BOARD OF COMMISSIONERS 2/23/2015 304 E. Grand River Ave, Board Chambers, Howell, MI 48843 7:30 PM
AGENDA
1. CALL MEETING TO ORDER 2. PLEDGE OF ALLEGIANCE 3. ROLL CALL 4. CORRESPONDENCE 5. CALL TO THE PUBLIC 6. APPROVAL OF AGENDA 7. REPORTS
9-1-1 Central Dispatch - Report from Fitch & Associates, LLC 8. CLOSED SESSION
9-1-1 Central Dispatch - Confidential Report from Fitch & Associates 9. CALL TO THE PUBLIC 10. ADJOURNMENT
NOTE: The Call to the Public appears twice on the Agenda: once at the beginning and once at the end. Anyone wishing to address the Board may do so at these times. 12 February 2015
911 Central Dispatch Communications Review & Strategic Plan
Livingston County, MI 304 East Grand River Avenue Suite 204 Howell, MI 48843-2323
Prepared by:
FITCH & ASSOCIATES, LLC 2901 Williamsburg Terrace #G Platte City Missouri 64079 816.431.2600 www.fitchassoc.com
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Livingston County 911 Central Dispatch Communications Review & Strategic Plan
Table of Contents
I. EXECUTIVE SUMMARY ...... 5 A. FINDINGS ...... 5 Inadequate Staffing Compromises Dispatch Effectiveness ...... 5 FITCH and IOS Recommendations Are Comparable ...... 6 Hiring and Training Procedures Are Ineffective ...... 6 Published Reports Contain Few Meaningful Metrics of Performance ...... 6 Need for New 911 Central Dispatch Facility ...... 7 Serving Multiple Jurisdictions Is Challenging ...... 7 B. RECOMMENDATIONS ...... 7 Improve Dispatcher Hiring and Training ...... 7 Option 1 – Caller Centric Dispatch Model ...... 7 Option 2 — Responder Centric Dispatch Model ...... 8 Incremental Augmentation of Staff ...... 8 Improvements for EMS, FIRE, and LAW Dispatching ...... 9 Internal and External Reporting ...... 10 New Facility and Infrastructure Projects ...... 10 Implementation Schedule and Costs ...... 10 II. METHODOLOGY ...... 11 A. INFORMATION GATHERING ...... 11 B. DATA GATHERING /A NALYSES ...... 12 III. BACKGROUND ...... 12 A. AREA DEMOGRAPHICS ...... 12 B. LIVINGSTON 911 CENTRAL DISPATCH PROCESSES ...... 15 Current Dispatch Practices ...... 16 Current Dispatch Operations ...... 16 C. APPLYING BEST PRACTICES /A CCREDITATION ...... 17 Measuring Customer Service...... 18 D. LIVINGSTON 911 CENTRAL DISPATCH INFRASTRUCTURE ...... 23 Technology Issues And Infrastructure Needs ...... 23 E. DISPATCH CENTER GOVERNANCE ...... 24 911 Administrative Oversight Board ...... 24 Central Dispatch Leadership ...... 25 Personnel ...... 25 Stakeholder Groups ...... 27 First Responder Safety Issues ...... 28 Funding/Finance ...... 28 Consolidated Dispatch Centers ...... 30 IV. POLICE, FIRE AND MEDICAL DISPATCH NEEDS ...... 31 A. DIFFERENT DISPATCHER FOCUS ...... 31 B. 911 EMERGENCY CALL PROCESSES AND STANDARDS ...... 32 NFPA and NENA Standards ...... 33
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V. TREATMENT OF CAD DATA ...... 34 A. SUBSET OF FIELDS EXTRACTED FROM CAD ...... 35 B. DATA TRANSFORMATIONS ...... 35 C. SELECTION OF BASELINE PERIOD ...... 36 D. ERLANG -C ANALYSIS ...... 37 E. CALCULATION OF TIME INTERVALS FROM TIMESTAMPS ...... 38 F. VARIATION OF CALL COUNTS BY DAY OF WEEK AND HOUR OF DAY ...... 38 G. INCIDENT COUNT AND CALL TYPES ...... 40 VI. DISPATCH OPERATIONS ...... 44 A. FLOW OF 911 EMERGENCY INCIDENTS ...... 44 B. APPROACH TO ANALYSES /W ORKLOAD QUANTITATION ...... 45 VII. DESCRIBING CURRENT MODEL & RECOMMENDED OPTIONS ...... 46 A. CURRENT – VERTICAL DISPATCH MODEL ...... 47 B. OPTION ONE – CALLER CENTRIC DISPATCH MODEL ...... 47 C. OPTION TWO – RESPONDER CENTRIC DISPATCH MODEL ...... 48 D. DISTINCTIONS BETWEEN DISPATCH OPTIONS ...... 48 VIII. MODELING CURRENT OPERATIONS...... 50 A. RESPONDER CENTRIC OPERATIONS ...... 50 B. VERTICAL OPERATIONS ...... 51 C. COMPARISON OF CURRENT OPERATIONAL MODES ...... 51 IX. OPTIMAL STAFFING FOR RECOMMENDED OPTIONS ...... 52 A. OPTION 1 – OPTIMAL STAFFING FOR CALLER CENTRIC MODEL ...... 53 B. OPTION 2 – OPTIMAL STAFFING FOR RESPONDER CENTRIC MODEL ...... 54 X. COMPARISON WITH ISO RECOMMENDATIONS ...... 55
Table 1. Implementation Plan and Timelines ...... 10 Table 2. Estimate for New Communications and Emergency Operations Center...... 11 Table 3. Livingston County Change in Population Estimates for Aged 65 Years + ...... 15 Table 4. Summary of Functions Required to Handle A 911 Call ...... 17 Table 5. EMS Best Practices Applied to Livingston County 911 Central Dispatch ...... 18 Table 6. Common Themes In Agency Customer Satisfaction Surveys ...... 19 Table 7. Common Themes In Field Responder Surveys ...... 20 Table 8. Requirements for IAED Dispatch Center Accreditation ...... 22 Table 9. Principles of CALEA Public Safety Communications Accreditation...... 23 Table 10. Central Dispatch Budget Changes 2014 to 2015 ...... 29 Table 11. Central Dispatch 2015 Budget Request for Additional Resources ...... 29 Table 12. NFPA 1221 Dispatch Standards ...... 34 Table 13. NENA Call Taking Operational Standards ...... 34 Table 14. Response Functions by Date Ranges ...... 37 Table 15. Sample Record of Manual Incidents Consolidated by Hour of Year CY 2012 ...... 38 Table 16. Combined Fire+EMS+LAW Incident Counts by Day-of-Week for CY2012...... 39 Table 17. Livingston County 911 Incident Records and Response Function for CY 2012 ...... 41 Table 18. Components of Total Dispatch Workload ...... 46 Table 19. Allocation of Functions to Personnel: Vertical, Options 1 and 2 ...... 48 Table 20. Distinctions Between Options – Advantages and Disadvantages...... 49 Table 21. Erlang Analyses of Dispatch Workload With Current Staffing In The Responder Centric Dispatch Model...... 50 Table 22. Optimal Staffing for Option 1 – Caller Centric Dispatch Model ...... 54 Table 23. Optimal Staffing for Option 2 – Responder Centric Dispatch Model ...... 55 Table 24. ISO Call Volume Matrix ...... 56
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Figure 1. Livingston County Township Map With 2010 Population...... 13 Figure 2. Livingston County Major Transportation Corridors ...... 14 Figure 3. Livingston County 911 Central Dispatch Organization Chart ...... 26 Figure 4. Flow of A Typical EMS Incident– Caller and Responder Perspective ...... 33 Figure 5. Flow of A Typical Emergency Incident – Dispatch Center Perspective ...... 33 Figure 6. Sample Record Containing Data Fields Exported From The Livingston CAD ...... 36 Figure 7. Average Call Counts & Standard Deviation by Day for Combined FIRE, EMS, LAW Incidents ...... 40 Figure 8. Distribution of Processing Times for All Manual Incident Records CY2012 ...... 42 Figure 9. Distribution of Processing Times for FIRE Manual Incident Records CY2012 ...... 43 Figure 10. Distribution of Processing Times for EMS Manual Incident Records CY2012 ...... 43 Figure 11. Distribution of Processing Times for LAW Manual Incident Records CY2012 ...... 44 Figure 12. Flow Of An EMS Incident – Perspective of Caller and Field Responders ...... 45 Figure 13. Flow Of A 911 Incident – Perspective of Dispatch Center ...... 45
ATTACHMENTS: A – EMS Call Evaluation Process B – EMS Functions by Fire Agencies C – Erlang-C Mathematics and Assumptions D – CAD Time Interval Definitions E – FIRE + EMS + LAW Call Counts by Hour of Day F – Quantitation of Workloads G – Personnel Functions by Operational Models H – Erlang Analysis: Models of Current Operations I – Erlang Analysis: Option 1 - Caller Centric Model J – Erlang Analysis: Option 2 - Responder Centric Model
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I. Executive Summary
In the fall of 2014, Livingston County engaged Fitch & Associates (“ FITCH ” or “Consultant”) to conduct an assessment of Livingston County 911 Central Dispatch (“Central Dispatch”) and develop a blueprint for the next several years. Primary objectives of the project are to conduct a comprehensive review of Central Dispatch including comparison to best practices, review of governance structure and evaluation of physical infrastructure, technology, information systems, personnel, and customer service. FITCH was asked to make specific recommendations, as needed, for improvement and provide a timeline to produce the recommended outcomes.
