Name: Lavinia Ferraro
Agency: 118 Genova Soccorso
Location: Policlinico San Martino, Genova
Country: Italy
Service Area: 1,123 km2
1. How long have you been working with the AMPDS™ and ProQA®?
I have been working with the AMPDS™ and ProQA® for 12 years. However, I’ve been an emergency dispatcher at Genova Communication Center for 21 years. Before that I volunteered as an ambulance driver and responder with the Italian Red Cross. In short, a lifetime dedicated to medical emergencies. We could say that working with ProQA is the final prize. Having worked as a dispatcher for almost 10 years before AMPDS was implemented in our center, I experienced firsthand how things changed after the introduction of this system. I can still remember the difficulties of having to process emergency calls without a protocol, having to rely only on improvisation, and having no consistency between dispatchers. I also remember the difficulties I experienced when adjusting to a protocol system, but once this initial phase was over and I learned how to use ProQA, I realized how much easier and straightforward my work was.
2. What do you like most about ProQA?
It is clearly structured. It requires me to follow the protocol, but at the same time it allows me to navigate its different sections easily and quickly. For example, if the patient's condition changes during the call, I have all the links available to quickly move to the correct protocol and/or appropriate PAIs. In addition, ProQA does not display questions, instructions, or even protocols that are not relevant based on the information I, as the EMD, have acquired—such as their sex, age, relation to the patient (first- or second-party caller). As an example, if I select “male” in the Case Entry Protocol, I will not see Protocol 24: Pregnancy/Childbirth/Miscarriage. Of course, this is only true if all the fields are filled in accurately and precisely!
3. Can you think of a specific example when ProQA helped you? Tell us about an experience, a memory, or an anecdote.
I remember receiving a call last year from a father who called for his 24-year-old daughter. She was “overtalking,” as her dad put it, when answering Case Entry Question 3. When I asked what he meant—if his daughter was talking nonsense or was not articulating the words correctly—the father replied "both." The patient was able to speak well enough to say what she meant to say, and only when I used the Stroke Diagnostic Tool, did I find clear evidence of expressive aphasia. The patient could understand the questions, but she was unable to articulate any words and could only make some sounds. It was shocking to hear her over the phone! If I had not been compliant to the protocol, I could have made a serious mistake.
Thanks to the Stroke Diagnostic Tool, we were able to admit the patient to the Policlinico San Martino where mechanical thrombolysis is performed to treat some special types of ischemic strokes.
Note by Greg Scott, Associate Director of Protocol Evolution at the IAED: It would be easy to overlook a stroke in a 24-year-old female, since strokes are very unusual at this age. By following the directions for selecting Protocol 28 listed in the AI section of this protocol, one is reminded to select P28 for a sudden onset of speech problems.
4. What do non-users need to know about the AMPDS and/or ProQA?
They protect both the patient and the dispatcher. They reduce the risk of subjectivity, allowing the EMD to focus on the patient’s complaint and on caller management. Most importantly, the protocol does not forget!
5. Do you have any recommendations for the users?
I would urge them to remain compliant to the protocol. The protocol makes it possible to collect all the information essential for handling the call, without being distracted by other situations or having to invent instructions on the spot; this allows the EMD to actively listen to the caller and address and manage their emotional state.
Obviously, all the system’s benefits increase in proportion to the knowledge acquired—the better one knows the protocol, the easier it will be to use it and the better the quality of the service will be.
