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Fla. Nurse Dispatcher Program Reduces Non-Emergent Transports

The News-Journal, Daytona Beach, Fla.

Accidentally cutting a finger while chopping vegetables, having an itchy eye or experiencing flu symptoms for the first time may feel like an emergency.

And quite often, people call 911 because they don't know what else to do. But many times, over-the-counter medication or a stop at an urgent care facility is all they need—not a trip to the hospital emergency room.

During the 2018-19 fiscal year, 44% of dispatched ambulances in Volusia County did not result in a transport to a local hospital because the patients did not require emergency assistance.

To prevent ambulances from being dispatched to non-emergency calls, Volusia County created the E-911 Redirect Nurse Triage Program.

"We want to optimize the systems," said Peter Springer, Volusia County EMS director. "We want to make sure we have ambulances for these serious 911 calls."

The program is staffed with seven part-time nurses from Halifax Health and AdventHealth in addition to one full time-nurse. They have all been trained as 911 operators and work in the same room as the full-time county 911 operators.

If a 911 operator determines the call isn't serious enough to send an ambulance, they will transfer the call to the nurses. The nurses will then ask a list of questions based on the injury or illness and either give caller home-care instructions, refer them to a doctor or, in some cases, dispatch an ambulance.

"We are not saying that we won't transport because if they request an ambulance we will send one," said Michael Vincent, Volusia County EMS clinical services manager. "And if they are on the border about sending an ambulance, they will always send the ambulance."

The program, which started Dec. 9 and runs from 7 a.m. to 7 p.m. Monday through Friday, diverted 20% of 911 calls in its first week. This helps to save the patient money, since an ambulance ride can cost a minimum of $500 to $600.

"It's not just savings on our side, but for patients, too," Springer said. "We're trying to educate the population on what is an emergency."

On average, the Volusia County EMS receives 1,000 calls a day. And while cities like Reno, Las Vegas, Fort Worth and parts of Canada have similar programs, Volusia County is leading the charge in Florida.

"Today's ambulances are mobile emergency rooms on wheels with clinicians highly trained to care for life-threatening emergencies," said Joe Pozzo, Volusia County's director of public protection. "Appropriately redirecting the mode of transport and destination of non-emergent patients to more appropriate facilities improves the availability of our clinicians and ambulances for those time- and life-critical emergencies and reduces unnecessary congestion in our emergency departments."

The program is projected to save the county money. The initial cost was $284,000, which included staff training and creating necessary software. The cost of two new ambulances, which county officials estimate they would need to purchase each year due to the rising number of 911 calls, is $520,000, or $260,000 each.

If the program proves to be successful, Volusia County EMS will look into hiring more nurses and expanding the hours of operation.

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