Central Dispatch is the only public safety answering point (PSAP) in Livingston County. As a consolidated dispatch center, it provides service to multiple jurisdictions with fire, emergency medical services (EMS), and law enforcement agencies. The Center faces a number of challenges including aging infrastructure, aging technology, and inadequate staffing. One of the bright spots is the recent change in management with its proactive approach and “get it done” attitude. The challenge faced by the new team is that needed improvements will require multiple years to be accomplished.
The Consultant interviewed system participants and stakeholders, gathered and analyzed data, developed options for optimal dispatch operations, and the staffing required for each option. Central Dispatch technology and physical plant infrastructure were reviewed and compared to best practices. FITCH provided two options for Central Dispatch operations that include detailed models of operations and the staffing requirements for each. There are other operational options available, but the two recommended options are the most common delivery models in the industry. Findings, recommendations, options descriptions and a proposed implementation timeline are provided in the sections that follow.
A. Findings
Inadequate Staffing Compromises Dispatch Effectiveness The current on-duty staffing configuration for Central Dispatch is most often one team leader and three to four dispatchers. With this staffing configuration, Central Dispatch management aspires to implement a high quality “Responder Centric” dispatch model. In such a model, call takers assess the acuity of incidents and set response priorities for all disciplines, and dedicated radio operators assign units and provide radio support to a specific discipline - fire, EMS, or law.
Central Dispatch’s actual experience is that for most of any 24-hour period the current workload and staffing compels the use of a “vertical” mode of dispatch operations. This mode is the best accommodation to the understaffed condition that now exists. To the credit of the dispatch teams, they successfully maintain prompt pickup of incoming emergency calls under these conditions. To do so, the dispatch team leader must abandon lead functions and assume a task workstation. All team members must rotate through all aspects of the dispatch process - intake, assessment, assignment, and radio support, on an ad hoc basis. All team members must be proficient in all four dispatch functions for each of
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the three disciplines. This contributes to a high-stress working environment that likely makes employee retention more difficult.
In the vertical mode, radio support is routinely interrupted and curtailed because answering the next incoming 911 call must be given priority. This puts field responders in jeopardy as they require reliable radio support in order to effectively deliver emergency service and maintain a safe environment. FITCH and IOS Recommendations Are Comparable The recommended size of the dispatch team in this report conforms to the Insurance Services Office (ISO) Call Volume Matrix for public safety answering points that perform call taking and dispatching. According to the ISO, the number of incidents flowing through Livingston County 911 Central Dispatch should require a dispatch team, “on duty and awake,” of one supervisor plus seven dispatchers. FITCH recommends a dispatch team of one supervisor plus nine dispatchers.
The difference between the FITCH and ISO recommendations arises from two sources. The FITCH numbers are based on detailed models incorporating data specific to Livingston County. In contrast, the ISO numbers are nationally generic. In addition, the FITCH numbers provide for on-shift relief staffing as team members rotate from being “on-duty” to being “on-break” during their 12-hour shifts. Also, ISO does not account for the differences in disciplines between FIRE, EMS, and LAW. Call taking for law enforcement incidents is more time consuming than for other disciplines. Hiring and Training Procedures Are Ineffective For the 12-month period ending June 27, 2014, there were 13 dispatcher applicants who completed the hiring process and were offered employment. Of the 13, only two have completed initial training and remain on the job after four months. Most dispatch centers experience a dropout rate of about 50% of new hires. Livingston’s new hire dropout rate for 2014 was 85%. There is sentiment that the current training program and supervision is seriously lacking. Workload factors are likely to also contribute to the dismal retention of new employees.
The hiring and training procedures are so ineffective that maintaining the current level of staffing is problematic in the face of normal attrition. Given the current experience, the ability to increase the current level of staffing will be challenging. Published Reports Contain Few Meaningful Metrics of Performance Formal reporting is not robust and provides little to no meaningful performance measures. Time intervals are available in the Computer Aided Dispatch (CAD) system that would quantitatively define dispatch performance, yet there appears to be no reporting of internal performance other than how quickly a 911 call is picked up. There should be regular reporting of all time intervals from call pickup to the close of a call for the system as a whole. A graphic representation of the time intervals of a 911 call is presented in the Police, Fire, and Medical Dispatch Needs section of this report.
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Need for New 911 Central Dispatch Facility The need for a new 911 facility and several other areas for concern are discussed in a separate document titled “Confidential Public Safety Appendix”. Serving Multiple Jurisdictions Is Challenging Central Dispatch provides services to 22 separate governmental agencies and has little authority to impose procedural consistency. The most important shortcoming from an operational standpoint is that Central Dispatch does not have authority to assign the physically closest unit as responder to an incident. The system operates with hard boundaries, and thereby makes the assignment of a response unit take additional time.
B. Recommendations
Two principle metrics drive staffing levels in dispatch centers:
1. The number of incidents per unit of time (call volume) that flow through the dispatch center, and 2. The performance level that the dispatch center is expected to achieve.
Call volume is an external metric that is imposed upon the dispatch center, while expected performance is a matter of local policy. Decisions regarding what performance level to strive for should be thought of in the context of fiscal responsibility that is, balancing what the community can afford with what the community expects.
In order to develop the models presented in this report, FITCH used high performance standards that are published by NENA (National Emergency Number Association) and NFPA (National Fire Protection Association). Meeting these high performance standards will require increases in staffing over current levels. The two options that FITCH developed for Livingston County 911 Central Dispatch should be interpreted as maximum performance levels and maximum staffing levels.
FITCH recommends that Central Dispatch adopt Option 1 – Caller Centric Dispatch Model. Both options are summarized below and developed in detail throughout the report. Both options require additional personnel. The report section titled Distinctions Between Dispatch Options explains the advantages and disadvantages of the two options. Other recommendations that will support management’s efforts to improve effectiveness are also provided in the report. Improve Dispatcher Hiring and Training The procedures for hiring and training dispatch personnel must be reviewed in detail to determine why the throughput of the process is so far below national experience. The procedures must be changed so that hiring and retention become more effective. Option 1 – Caller Centric Dispatch Model The composition of the dispatch team presented below is for a dispatch team organized to function using a “caller centric” mode of operations.
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1 Supervisor 2 Call Intake Specialists 1 FIRE Dispatcher/Radio Operator 2 EMS Dispatchers/Radio Operators 4 LAW Dispatchers/Radio Operators (1 with LEIN 1 responsibilities)
This dispatch team has only two call intake specialists and three types of dispatchers/radio operators, each specialized by discipline. The role of the call taker is similar to that done in independent 911 centers: to open an incident record in the CAD and to determine only if a caller requires a fire, emergency medical or law enforcement response function. Once that is established, the incident record and caller are internally transferred to the specialized dispatcher/radio operators. Thus, the assessment of acuity of the incident is conducted between the caller and a dispatcher/radio operator who specializes in a single discipline, FIRE, EMS or LAW. The dispatcher/radio operator then sets a priority of response for the incident and assigns the response unit(s). Radio support to field responders as the incident progresses is provided by this dispatcher/radio operator. The supervisor is to assume only supervisory and quality assurance functions. Option 2 — Responder Centric Dispatch Model The composition of the dispatch team presented below is for a dispatch team organized to function using a “responder centric” mode of operations.
1 Supervisor 3 Call Intake Specialists 1 FIRE Dispatcher/Radio Operator 2 EMS Dispatchers/Radio Operators 3 LAW Dispatchers/Radio Operators (1 with LEIN responsibilities)
In this organization, there are three call takers and three types of specialized radio operators, fire, EMS, and law. The role of the call taker is to open an incident record in the CAD, to determine if a caller requires a fire, emergency medical, or law enforcement response function, to assess the acuity of the incident, and to set the priority of response. Thus, the acuity of the incident is conducted between the caller and a call taker who must be proficient in assessing acuities for all three disciplines. The incident record is internally transferred to the specialized radio operators for assignment of the response unit(s). Radio support to field responders as the incident progresses is provided by this radio operator. The supervisor is to assume only supervisory and quality assurance functions. Incremental Augmentation of Staff The increase to the size of the dispatch team to implement either Option 1 or Option 2 can be approached incrementally. As new dispatch personnel are hired and trained, they should be added to the existing dispatch teams as soon as possible.
