SETTING THE TONE

By James Thalman

Sunnyvale, Calif., Dept. of Public Safety communication center manager and ED-Q instructor Michael Spath has a large audio collection of 9-1-1 calls, some featuring him in the central role. He believes his calls should be as subject to open review as anyone else’s.

His favorite recording, though, has nothing to do with dispatch. He played it to open his “100 Percent Customer Care” course at NAVIGATOR. It is the opposite of customer care depicted in a nearly six-minute, meandering voice menu from an actual but nameless Department of Motor Vehicles.

Callers, after being thanked for dialing the DMV, are given a list of around two dozen options, after first selecting English or Spanish. At that point, rotary phone users are advised to stay on the line to be transferred (where to isn’t made clear). As callers paddle against the stream of options, they are told that pressing various numbers will take them from watercraft registration to the organ donor registry to what will happen if a caller knowingly gives false information. The caller ends his or her sojourn by being told, “All of our representatives are helping other customers, but pressing 9 will take you back through the menu options.”

“I really wanted to find a call to illustrate the opposite of what emergency dispatch should be about,” Spath said, after forcing attendees in his NAVIGATOR course to sit through what he said might well be the Guinness record holder for longest voice mail.

Of course, no one calling 9-1-1 should ever face such bewildering misguidance, he said. 

“Calls to 9-1-1 can get dropped or go unanswered,” Spath said. “It happens. But someone in trouble never wants to get voice mail. The goal is they call, we pick up and we help, however we can, no matter what.”

Ironically, the public doesn’t tend to believe that’s what will happen. In fact, research by the International Academies of Emergency Dispatch (IAED) on caller/calltaker interactions shows that nearly half of the people who dial 9-1-1 believe they aren’t going to automatically be helped. Instead, the study shows that members of the public believe that they will get the runaround, and that they’re going to have to convince whoever answers that they need help immediately.

“That’s why many callers will immediately be defensive or start by demanding an ambulance right now,” Spath said. “They are in an emotional state already, and they don’t know who else to call but 9-1-1. But some believe if they don’t loudly and repeatedly insist what’s wrong and what they need, they won’t get help.”

One of the difficulties in the demanding profession of dispatch is not to respond in kind to an over-amped caller, he said. Instead, Spath stresses that that exact moment is the time to remember, “Although you may have answered 13,000 rude calls, it’s the first time for the caller. Stick to the protocols and talk to them in a tone of voice that is calm, consistent, and persistent.”

“We have a hard job, and it takes practice to find a way to tell emotionally agitated callers to ‘Shut up and listen’ when you can’t ever say ‘Shut up and listen,’” Spath said. “I’ve found that simply and repeatedly telling people that help is on the way and that we are helping right now over the phone has an almost magical calming effect.”

Sometimes callers need to be told multiple times that they are crucial to providing the help to their loved one, and that there is critical information that the calltaker needs at that moment to keep them providing that help.

A call involving a daughter whose elderly mother had all but stopped breathing put Spath’s approach to the test several times. The caller kept yelling, “My mother isn’t breathing; we need help now! Send help now!”

Spath said he had noticed and heard Qs say in case review that while dispatchers might be doing their level best to reassure, many don’t just flatly say so.

“Maybe it’s too direct to say, ‘We are helping you,’ or ‘Listen, we are helping right now, and I need to get vital information from you right now,’” Spath said. “I’ve found that unless the caller is hysterical or is a level five on our emotional status scale, people will settle down.”

In this particular call, Spath repeatedly reassured the caller that help was on the way, but added, “We can help your mother best if you answer my questions.”

“That settled down the caller momentarily, but her emotions would suddenly pitch up and she would start yelling, ‘Hurry, hurry, hurry. She’s not breathing!’ if she thought asking whether her mother had a heart condition or had asthma was irrelevant to the obvious goal of getting her ‘an ambulance right now,’” he said.

The caller either didn’t hear that help was on the way, or she forgot because she was so fearful of what was happening to her mother, Spath said.

“And who can blame her?” he asked.

Spath said the level-five caller—the most distraught—is rare. He’s only had one. It was from a young mother who had apparently found her baby dead in its crib. He repeatedly asks her questions, but screams from the mother and attempts by the husband to comfort the mother is all that can be heard.

“Anyone who has had one of those calls never forgets them, and we shouldn’t,” Spath said. “But we can’t go there emotionally during the call. Keep in mind that your next call could be one like that.”

Knowing and applying the Universal Customer Service Standards 1–6 as described in the IAED’s performance standards, will sufficiently calm and reassure most callers, Spath said. “Listen, Mary, help is on the way,” or “Please, listen to me very carefully so I can get some vital information and give you instructions until help arrives,” are statements that should come automatically to the calltaker handling a high-stress call.

Reassurances tend to be regarded as risky territory to many calltakers, who fear that they can so easily go off protocol and get dinged in their case review.That’s rarely the case in his experience, Spath said, noting that a greater risk comes when calltakers go too far by saying things that create unrealistic expectations for the caller or simply aren’t true. Spath said these might include: “Don’t worry, he’s going to be fine,” “Firefighters will be there in three minutes,” and “Don’t blame yourself, you didn’t do anything wrong. Your baby was only under the water a few minutes; she’ll be OK.”

Instead, calltakers need to have a ready list of statements that are positive but ambiguous, such as “Everything possible will be done for him,” or “The ambulance is coming and will be there as soon as possible.”

“Dispatchers who believe they’ll just be able to say the right thing when the high-stress call comes along, they won’t,” Spath said. “They won’t.”

Spath said the bottom line is that “Dispatchers want to help, and that’s what we do, even if we’re just referring a call elsewhere. No matter how cynical someone becomes or how dark the humor gets in the call center, we’re there to help, and that’s exactly what we do.”

Jim Thalman

ABOUT THE AUTHOR :
Jim wrote about public and higher education, local and state government, police and fire, and health care reform before joining the IAED. As a Senior Editor, he has written about ACE organizations, a National Championship Air Races crash, the London Olympics, and Hurricane Sandy. Jim has also written for the quarterly QTips newsletter, which covers quality assurance and quality improvement.

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