capabilities and turn on or off what is causing the problems. There are use manuals... if you really want to know how things work, find the book and read it; I did. And now that I understand it more, I can now train others how to use it to their advantage. Yes, there are a lot of bells and whistles, things you will learn to use all the time, and things like SNAP shot or GIS playback that you have no need for. But having many options allows the individual to perform their duties to the best of their abilities. If you don’t like dragging and dropping, use the command line, etc. As well, you must understand that as a user, as horrible as it sounds, management does often have other goals in mind and data manipulation, retrieval, and even budget can seemingly overpower “our” needs. But it isn’t the end of the world.
Someone pointed out service issues. While our contract provides services to the City of Atlanta, Fulton County oversees 3 zones as mandated by the State, the other 2 being North and South Fulton County. They have Rural-Metro as their ambulance provider. It’s not a matter of inferior services; I believe that all bureaus do the best they have with their resources under sometimes extenuating circumstances and challenges that include management practices, morale issues, funding, staffing, etc.. We too have helped the North and South through mutual aid, but it’s because that is what’s right! If someone needs help, does it matter than our ambulance responded rather than the zone provider? If service issues are compromising patient care, there are mediums for addressing this. Recently, because of the job the county government has been doing, the unincorporated areas have formed cities. When done, there will be essentially, no county EMS oversite or Fire or Police department. Oversite will go to the new cities who have for years complained about the counties management inadequacies – so now they have it. We will see how they do. As for us, the COA looks at taking measures to integrate our PSAPS, another CITIZEN and PATIENT CARE priority. But the point is, these other areas found a solution to their public safety “nightmare”. They took matters into their own hands.
For anyone, once you stop believing in your management team to the point that you can’t follow nor support their mission, you should leave. Changing your attitude means changing your perception and many of us hated the changes anyway so we already have a mental block when it came to adapting to I (we slept through training, didn’t attend training, or weren’t paying attention). Many things you feel don’t work well because you haven’t tried it (so how do you know it doesn’t work). If it really doesn’t… then bravo for trying, now do something about it. Stress comes from trying to control things we don’t have control over. Either adapt, accept, or move on… because I am sure the complaints of the few don’t outweigh what is going right and the only thing you are doing is drawing more negativity to the “cause.” That behavior is self destructive and one way or another, you will be held accountable for your actions and attitude (which you do have control over). Use what controls you do have and stick to what is important. Be committed, be loyal and care! Don’t feel trapped. No good can come of you being so bitter about the CAD that you can’t function. That’s how people get hurt. Develop your skills, seek out those who can do it well and learn from them.
Grady EMS SSC Spv/QI/PIC
AMR Atlanta Alt SSC Spv
Disclosure: These thoughts and ideas and opinions are all my own and I am no way speaking on the behalf of whom I work for.