At intervals of low workload, the organization of dispatch operations should conform to the recommended Option 1 - “Caller Centric” model. Until the dispatch teams are brought to recommended staffing levels, intervals of high workload will continue to overwhelm
1 Law Enforcement Information Network
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operations. During these intervals, operations must revert to a “vertical” model in which specialization is abandoned and everybody does everything in order to focus on picking up the next 911 call as the priority.
As the dispatch team approaches the recommended staffing levels, the intervals of overwhelming workload and a “vertical” model of operations will become less frequent. Finally, operations will be conducted using only the recommended Option 1 - Caller centric” model or the Option 2 – Responder Centric model.
Central Dispatch’s 2015 budget includes $405,345 to fund six positions at approximately $68,000 per position. Management estimates that the time required to hire and train personnel in all functions requires at least nine months. The number of trainees that can be handled at one time is between four to six individuals. Given the hiring and training timelines and training capacity, full implementation of either Option 1 or Option 2 will optimistically span budget years 2015 through 2017. Annual budgeting for six positions is a reasonable assumption going forward. Improvements for EMS, FIRE, and LAW Dispatching
Medical Dispatch ProQA is a formalized system of attaching acuity determinants to EMS incidents. This is meant to be a starting point for consistently setting response priorities. A formal system that connects incident acuity to response priority serves to mitigate legal liability. It is the intent of the Medical Priority Dispatch System that response priorities, ALS – BLS, Hot – Cold, engine only, etc ., remain a local decision, in this case to remain with Central Dispatch. The matrix of Livingston response priorities and ProQA determinants will need to undergo a formal review.
For the handling of emergency medical incidents, FITCH recommends that the Livingston County 911 Central Dispatch achieve accreditations by the International Academies of Emergency Dispatch (IAED) within three years.
Law Enforcement Dispatch The Livingston County 911 Central Dispatch should achieve accreditation through the Public Safety Communications Accreditation Program for dispatch of law enforcement incidents within three years. The Commission on Accreditation administers this program for Law Enforcement Agencies, Inc. (CALEA). This goal should be accorded the highest priority.
FIRE Dispatch Livingston County should explore methods to gain increased control of response size and response priorities to fire incidents by local jurisdictions. The current protocols for managing responses to fire incidents put the allocation of fire suppression resources under the control of the local jurisdictions and not Central Dispatch. This structure precludes implementation of a Fire Priority Dispatch System because Central Dispatch has no mechanism that ties either response size or response priority to incident acuity.
This goal is subordinate to improvements in medical and law enforcement dispatch because of the small number of fire incidents in Livingston County.
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Internal and External Reporting It is highly recommended that Central Dispatch produce monthly internal reports that indicate the overall performance of the agency and at the level of individual employee. Periodic reporting will allow management to identify problems and accomplishments as changes are implemented. Formal performance reports should be provided to the Administrative Oversight Board at least quarterly. New Facility and Infrastructure Projects Central Dispatch’s 2015 budget includes $1.5 million for capital projects that address some immediate needs. However, it is most urgent that the County initiate plans for a new emergency communications and operations center to replace the current facility. This is a major project that will cost between $3.9 and $4.9 million and will require at least two years for planning, design, and construction. Some form of financing will be necessary to fund the project. Other infrastructure needs that the Consultants found noteworthy are included in a separate document titled “Confidential Public Safety Appendix”. Implementation Schedule and Costs Table 1 below presents an overview of the major implementation items covered in this report and indicates estimated timelines.
Table 1. Implementation Plan and Timelines Year Year Year Year Year Implementation Items Priority 1 2 3 4 5
Staff Call Takers increased to recommended count 1 Radio Operators increased to recommended count 1 Supervisors increased to recommended count 1 Accreditations, NENA and NFPA standards achieved 2 Technology Make current telephone system functional 1 Add consoles for new staff 1 Replace existing radio system 2 Replace CAD 3 Infrastructure Backup Center - see Confidential Public Safety Appendix 1 Other projects – see Confidential Public Safety Appendix 1 Construct purpose built Dispatch Center 3
The most challenging project for Central Dispatch is funding and building a new communications center that will house both emergency communications and the emergency operations center. Table 2 below is an estimate of the cost for a 12,000 square foot facility. Costs are best estimates based on Consultants immediate experience assisting in the build out of the same type of facility.
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Table 2. Estimate for New Communications and Emergency Operations Center Description Estimate Construction: 12,000 sq. ft. @ $200/sq. ft. $2,400,000 Specialized workstation, dispatch furniture and general furniture and fixtures $515,600 Radio system computers, PC monitors, phone system, servers and licensing, IT $1,023,400 connectivity Total Estimate $3,939,000
Building space and dispatch configuration is designed to serve Livingston County for at least two decades and assumes between 11 and 18 dispatch personnel.
The annual cost of phasing in of additional dispatch personnel year over year will range from $400,000 to $450,000. Retaining employees through the training and probationary processes has been a significant challenge for Central Dispatch in past years and will define the pace of improvement.
II. Methodology
The project’s goal is to provide actionable recommendations that address policy and operational issues concerning emergency fire, EMS, and law enforcement call dispatching. The report is designed to inform policy makers of current conditions and provide options for a future strategic roadmap. To achieve that goal, FITCH employed an evidenced based methodology to conduct an objective assessment and develop a clear baseline.
While the project focuses on Livingston County 911 Central Dispatch, it was necessary to develop an understanding of all of the organizations that influence the 911 call and dispatch process in Livingston County. FITCH accomplished this through a multi-step information gathering and analysis process.
A. Information Gathering
The Consultant team used a multi-pronged approach for this project that included on-site interviews with a broad spectrum of stakeholders. In all, approximately 30 individuals were interviewed from six law enforcement agencies, four fire agencies, County administration, County EMS agency, Central Dispatch Administrative Oversight Board and Central Dispatch. Members of the Board of County Commissioners were interviewed and a formal presentation was made to update the Board as the project progressed. Consultants toured the County EMS and Central Dispatch Center facilities. Consultants also observed Central Dispatch Center operations. A number of themes emerged from the interviews. While anecdotal in nature, the themes provide an understanding of the issues and concerns of key stakeholder groups. The major themes are noted below:
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Concerns regarding Central Dispatch staffing, workload and training Inconsistent dispatch policies and procedures across agencies/jurisdictions; adds to dispatch process complexity Need for a comprehensive workgroup to implement solutions Physical infrastructure lacking; functional backup center needed Concerns that certain procedures and practices endanger responder safety Technology needs upgrading in multiple areas Data from CAD and reporting capabilities are not functioning well Need to fully utilize Medical Priority Dispatch System particularly in assigning call priorities and implementing meaningful quality assurance reviews
Central Dispatch staff received an extensive Information and Data Request tool that provided Consultants with written policies, procedures, organizational structure, equipment, budgets, administrative reports, evaluation processes, training records, and other pertinent documents.
B. Data Gathering/Analyses
The Consultant reviewed a three-year extraction of primary data from the 911 Central Dispatch Computer Aided Dispatch (CAD) system. No primary phone or radio data was made available. However, certain Cassidian Aurora phone reports served to fill these gaps.
The Consultant used the amended CAD data and in some cases experienced based knowledge to conduct analyses of workloads for incident processing, nuisance/no response calls, outgoing calls, and radio traffic. Erlang-C methodology utilized available workload data and then projected optimal staffing numbers needed to ensure 911 call processing at high performance levels. Complete details of the analytics are presented in the section titled Treatment of CAD Data and in attachments that are referenced in the text.
III. Background
A. Area Demographics
The Livingston County jurisdiction covers 585 square miles. The estimated 2013 population is 184,443, and the population is projected to grow to 192,116 by 2020.2 The County is located within commuting distance of several metropolitan regions including Ann Arbor, Lansing, and northwest Detroit suburbs of Oakland County.
There are 16 townships, two cities, and two villages within County boundaries. Much of Livingston County is rural and agricultural land. Figure 1 below is a map of Livingston County indicating townships, villages, and cities.
2 US Census QuickFacts, 2013 estimated July 2, 2014 population,
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Figure 1. Livingston County Township Map With 2010 Population
Half of the County’s estimated 2013 population resides in the five townships located in the County’s southeastern quadrant, namely, Hartland, Genoa, Brighton, Hamburg, and Green Oak Townships. I-96 and US 23 are major transportation corridors in Livingston County and are depicted in Figure 2 below.
Livingston County 911 Central Dispatch Page 13 of 57 ©Fitch & Associates, LLC Communications Review & Strategic Plan 12 February 2015 Figure 2. Livingston County Major Transportation Corridors
Total population is projected to increase to approximately 192,116 by 2020 and to 204,700 by 2030, an increase of approximately seven percent from decade to decade. 3
The area enjoys continued, steady population growth and above average income levels. Median income for Livingston County is relatively high compared to other areas of the US. Within the individual townships, the median income ranges from a high of $93,300 to a low of $41,700. Median household income within the County as a whole for the period 2008-2012 is $72,396 as compared to US median household income $48,471 for the same period.
