By Audrey Fraizer
Call it the ideal dispatch venue to learn, network, or refresh, but never can it be said that this is the place to kick back and put your feet up.
“The experience of UK NAVIGATOR was motivating, rejuvenating, and informative,” said Antoinette Smith, quality assurance manager, London Ambulance Service (LAS) NHS Trust. “I came away with a new zest and energy ready to find new ways of doing things and to test the skills and techniques l learned. The opportunity to communicate with other ED-Qs and EMDs from other services was invaluable.”
Smith was among the 90 emergency center professionals—from England, Scotland, Wales, Northern Ireland, Ireland, Gibraltar, and the USA—attending UK NAVIGATOR in the Old Market area of Bristol, England. The three-day conference, Sept. 17-19, highlighted each set of protocol specifically—such as the police and fire leader seminars—and broadly in addressing daily operations of managing staff, setting policy, and getting the most out of the protocols.
And, of course, there were the awards.
Yorkshire Ambulance Service (YAS) NHS Trust brought home three awards recognizing the center’s high standards of care: Accredited Center of Excellence (ACE) for each of their two Emergency Operations Centres (EOCs) in Wakefield and York; Dispatcher of the Year presented to EMD Fiona Dinkel; and the Bill Boehly Clinician of the Year Award presented to Jan Matulewicz.
Dinkel was selected from 29 nominations—11 of those from YAS—and all exemplifying the “very high standards” the judges look for in choosing the Dispatcher of the Year, according to Louise Ganley, PDC clinical support representative.
“This was a really hard decision,” Ganley said. “It finally came down to the type of call, and Fiona was brilliant in the way she handled a very difficult situation (see sidebar).”
The Bill Boehly Award is exclusive to UK NAVIGATOR and recognizes an individual making significant contributions to the clinical assessment of the patient over the telephone and/or policy development in the area of secondary triage of emergency callers.
According to the nomination submitted by Annette Strickland, YAS Clinical Hub team leader at the Wakefield EOC, for the past two years, Matulewicz has combined his clinical adviser role with a project to improve the care and clinical support to nursing home staff and patients:
He has attended meetings on his own time to educate care home staff and develop a direct access clinical advice service that signposts care home staff to the appropriate pathway to meet the needs of their patients. This work has been proven to reduce the volume of 9-9-9 calls received from the care home following the training and education Matulewicz contributed to around the role of the ambulance service.
Matulewicz is currently conducting an audit project for the YAS Clinical Hub focusing on breathing diagnostics and abdominal pain.
The two centers comprising the YAS were certified as an ACE in January 2013.
The 12 one-hour sessions featured customer service, emergency center nurse triage, evidence-based dispatching, the power of listening, leadership, and managing suicidal callers. Longer sessions included the police and fire seminars, medical instructor workshops, and EMD-Q® certification courses.
There were favorites mentioned in the mix, of course, although appeal often hinges on the individual’s reason for signing up for the session.
“These are busy people taking at least three days away from work, and they want to be absolutely sure they are using the time well,” said Beverley Logan, IAED accreditation officer. “They want information that is relevant and allows the time to provide insight into a different view to the way they might be handling various situations. I think UK NAVIGATOR did that. We had an enthusiastic response.”
Melissa Thiele gave a high thumbs-up to the dynamics of IAED Research & Studies Officer Tracey Barron’s “Ignite Your Staff Performance” session.
In addition to the great “how-to” tips of motivation, such as serving cups of tea at random, Thiele welcomed Barron’s refreshing look at the supervisory positions, such as the job Thiele performs at East Midlands Ambulance Service (EMAS) NHS Trust.
“She motivated me to see not only my role as a calling, but to help inspire staff to see their role not as a job, but as a calling,” said Thiele, EMAS control training officer. “Added to that, her talk reminded me to keep an element of fun in all aspects of my life, not only in my role at EMAS.”
Another favorite mentioned was Maxine Davis’ “Changing the Emergency Dispatch Centre,” which broke down facility and staffing proposals into “who” and “what” will be affected. Davis took the team approach to her talk, dividing the audience into groups to collectively tackle a practical example of control room layout.
“The groups swapped sheets and added ideas to the existing lists,” Thiele said. “Overall, this gave me a very practical approach to problem solving.”
Jason Beese, who co-presented “Does One Glove Fit All?,” found the presentations thought provoking and—high on his list—the camaraderie superb.
“UK NAVIGATOR 2013 was a very worthwhile experience,” said Beese, EMD quality assurance auditor, South Western Ambulance Service NHS Foundation Trust. “The opportunity to meet with colleagues and friends from other dispatch agencies was invaluable.”
Susan Ozyer couldn’t be anymore effusive about her three-day stay.
“This was a fantastic opportunity to network with colleagues from all over the world,” said Ozyer, quality auditor, Wakefield Emergency Operations Centre, YAS. “It’s the perfect environment to have healthy debate among other professionals and pick up fresh, new ideas for the dispatch center.”
And if it’s a person of few words you’d like to ask, there’s EMAS Control Training Officer Jonathan Pearson.
“I found it enjoyable and we learned something,” he said.
True EOC Ambassador
Fiona Dinkel was the EMD answering the 9-9-9 call placed by a husband whose wife was alerting him to the visible slippage of their baby’s umbilical cord through the birth canal during her early stages of active labor (prolapsed cord).
“The couple was home, and she had just gotten out of the shower,” said Louise Ganley, PDC clinical support representative. “Fiona started giving instructions (PAIs) but they couldn’t relocate the baby.”
According to the nomination submitted by Yorkshire Ambulance Service (YAS)Quality Auditor Linden Horwood, Dinkel’s call signified one of the “truly rare instances whereby AMPDS™ directs the EMD to ‘Clarify & Reassure’—only to repeat the same panel.”
Takes a team
While still on the call and unbeknownst to the caller, Dinkel liaisoned with her EMD supervisor and the supervisor contacted the hospital’s midwifery unit. Without any signs of nervousness, she used her “outstanding protocol knowledge” to navigate through the appropriate Protocol F: Childbirth – Delivery panels and the midwife’s instructions, which duplicate the positioning of a pregnant female (lay her on her left side with a pillow wedged behind her lower back) already found in Protocol C: Airway/Arrest/Choking (Unconscious) – Adult ≥ 8Yrs and the Post-Dispatch Instructions (PDIs) of Protocol 12: Convulsions/Seizures.
Dinkel also incorporated instructions from the midwife at the hospital; this enhancement to Protocol F was later submitted to the Academy through the Proposal for Change process.
Dinkel handed over patient care to the crew arriving on scene, providing them with an update. The baby was later delivered in the hospital.
“She was amazing,” Ganley said. “Brilliant. She was able to calm the mother and father, which is so important when callers need to do what you are instructing.”
Dinkel had few words to say when accepting the award.
“She was really pleased,” Ganley said. “She thanked everybody and said that the award was not only about her. It was about her team.”