院外急救呼叫受理时间及影响因素分析

Emergency medical dispatch accepting interval and correlation factors of pre-hospital emergency medical center in Qingdao

目的调查青岛市各区(市)调度指挥中心呼救受理时间,探讨其影响因素。方法使用研究者自行设计的调度指挥中心一般情况问卷、调度员调查问卷,同时自调度系统数据库提取2016年1-12月调度员工作情况统计表对青岛市区和所辖区市共五个调度指挥中心68名调度员的呼救受理时间和相关因素进行调查分析。结果青岛市各区(市)调度指挥中心呼救受理时间中位数77(65-175)8,其中受理-调度间期中位数69(62-74)s,调度后指导间期中位数5(3~99)s;使用MPDS系统的两个区(市)总体呼救受理时间中位数为183(155-214)s,其中受理-调度间期中位数72(67~79)s,调度后指导间期中位数102(86~143)s,n =29例;使用普通调度系统的三个区(市)呼救受理时间中位数为66(61~74)s,其中受理-调度间期中位数63(58~70)s,调度后指导间期中位数3(2~4)s,n=34例。不同的调度系统比较其呼救受理时间,受理调度间期和调度后指导间期差异有统计学意义(均P<0.05),Spearman相关分析,调度员白班在岗时长、语言沟通障碍、呼救者的配合海调度席服务人口、受理数与呼救受理时间的相关性具有统计学意义(均P<0.05);多元线性逐步回归分析显示调度系统(B=143.823)、呼救者的配合(B=-12.707).每调度席服务人口(B=-0.891)和是否对调度过程常规监测并纳入考核(B=9.607)为呼救受理时间的预测因素.结论加强调度过程质量控制,合理设置调度席位,注重调度员沟通技能的培训,是提髙急救调度指挥运行效率,保证调度质量的有效措施。

Objective To evaluate the Emergency medical dispatch (EMD) accepting interval of the pre-hospital emergency medical dispatch system in Qingdao, and analyze its correlation factors. Method The administrative leaders of the 5 medical emergency dispatching command centers of Qingdao were asked to answer a questionnaire on the basic facts thereof. The total 68 dispatcher were asked to answer a questionnaire on their own individual background, such as demographical factors, professional backgrounds, cooperation of the caller, familiarity with the geographical in formation, etc. Relevant data, such as number of telephones received, number of acceptances, number of ambulances dispatched, average pick up time, average dispatching time, etc. were remotely extracted from the database of the dispatching command system to develop the work efficiency statistical table. Results The general median acceptance time of the 5 districts was 77 (65-175) seconds, the acceptance-dispatch interval and the post-dispatch instruction interval were 69 (62-74) seconds and 5 (3~99) seconds respectively(n=63);The median acceptance time of the 2 districts using the MPDS was 183(155~214) seconds , the acceptance-dispatch interval and the post-dispatch instruction interval were 72(67-79)seconds and 102 (86~ 143)seconds respectively (n=29), and the median acceptance time of the 3 districts using the ordinary dispatching system was 66 (61~74)seconds , the acceptance-dispatch interval and the post-dispatch instruction interval were 63 (58-70) seconds and 3 (2~4) seconds respectively (n=34). There were no significant differences among the age, professional title, and word input speed of the dispatchers (all P <0.05).The service year, familiarity with the geographical information of the dispatcher were not correlated with the acceptance time (both P >0.05)."the different dispatching systems" were significant differences in the acceptance time , the acceptance-dispatch interval and the post-dispatch instruction interval (all P <0.05). the districts using the MPDS take more time than the other group in all the time interval. Being on duty for long hours, obstacle in language communication, whether the callers were cooperative, number of people a dispatcher provided service to, and number of acceptance were all correlated with the acceptance time (all P<0.05).the cooperation degree of the callers and the number of population serviced per dispatcher are both negatively correlated to the acceptance time. Conclusion Monitoring of the efficacy of the dispatching service helps improve the dispatching work.