In 2013, the US Census estimates that 14.1% of Livingston County’s residents are 65 years of age or older. The percentage is comparable to 15.0% nationwide for the same age group. Long-range projections indicate that Livingston’s 65+ age group will continue to grow. The County’s Comprehensive Economic Development Strategy (CEDS) plan for 2014-2018 references efforts to expand facilities and infrastructure to encourage seniors to remain in Livingston County and for others to retire there. The same document estimates a significant
3 Livingston County Department of Planning, Profile Document prepared July 2012,
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increase in residents who are aged 65 to 75 years old and older by the year 2040. Table 3 below summarizes the data from the CEDS.
Table 3. Livingston County Change in Population Estimates for Aged 65 Years + 4 As % of Total 2040 As % of Total 2010 US Census Census 2010 SEMCOG 5 Estimates SEMCOG Total Residents 75 8,626 4.8% 21,967 10.2% Years+ Residents 65+ 21,644 12.0% 55,399 25.8% Years & Older All Ages Total 180,967 214,323
By 2040, Livingston residents aged 65 years and older are estimated to make up at least one- quarter of the total County population. As a percentage of the total, this age group will have doubled. More striking is the increase in the age group 75 years and older; this group more than doubles and will make up at least 10% of the population. At the same time, the age group from 35 to 59 years declines by 9%.
The impact of the projected population shifts will have its greatest impact on demands for emergency medical services. Studies in other areas of the US show that the 65+ age cohort originates emergency medical incidents at twice the rate of all other age cohorts put together. The demand for emergency medical services in Livingston County will grow faster than the growth in absolute population.
B. Livingston 911 Central Dispatch Processes
Livingston County 911 Central Dispatch Center is a consolidated fire, EMS, and law enforcement emergency communication center servicing 22 agencies: nine fire, 12 law enforcement, and one EMS agency. Central Dispatch’s service area covers approximately 585 square miles and includes a combination of urban, suburban, and rural development.
Consolidation of 911 functions for the multiple agencies across the County benefits the community in that economies of scale are realized. Additional benefits are enhanced coordination, interoperability and consistent communications equipment and technology.
A consolidated center serving multiple agencies and jurisdictions faces specific challenges. For example, Livingston County has no authority to mandate that other jurisdictions implement vehicle location systems to a common standard. Some response vehicles are equipped with automatic vehicle locations systems (AVL) and global position systems (GPS) and other response vehicles are not. Even if the physical locations of all response vehicles were known in real time, Central Dispatch does not have the authority to dispatch the closest resource to an incident.
4 Livingston County, Michigan, Department of Planning, Comprehensive Economic Development Strategy (CEDS) 2014-2018, pages 48-50. April 2014 5 SEMCOG: Southeast Michigan Council of Governments
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All emergency vehicles should be equipped with GPS so as to supply the most accurate location of responders. This is best practice from a patient centered and field personnel safety perspective. Current Dispatch Practices
Assigning Fire Response Units Currently, Central Dispatch notifies the fire station that is closest to the incident. The notification is repeated once to assure receipt. Fire personnel acknowledge receipt of the notification back to Central Dispatch and specify the unit(s) that will respond and the number of personnel on board.
Assigning EMS Response Units To assign an EMS response unit, Central Dispatch checks the automatic vehicle location system and notifies the closest EMS unit. To assign a fire unit to an EMS incident, Central Dispatch checks the emergency medical dispatch code for the incident and then notifies the closest available fire department that is capable of handling the incident.
Assigning Law Response Units LAW agencies in Livingston County require Central Dispatch to “bid” incidents to law responders. The incident is broadcast over the radio to see which law unit(s) decides to respond. When a law unit acknowledges acceptance of the incident, the unit information is then added to the incident record in the CAD. This “bidding” procedure persists even though every law response unit is currently equipped with AVL and thereby Central Dispatch knows, in real time, which available law response units are physically closest to the incident. This process is currently being modified to best practice and will be implemented before the end of the year.
A related “bidding” procedure applies to law participation in EMS incidents. In certain jurisdictions, Central Dispatch is required to announce all EMS incidents to the law responders. Participation by the law responders is at their own discretion.
Both of these processes should be changed to reflect a more contemporary approach to dispatch. Current Dispatch Operations Dispatch operations describe the way the dispatch staff is organized to execute the functions required to respond to a request for emergency services. These functions are presented in Table 4 below.
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Table 4. Summary of Functions Required to Handle A 911 Call Summary of Dispatch Functions Call pickup Determine fire, EMS, and/or law discipline(s) Assess acuity of incident Set priority of response Assign response unit(s) Notifies fire agency with jurisdiction Dispatches EMS and/or fire agencies to EMS incidents “Bids” incident to law agencies Provide radio support and communication with field unit specific to the incident Complete documentation and close incident in CAD
The staff at the Livingston County 911 Dispatch Center aspires to implement a “Responder Centric” model for the organization of dispatch functions. In such a model, there are call takers who assess acuity of incidents and set response priorities for all disciplines, and radio operators who each assign units and provide radio support to a specific discipline - fire, EMS, or law.
The workload flowing to the Central Dispatch routinely overwhelms the currently available staff. In response, the dispatch staff implements a “Vertical” model for the organization of dispatch functions, whereby everyone rotates through doing everything on an ad hoc basis. Specialization by discipline of call intake, dispatch, and radio support functions is abandoned. Answering the next incoming 911 call has priority. Radio support to field responders of ongoing incidents is curtailed.
In taking this approach, the dispatch staff succeeds in maintaining a very high percentage of immediate answers on the next incoming 911 call. However, field responders are acutely critical of the deterioration of their radio support because it can seriously compromise responder safety during an incident in progress, especially for LAW and FIRE incidents.
C. Applying Best Practices/Accreditation
Central Dispatch does not periodically extract formal performance metrics from the CAD. This precludes measurement as being the prelude to improved performance. Consultant site visits revealed the absence of a random emergency call review process or feedback. Call review appears to occur only after a complaint is received.
Between January 1 and September 5, 2014, the historic CAD logs the dispatch of 18,242 emergency medical incidents. Of these, 10,661 were the result of call ring-ins and the remaining 7,581 were either auto-generated or self-initiated. The Consultants could not determine whether Central Dispatch reviewed any of these incidents. There is no method available to determine whether established protocols for call processing and dispatch were followed consistently.
Attachment A is an example of EMS Call Evaluation Process. The example is from a 911 Public Safety Answer Point that is in the process of attaining their fourth Accredited Center of Excellence award for emergency medical dispatching.
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Central Dispatch leadership recognized the need for Continuous Quality Improvements and in November 2014 the County hired a Continuous Quality Improvement supervisor. As a benchmark, Table 5 below lists the 11 practices that are recognized in the dispatch industry as best practices. Each has been designed as Yes, No or Partial and applied to 911 Central Dispatch operations.
Table 5. EMS Best Practices Applied to Livingston County 911 Central Dispatch Best Practice Livingston County 911 Central Dispatch 1. Call intake primarily done PARTIAL – Depending on workload call taking is done by all. by a call taker
PARTIAL – No fire or law enforcement based call taking protocols are 2. Protocol based call taking used. MPDS is strong.
3. Quality assurance program with calls reviewed NO – No quality assurance program for fire, EMS, law for call taking accuracy 4. External oversight YES – Independent medical director for EMS dispatch
5. Time measurements and NO – There are no performance reports for call processing time reporting. intervals for either the system or individual dispatchers 6. Computer aided dispatch YES – Geospatial capabilities (CAD) with mapping 7. AVL/GPS, automatic vehicle location, global PARTIAL – See separate “Confidential Public Safety Appendix” positioning system 8. Mobile data terminal or computer communication PARTIAL – See separate “Confidential Public Safety Appendix” with CAD 9. Radio Interoperability PARTIAL – See separate “Confidential Public Safety Appendix” with all responding agencies YES – Web based Medical Priority Dispatch System 24 hours every 2 10. Prescribed continuous years and web based Police Legal Services training; however, training for call takers dispatchers are EMD certified 11. Dispatch SOP, standard NO – Training materials for new personnel are not up to date. SOP and operating procedures up to standards are not up to date and are difficult to find date
Of the 11 best practice items above, Livingston Central Dispatch is affirmative for three and either does not meet or partially meets best practice for the remaining eight areas. Measuring Customer Service Dispatch centers are, in most instances, sole service providers. Nevertheless, meeting performance expectations and providing excellent customer service are hallmarks of high performance organizations. Customer/client stakeholders include the community, field responders, communications center personnel, and elected and appointed officials in the agencies served.
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High performance organizations seek out extensive means to measure customer service. The result is a comprehensive snap shot of how well the organization is attaining excellence in customer service.
Internal and external evaluations of performance and customer service should evaluate:
Transparency of operations Customer satisfaction Good reputation Recognition High conformance to standards
The means to evaluate customer service can include, surveys, evaluations, quality improvement practices, documented expectations, stakeholder meetings, and community outreach programs. Social media is a more recent tool used by many organizations to assess customer satisfaction.
Measuring Community Satisfaction The most common means by which emergency communication centers measure community satisfaction is through direct mailers, emails, and agency website surveys. The most common method to solicit customer experiences is through Customer Satisfaction Surveys accessible from the agency’s website. These are typically targeted at callers and the public who may have called 911 at some point in time.
Table 6 below indicates the major themes of community surveys.
Table 6. Common Themes In Agency Customer Satisfaction Surveys Themes of Agency Customer Satisfaction Surveys Number of times the caller called 911 within the Date and time of call last 6 to 12 months Promptness in answering the phone Competency Communicating clearly and effectively Courtesy Attitude Overall Satisfaction Communicated to you what to expect next Rating overall professionalism of the Call Taker Overall knowledge and understanding of Did the 911 operator or dispatcher thank you for the 911 operator the information you provided? The instructions or information I was given The dispatcher was calming and gave appropriate were clear and concise directions Would you like to be contacted to discuss Comment area for how service could be improved this information further? Quality Response Options Agreement Response Options Excellent Strongly Agree Good Agree Adequate Some What Agree Poor Strongly Disagree Unacceptable Not Applicable
Central Dispatch offers several outreach programs that involve and educate school children and residents. The programs are a platform to inform the populace about Central Dispatch’s
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services and better inform their expectations. The community and Central Dispatch would be well served to continue and even expand the outreach programs.
Field Responder Surveys Measuring customer service between the communications center and field responders provides an additional perspective of performance/customer service. Online surveys accessible to all first responders are a critical means for managers to hear about process, technology, or personnel issues. Management must not only provide a survey platform, but also promptly review survey answers and seek to resolve common issues that are identified in the surveys. Both components are essential – offering a survey that is not monitored can create more ill will than not providing one at all.
Table 7 below provides examples of common themes in field responder surveys.
Table 7. Common Themes In Field Responder Surveys Themes of First Responder Surveys How would you rate the overall service level As a user of the center, describe your interactions provided to citizens calling your dispatch with dispatch personnel center Dispatch policies and procedures are The dispatch center understands the information consistently applied requirements of field personnel Generally the information we receive about The dispatch center has adequate staff to handle calls is correct existing workloads When problems arise between the The communication equipment and information communication center and field units, they systems utilized by dispatch increase our are resolved quickly efficiency Radio dispatchers processing telephone
calls hampers our operation Quality Response Options Agreement Response Options Excellent Strongly Agree Good Agree Adequate Some What Agree Poor Strongly Disagree Unacceptable Not Applicable
In addition to online surveys, regular (suggest monthly) meetings between field responders and communication center management can mitigate the majority of the issues. Regular meetings provide a forum for resolution of the issues identified in the surveys and reinforce the idea that the survey comments result in action. Field responders are thus encouraged to continue use of the online survey tool.
Dispatch Personnel A consistently applied Quality Improvement program in the dispatch center is considered a “best practice” to determine both conformance to protocol and measure customer service as provided to the community and field responders. Random telephone and radio audits of first responder interactions with dispatch personnel provides additional customer service measures.
Central Dispatch’s Medical Priority Dispatch System (MPDS) medical call evaluation
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addresses the compliance to protocol and customer service. The International Academies of Emergency Dispatching (IAED) provides a sliding scale of the number of calls to be reviewed based on medical call volume.
Using IAED’s guidelines, Central Dispatch should review approximately 1,300 cases annually or 25 medical calls per week. Central Dispatch recently created a Quality Improvement position to assist in measuring compliance to protocol. Establishing this position should result in measuring the customer satisfaction levels associated with medical incidents.
Recommendations For A Customer Service Program Recommendations to measure and improve Customer Service include:
The creation of a Customer Satisfaction Survey on the Central Dispatch website o Communicate with the agencies served to encourage users to complete the surveys o Establish a regular forum between Central Dispatch management and field agency management for the review of issues identified in both the surveys as well as issues obtained from other means Review at least 25 medical calls per week for protocol compliance and customer service levels Document and report results of Central Dispatch performance and customer service outreach at least quarterly (annual reporting is not sufficient) Publish performance and customer service levels in the annual report Stress customer service during the initial and continuing education training of dispatch personnel Create a Customer Bill of Rights to include the following expectations for callers: o Answer the call in a timely manner o Treat them fairly, impartially, courteously and respectfully o Hear and understand them o Give them a turn to speak and listen actively when they do o Show a degree of empathy o Have tolerance for a lack of understanding o Process their call quickly and effectively o Provide an explanation of the processes (i.e., delays, non-response calls, confirmation of response or action that will be taken, referrals, etc.) o Provide an avenue for making complaints if needed o Terminate their calls courteously
As a compliment to a customer service plan, there are several accreditation programs designed to enhance dispatch center operations and move them to excellence. Two of these are discussed below. IAED Accreditation For the handling of emergency medical calls, best practice dispatch centers strive for accreditation by the International Academies of Emergency Dispatch (IAED). Complete adherence to ProQA and the Medical Priority Dispatch System are hallmarks of accreditation. Table 8 below displays the requirements to be described as part of the IAED Dispatch Center Accreditation process. FITCH highly recommends that Livingston Central Dispatch seek to
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meet these requirements and set a goal for accreditation within the next three years.
Table 8. Requirements for IAED Dispatch Center Accreditation 6 Formally describe and document the following – 1. All medical dispatch call-taking, dispatching, and supervisory workstations. 2. Current Advanced Medical Priority Dispatch System (MPDS) licensing of each EMD position. 3. Current Academy certification of all EMD personnel. 4. How Academy certifications and case review will continue to be maintained. 5. Full activity of Quality Improvement (QI) committee processes. 6. EMD quality assurance and improvement methodology. 7. Case review at the Academy’s recommended number and percentage of randomly reviewed cases. 8. EMD quality assurance and improvement database. 9. Consistent, cumulative MPDS case review at or above the following percentages: 95% - Case Entry protocol compliance; 95% - Chief Complaint selection accuracy; 90% - Key question protocol compliance; 90% - Post dispatch instruction protocol compliance; 95% Pre-arrival instruction protocol compliance; 90% - final code selection accuracy; 90% - cumulative overall score 10. Correct case review and QI procedures validated through independent Academy review. 11. How EMS field personnel were oriented to the proper use of the MPDS and feedback report. 12. Local policies and procedures for implementation and maintenance of the EMS program. 13. Current Continuing Dispatch Education (CDE) and EMD recertification program functions. 14. How police and fire dispatchers were oriented to the proper use of MPDS (S.E.N.D. protocol). 15. Properly established local configuration of all MPDS response assignments. 16. How MPDS response assignments will be regularly reviewed and recommended changes approved. 17. Incidence of all MPDS codes and levels. 18. Specific medical director oversight and involvement in EMD activities. 19. Sharing of non-confidential data with the Academy. 20. Support of the Academy’s Code of Ethics and practice standards.
CALEA Accreditation The Commission on Accreditation for Law Enforcement Agencies, Inc. (CALEA) provides a Public Safety Communications Accreditation Program for law enforcement dispatching much like the IAED program described above. The CALEA program provides a process to systemically review and internally assess dispatch center operations and procedures. The standards upon which the Public Safety Communications Accreditation Program is based reflect the current thinking and experience of public safety communications executive and accreditation experts. Program hallmarks are listed in Table 9 below.
6 International Academies of Emergency Dispatch, Twenty Points of Accreditation Excellence, December2014,
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Table 9. Principles of CALEA Public Safety Communications Accreditation 7 CALEA Accreditation Principles 1. Communications center is to develop a comprehensive well thought out uniform set of written directives. This is one of the most successful methods for reaching administrative and operational goals, while also providing direction to personnel. 2. The standards provide the necessary reports and analyses a CEO needs to make fact-based, informed management decisions. 3. Requires a preparedness program be put in place so that a communications center is ready to address natural or man-made unusual occurrences. 4. Accreditation is a means for developing or improving upon a communications center’s relationship with the community or the agencies it services. 5. Accreditation strengthens an agency’s accountability, both within the agency and the community, through a continuum of standards that clearly define authority, performance, and responsibilities. 6. Being CALEA accredited can limit a communications center’s liability and risk exposure because it demonstrates that internationally recognized standards for public safety communications have been met and verified by an independent assessors.
Again, the Consultants recommend that Livingston Central Dispatch seek accreditation for both law enforcement and EMS dispatching activities. Overall, accreditation requires top- notch systems, reporting and processes. Accreditation, whether by IAED or CALEA, ultimately benefits the organization and community-at-large. While Livingston Central Dispatch follows some of the accreditation standards, policies and procedures, it would be in the best interest of the County to pursue and achieve accreditation status. This is particularly important as a liability mitigation tool in the area of emergency medical dispatching. Achieving accreditation means that either IAED or CALEA, third-party agencies have stated that Central Dispatch has met and continues to meet the highest standards of triage protocols.
D. Livingston 911 Central Dispatch Infrastructure
Technology Issues And Infrastructure Needs Livingston County 911 Central Dispatch is located in the City of Howell in a government- shared facility owned by the County. Internal to the Central Dispatch portion of the facilities is the Emergency Operations Center that is activated during large-scale or expanded incidents. Other occupants of the facility include the civil secti0n of the Livingston County Sheriff’s Office.
The Consultants identified needed infrastructure improvements. The County’s Capital Plan includes a few of these projects in various stages of progress, planning, or budget authorization. Nevertheless, several projects are not funded or even in planning stages. These are mission critical projects that need serious prioritization with the understanding that some improvements are more costly and complex to implement than others.
New Emergency 911 Communication Center Needed – Best practices dictate that a 911 Emergency Communications Center (ECC) is defined as a critical infrastructure for the effective and efficient mitigation of emergency incidents and large-scale natural or man-
7 The Commission on Accreditation for Law Enforcement Agencies, Inc., Public Safety Communications Accreditation Program, < www.calea.org > accessed December 27, 2014.
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made disasters. Central Dispatch’s 911 emergency communications facility is a key link between the County’s Emergency Operations Center (EOC), field responder agencies, and the community.
The current Central Dispatch facility is a second-generation occupancy for the County. The facility was originally built in 1978 and was utilized by the District Court and the Livingston County Sherriff’s Office for over two decades. In 2002 Central Dispatch was moved into the 12,000 square foot facility occupying approximately 8,000 square feet of the available space. The facility is also shared with the County’s Emergency Operations Center and the Emergency Management Office. Although there is space available, the layout of the structure is not easily modified to accommodate the design and layout requirements for a modern emergency communications center.
The observations from the Vulnerability Assessment Security Assessment Survey Tool (VASST) report along with FITCH’s risk analysis support the recommendation to build a new facility that is specifically designed for the mission of an ECC and EOC and that the design includes consideration of the vulnerabilities of the physical plant and property utilized. A new facility should meet the needs of the community and prepare for the next 40 to 50 years. In concert, it is recommended that the County explore the feasibility of retaining the current emergency communication center structure as a back-up facility that will assist in reducing the potential risk to the continuity of operations.
Include Information Technology (IT) Staff and Infrastructure in New Facility – IT infrastructure is critical to the County’s continuity of operations as a whole and should reside in a hardened structure. When the new Emergency Communications Center is designed, it would be prudent to include IT staff and related technology in the same building.
Radio System – Requires upgrading to replace aging equipment and provide improved security. This was recognized as a pressing issue by the team and is currently in progress; implementation is planned for current physical year.
E. Dispatch Center Governance
Livingston County 911 Central Dispatch was established in 1993 by County Resolution. The Michigan Public Act 32, Emergency Telephone Service Enabling Act (PA32) enacted in 1986 provided the basis for counties to establish universal emergency telephone districts to “install, operate and maintain 91-1- systems in Michigan.” Later amendments gave powers to county commissions to establish an emergency 9-1-1 district board for a consolidated dispatch center and determine the board’s scope of authority.8 Livingston County 911 Central Dispatch complies with the governing structure as outlined in PA32. 911 Administrative Oversight Board The 911 Central Dispatch / Emergency Management Administrative Oversight Board (AOB) is comprised of individuals representing the following services or organizations:
8 State of Michigan, State 9-1-1 Plan, September 20, 2011, Revision 2.0.
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Fire Service Representative EMS Representative Sheriff Representative Police Service Representative State Police Representative
The Board’s purpose is to provide a forum for resolution of dispatch procedural issues, policies and projects that impact user agencies. Central Dispatch Leadership In the past few years, there was significant turnover in management positions. At least five members of the leadership team either retired or resigned since 2009. A new Director was appointed in April of 2014. The County created a new 911 Dispatch Center Deputy Director position and it was filled in September 2014.
Since the new appointments, the following items have been accomplished:
Working with fire, EMS and law managers to streamline dispatch operations Completed replacement of dispatch consoles and chairs Moved the radio upgrade project forward; the project includes the 911 Central Dispatch console radio system and 800 MHz radio system replacement and upgrade of police- fire-EMS mobiles and portables Developed a uniform policy Provided operational oversight with the reorganization of supervisor roles Reactivated emergency trigger buttons for responder safety
Additional personnel changes occurred during the project as the new management team settled into their positions.
Personnel The 2015 approved budget for Central Dispatch includes a total authorized position count of 32.25 as follows:
1 Director (0.5 Full-Time Equivalent) 1 Deputy Director 1 Assistant Deputy Director/Emergency Program Manager (.75 Full-Time Equivalent) 1 Administrative Assistant 1 Operations Manager 2 Dispatch Supervisors 1 Quality Improvement Specialist 4 Shift Leaders 21 Dispatchers
Dispatchers work on a two-week rotating schedule of twelve hour and eight hour shifts and complete 80 hours in a two-week period.
Figure 3 below is Central Dispatch’s organization chart.
Livingston County 911 Central Dispatch Page 25 of 57 ©Fitch & Associates, LLC Communications Review & Strategic Plan 12 February 2015 Figure 3. Livingston County 911 Central Dispatch Organization Chart
Staffing configurations can take on many forms, but it is more typical that there are shift supervisors in dispatch and not shift leaders. The shift supervisors are able to handle discipline and on-site Quality Assurance.
New dispatcher employees are first trained as call takers. The training consists of a two-week in-house classroom didactic instruction on a four-day 10-hour work schedule. After successful completion the members are assigned to a Communications Training Officer (CTO) to complete five phases of training. Each phase teaches a different dispatch position in the 911 Center. A trainee is assigned to a CTO for the entire phase. The CTO will instruct and observe the trainee in on-the-job training for the specific training for that phase as well as review and complete daily check lists. Daily Operator Reports document their progress accompanied by timely feedback.
Employees noted during Consultant interviews that while they thought that their own initial training was adequate they believed that on-going training for new employees is hampered by the workload. They also expressed that the current training process and materials need to be reviewed and possibly revamped.
The Consultants recommend that training cycles for Central Dispatch personnel are inadequate and should be increased to provide measured continuous improvement.
Current continuing education at Central is limited to MPDS web based training and testing,
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police legal service training, and some other external training programs. Best practice is to analyze data to identify high frequency events that promote complacency and low frequency events with high liability potential (i.e., communications center infrastructure failure). The benefits of professional development through continuous education, objective measurements of performance, and integration of emerging trends in the 911 industry, can provide exponential stability in the work force and reduce liability for the organization.
Hiring and retention for most dispatch centers is challenging. The wash out rate for new hires is typically 35% within the first two years. Individuals who enter the Livingston dispatcher hiring process must pass several skills test, interviews, background checks, and psych test prior to being offered employment. These are typical steps for dispatcher hiring.
Central Dispatch’s experience in getting new hires to final employment is dismal. For the 12 month period of July 2013 to June 2014, Central Dispatch reports that of 13 individuals who completed the hiring process and were offered employment, only two individuals completed the initial three months of training.
Clearly, recruitment and training processes are not working well for Livingston. It may be beneficial for Central Dispatch to work with County Human Resources to identify recruitment processes that hamper employment and processes that may have more positive results. It is very costly to bring potential employees so far in the hiring process only to have them fail or leave employment. This is an area of critical importance for the Dispatch Center. An inadequate training program along with current workload may also be part of the retention problems. The new management team has changed the current hiring processes in order to deal with the above issues. Currently the dispatch center is at or near full staffing. Stakeholder Groups During the information gathering process of the project, the Consultants interviewed the major stakeholder groups served by Central Dispatch namely, police chiefs, fire chiefs, and EMS agency and Central Dispatch personnel and staff.
Certain themes emerged from the interviews of Central Dispatch’s “clients” as follows:
Need more comprehensive oversight board and/or workgroup to resolve issues Dispatchers need to be dedicated to specific disciplines Need to streamline policies Specific responder safety issues should be addressed Inadequate fallback plan for secondary facility
Interviews with Central Dispatch staff provided additional themes:
Desire for methods/reports to measure results Need to determine minimum staffing Numerous inefficiencies in dispatch processes Entire training process should be improved Need for better collaboration between field responders and Central Dispatch staff Need to utilize Medical Priority dispatch codes in place of Priority 1/Priority 3 call coding
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First Responder Safety Issues During the interview process, several first responder safety issues were brought to the Consultant’s attention by Central Dispatch and/or field personnel. Those issues are described below and in the separate “Confidential Public Safety Appendix”.
Incident Dispatcher – Fire Department managers voiced their concern that Central Dispatch is frequently unable (due to staffing shortages) to dedicate a dispatcher to communicate on the tactical channel when requested by the Incident Commander. NFPA, 1221 Standard 7.3.3. 2013 Edition states the following: 9
7.3.3 When requested by the incident commander, a telecommunicator shall be dedicated to communicating on the incident tactical channel and relieved of other duties within the communications center.
A.7.3.3 The issue of communication capabilities and/or failures is cited by the National Institute for Occupational Safety and Health (NIOSH) as one of the top five reasons for fire fighter fatalities. The importance of an assigned telecommunicator for specific incidents is a critical factor in incident scene safety. The assignment process should be outlined in specific SOPs within each agency represented in the communications center. This assignment process is further assisted when a command/communications vehicle is being staffed at the incident scene. Funding/Finance Funding for Central Dispatch is provided through three primary sources authorized by the state: 1) a statewide “all devices” surcharge, 2) a county “all devices” operational surcharge, and 3) a technical fee (wireline-based).
The state allows 911 surcharge funds to be used for a broad range of expenditures that are directly attributable to delivery of 911 services. 10 These include the following:
Personnel costs of dispatchers, supervisors (not field response personnel) Facility costs of dispatch center (utilities, insurance, maintenance and capital improvements) Training and memberships Hardware, software, connectivity and peripherals Staff vehicle costs specific to delivery of 911 service Public Information/Education Expenses
Central Dispatch 911 surcharge revenues have remained constant at approximately $4.2 million annually for the past several fiscal years. State and federal grants fluctuate and have added to the bottom line by $400,000 to $700,000 each year.
9 NFPA [2013]. National Fire Protection Association, NFPA 1221: Standard for the Installation, Maintenance, and Use of Emergency Services Communications Systems, Chapter 7, Sub-Section 7.3.3 Operating Procedures, 2013 Edition, p. 20 and 39. Quincy, MA: National Fire Protection Association
10 Allowable/Disallowable usage of 9-1-1 Surcharge Funds, State of Michigan Emergency Telephone Service Committee, 6/21/2005, State 911 Committee, revised 6/23/2009.
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Central Dispatch does not receive general fund revenues. It is funded completely from the fees for services noted above and is accounted for as a special revenue fund of the County. As such, funds remaining at year-end as a result of more annual revenue than annual expenditures will accrue to an ongoing fund balance. By the same token, any deficit resulting from more annual expenditures than annual revenues will result in the reduction of the fund balance. As of January 2015, the Central Dispatch fund balance is approximately $5.1 million. The fund balance is often used to fund specific capital projects.
The County operates on a January to December fiscal year, and the Board of County Commissioners adopted the 2015 Annual Budget in mid-November 2014. The 2015 budget authorizes the following changes as compared to the 2014 budget as shown Table 10 below.
Table 10. Central Dispatch Budget Changes 2014 to 2015 11 2014 2015 Authorized Position Count 30.75 32.25 Expenditure Budget $4,818,849 $5,981,979
Additional personnel and capital projects listed in Table 11 below account for most of the increased budget allocation.
Table 11. Central Dispatch 2015 Budget Request for Additional Resources Resource Request Cost 6 positions (2 Supervisors and 4 Dispatchers) $405,345 Redesign of dispatch consoles, including increase to 12 positions) 1,303,675 AT&T Phone upgrade, compatible with console redesign 57,993 Console furniture upgrade 138,173 Software upgrade, compatible with console redesign 15,188 Total Request $1,920,374
The capital (non-personnel) projects noted in Table 11 above total $1.5 million. Annual revenues for 2015 cover all but $1.3 million of the 2015 expenditures; monies in the 911 Central Dispatch fund balance will be used to balance the annual budget.
The Consultants have recommended two options to improve dispatch effectiveness, both of which will require the continued addition of personnel over multiple years. FITCH also identified a number of capital projects that are of high priority and will need to be addressed in current and future budget plans.
Funding options for Central Dispatch going forward are outlined as follows:
Increase surcharges and/or fees for telecommunications services – state and regulatory approvals are needed; an increase would provide a fairly steady revenue stream. Initiate charges to agencies for dispatch services and equipment support – jurisdictions have never budgeted for dispatch services or equipment; approval and implementation would be a challenge.
11 Livingston County 2015 Budget approved November 17, 2014.
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Authorize a Dispatch Service millage similar to the EMS millage currently in place – this could be the most viable solution; a vote of the public is needed for approval. Allocate general fund monies to supplement 911 Central Dispatch – While allowable, this is not a long-term solution for 911 Central Dispatch. Participate with the public safety strategic plan in order to harmonize funding opportunities.
All of the funding mechanisms noted require many months of planning, approval, and implementation processes that should be started sooner than later. For now, the 911 Central Dispatch fund balance can be tapped for immediate projects and improvements, but a new long-term, reliable revenue stream is needed. Consolidated Dispatch Centers A number of communities in Michigan and around the US have considered and implemented dispatch centers that consolidate emergency communication across multiple local jurisdictions and agencies that include fire, police, emergency medical services and other services such as animal services and forest service agencies. In most cases, the consolidation effort took several years to fully implement. Funding mechanisms differ from state to state but most provide for some form of tariff imposed on telecommunication providers.
Consolidated centers across the US report similar successes as a result of consolidation:
Increased communication and cooperation among emergency response agencies Greater success in obtaining grant funding to improve coordination with local agencies Greater ability to implement technology advances across the community Consistent and improved training and certification opportunities for dispatchers Improved best practices as acknowledged through Accreditations
Implementation efforts in most areas met with similar challenges. Issues that local jurisdictions frequently note are:
Loss of local identify with their constituents Questioning “real” savings as a result of consolidation Concerns that fire and EMS operations will take second place to law enforcement priorities Who has authority and responsibility for hiring personnel Operational leadership, oversight and accountability Ability to resolve issues and adequately meet individual jurisdiction’s needs
The Consultants have worked with a number of consolidated dispatch centers across the US and bring that knowledge base to this project. The most notable issue that arises in established consolidated centers revolves around the last issue stated above.
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Consultants also reviewed information on the following consolidated dispatch centers:
Charleston County Consolidated 9-1-1 Center, Charleston, South Carolina West Suburban Consolidate Dispatch Center, Illinois Calhoun County Consolidated Dispatch Authority, Michigan Meceola Consolidated Central Dispatch, Mecosta and Osceola Counties, Michigan
Livingston County’s structure, funding, successes, and issues mirror those of other consolidated dispatch centers.
IV. Police, Fire and Medical Dispatch Needs
Emergency communication centers were originally simple structures that performed only two functions: complaint-taking and gathering the location of the complaint. Dispatch centers then broadcasted the information and field personnel decided on the response needed. This method is often called the taxi model of call taking. Over time, the emergency services branches - fire, emergency medical, and law enforcement - recognized that dispatch centers could serve two additional functions: 1) as an initial filter to distinguish calls of more and/or less critical nature and 2) to provide for more efficient resource distribution to prevent clustering of response units.
Each of the emergency services uses these functions differently and while all dispatch centers fundamentally perform the functions noted above, the reality is that they implement them in a very different manner. More recently, the advent of specific technologies to assist with dispatch tasks and the adoption of specific practices, legislation, and guidelines have raised the performance and quality bar for dispatch centers. From the dispatch viewpoint, police, fire, and emergency medical services have evolved differently to accomplish their specific missions, mandates and to provide for the best service outcomes.
A. Different Dispatcher Focus
After call intake, the next step in the dispatch process is to assess the acuity of the incident. It is at this step that the requirements of the dispatch process and the mindset of the dispatchers diverge depending on discipline involved, FIRE, EMS, or LAW.
In fire incidents, assessment of acuity by the dispatcher is secondary to getting the wheels rolling. Assessments of fire incidents are typically conducted after response apparatus arrives on scene, which means that fire dispatchers are less interested in gathering additional information from the caller about the event.
In assessing the acuity of an emergency medical incident the dispatcher is focused on coming to a swift and accurate determinant of acuity so that the appropriate response priority can be set. Getting wheels rolling is the priority. Providing medical pre-arrival instructions is a sub-discipline with explicit certifications of proficiency.
In assessing acuity of a law enforcement incident the dispatcher is focused on officer safety
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and the requirements of legal review and scrutiny. This means that the number of questions and the time required to get to a satisfactory determination of the situation is not a prime consideration. It is paramount that a responding officer is fully aware of the situation and the potential for danger. In a law enforcement environment, gathering the information to insure officer safety has priority over achieving a swift response. In keeping with this philosophy, there are no national, international, or even local response time requirements for police service responses.
B. 911 Emergency Call Processes and Standards
The processing of a 911 call is the key component of effective dispatching as well as cost efficiency. Each dispatch task is complex and requires different skills and training. Structures and technologies that recognize both the differences and similarities between dispatch tasks are able to maximize efficiencies. Those that do not tend to run slower and cost more.
The natural anatomy of a call starts with an individual observing the need for an emergency intervention; the individual initiates a 911 call; a 911 call taker receives the call and identifies the primary agency required to treat or handle the call (fire, EMS, or law) and transfers the call to that agency. The call taker from the responding agency uses experience, guidelines, or protocols (considered best practice) to define the category of call, the acuity of the incident, the priority of the response, and finally the information is handed to a radio operator to dispatch the appropriate response units.
The flow of a 911 emergency incident is usually viewed from the perspective of the 911 caller and the field responders. Among fire, EMS, and law emergency incidents, an EMS incident involving a patient transport has the most complex timeline. Fire and law incidents do not involve time intervals T 6 and T 7 as presented in Figure 4 below. Figure 4 depicts the typical flow of a 911 emergency medical call.
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Figure 4. Flow of A Typical EMS Incident– Caller and Responder Perspective
When viewed from the perspective of the dispatch center, the flow of the 911 emergency incident has a different appearance as presented in Figure 5 below.
Figure 5. Flow of A Typical Emergency Incident – Dispatch Center Perspective
The diagrams above clearly define the time segments in a service delivery system. When a service or system monitors performance of each time interval, then areas for improvement can be readily identified. The performance standards discussed below provide goals to be incorporated in Central Dispatch’s multi-year strategic plan.
NFPA and NENA Standards Two organizations, the National Fire Protection Association (NFPA) and the National Emergency Number Association (NENA), set standards for emergency call processing. NFPA norms/standards on dispatch (NFPA 1221) define both the flow of calls and the allotted time for high performance dispatching. Summaries of relevant NFPA and NENA standards regarding dispatch process and performance are provided in Tables 12 and 13 below.
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All calls/alarms to be recorded and tabulated to indicate origin of call; 95% to be Section 7.4.1 answered with 15 seconds; 99% within 40 seconds. 80% of call processing completed within 60 seconds; 95% completed with 106 Section 7.4.2 seconds. For law enforcement, the jurisdiction with authority determines standards for Section 7.4.3 dispatch completion. 12 95% of calls shall be transferred from primary PSAP to secondary PSAP within 30 Section 7.4.4 seconds (10 seconds for ring answer and 20 seconds for identification of primary resource required).
NENA standards are consistent with NFPA 1221 with some additional detail as noted in Table 13 below. When a Medical Priority Dispatch System is in place, this standard is applied only to the highest acuity, life-threatening calls (ECHO and DELTA).
Table 13. NENA Call Taking Operational Standards 13 NENA 56-005 Standards
90% of all PSAP calls to be answered within 10 seconds during the busy hour; 14 95% of all Master Glossary 00-001 calls should be answered within 20 seconds.
911 call taker limited to very few questions prior to transferring the call to the agency that Page 8 of 12 will dispatch the call . This is done in order to reduce the delay of the responding agency that will ultimately deal with the crisis.
All 9-1-1 calls at a PSAP shall begin with “9-1-1”. The correct statement is “Nine-One-One”, Section 3.3 never “Nine Eleven”. Additional information or questions may be added, as in: “9-1-1, what is the emergency?” or “9-1-1 what is the address of the emergency?” 15
NFPA and NENA standards reflect the need for rapid and accurate dispatch to fire and medical emergencies.
V. Treatment of CAD Data
The following sections provide details about the data that was extracted from the Livingston CAD, how it was organized, and the assumptions and calculations that were used to allow analyses to go forward. Additional explanations are provided in attachments to this report and are so noted in the text.
12 Note that there are no national, international, or even local response time requirements for police service responses. 13 National Emergency Number Association, NENA 56-005: 9-1-1 Call Answering Standard/Model Recommendation, June 10, 2006, p.8. 14 The hour each day with the greatest call volume, as defined in the NENA Master Glossary 00-001. 15 This is directly from the Operational Standards and cannot be modified. Other information, such as the operator identification number or that the line is recorded may also be added.
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A. Subset of Fields Extracted From CAD Livingston County 911 provided output of a limited subset of fields from the Central Dispatch Computer Aided Dispatch (CAD) records for the period January 1, 2012 through September 30, 2014. The subset was selected by Livingston County staff to pertain to the operations of dispatch processes rather than field operations. One exception to this limitation was necessary in that the Consultants required timestamps for “first arrived at scene” as we anticipated expanding dispatch responsibilities to include “pre-arrival instructions” for life- threatening (echo and delta priority) emergency medical service requests.
It is reasonable to expect that the interval over which the dispatcher will need to provide pre- arrival instructions will end with the actual arrival of the response unit at the scene which is noted in the CAD as “first arrived at scene”. Adding pre-arrival instructions to dispatcher functions is expected to contribute to the time-on-task workload and therefore the additional time increment is included in the analyses.
B. Data Transformations Data output included a unique incident identification for each record. In the Livingston CAD, the data field titled “Service” records the nature of the agency selected to respond to the call as either, “FIRE”, “EMS”, “LAW”, or “bbbb ”. County staff typified the “bbbb” designation as being applied to administrative traffic recorded into the CAD. These entries invariably had neither a responding agency nor a dispatch processing time recorded for them. To facilitate sorting functions, records with a service designation of “bbbb ” were reassigned a designation of “ADM” and a total of 29,705 records for CY2012, CY2013 and part-year 2014 were designated as such.
The raw data from the CAD was imported into the first of three cascading databases. A sample record showing the data fields contained in the first database is presented in Figure 6 below.
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Figure 6. Sample Record Containing Data Fields Exported From The Livingston CAD
In this database, records are organized on a per incident basis. The records in this first database were consolidated into a second database where records are organized as all activity per hour of year. The records in this second database were consolidated into a third database where records were consolidated by hour of day and averaged over a selected date range.
For purposes of this report, the analyses called for tallies of the service functions required to respond to each incident. For agency designations of EMS and law, the entries for service functions simply become EMS or law, respectively. For a fire agency designation, the service function response may be either fire or EMS. Based on examination of the “nature” of each FIRE incident, the service function response for each incident was determined to be either an EMS or a fire response. All incidents with a fire response agency designation were reviewed and assigned an EMS response function as appropriate . The incident records were then entered into the database for further analyses.
Attachment B provides a table that indicates the call count for EMS functions provided by fire agencies (nature of the incidents i.e., abdominal pain, chest pain, fall) for the period January 2012 through September 30, 2014.
C. Selection of Baseline Period
The Consultants reviewed the count of manually entered incident data available and determined that calendar year (CY) 2012 data would be the most reliable data for further analyses for several reasons:
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Only nine months of data is available for CY2014 The CY2013 incident count indicated an unexplained decrease in call volume CY2012 data more closely replicated current partial CY2014 call experience CY2012 includes a full 12-months of incidents.
Table 14 below provides CY2012, CY2013, and part-year CY2014 manual incident counts for FIRE, EMS, and LAW incidents and allows for call count comparisons.
Table 14. Response Functions by Date Ranges Manual Incident Records By Response Function Function Start Date End Date Count FIRE 01/01/2012 12/31/2012 2,212 EMS 01/01/2012 12/31/2012 15,207 LAW 01/01/2012 12/31/2012 44,452 TOTAL CY2012 01/01/2012 12/31/2012 61,871 FIRE 01/01/2013 12/31/2013 2,639 EMS 01/01/2013 12/31/2013 15,079 LAW 01/01/2013 12/31/2013 43,788 TOTAL CY2013 01/01/2013 12/31/2013 61,506 FIRE 01/01/2014 09/30/2014 2,115 EMS 01/01/2014 09/30/2014 11,778 LAW 01/01/2014 09/30/2014 32,583 TOTAL Part-Yr 01/01/2014 09/30/2014 46,476 2014 9 MO COMPARISON 2012 F+E+L 01/01/2012 09/30/12 46,208 2013 F+E+L 01/01/2013 09/30/13 45,962 2014 F+E+L 01/01/2014 09/30/14 46,476
Note that manually entered incident records are those that require dispatch personnel time- on-task. Other records in the CAD are self-initiated by field personnel or auto-generated and require little to no personnel time-on-task (zero to six seconds).
The last section of Table 13 above compares the nine-month data for each calendar year and reflects that incident counts for both partial year CY2012 and CY2014 are more similar than CY2013 counts.
D. Erlang-C Analysis
Agner Krarup Erlang was a Danish mathematician, statistician, and engineer who invented the field of telephone networks analysis while working for the Copenhagen Telephone Company from 1908 through 1929. The concepts and mathematics introduced by Mr. Erlang have stood the test of time. In the modern world, these methods are used to analyze queuing processes in systems as diverse as shoppers using grocery store checkout cashiers to data packet switching through internet routers at megahertz frequencies. The goal of Erlang’s queuing analyses is to determine how many service providers should be made available to satisfy users, without over provisioning.
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For Erlang’s analyses to apply to a system, two conditions must be met:
1. Users arrive more or less at random intervals and 2. Users receive exclusive service from any one of a group of service providing elements without prior reservations
The flow of calls through the Livingston County Central Dispatch conforms to these requirements. Thus, Erlang analyses are valid for evaluating the flow of calls through the Livingston County Communications Center. Attachment C provides a detailed explanation of how Erlang-C analysis and the relevant formula calculations were used to develop the staffing model for Livingston 911 and as used in subsequent sections of this report.
E. Calculation of Time Intervals from Timestamps
Five timestamps are included for each incident in the data exported from the Livingston CAD: [calltime], [MedPriStart], [timefini], [MedPriCompl], and [firstarrv]. These timestamps are used in calculations to determine current dispatcher workload or time-on-task and are used to estimate the additional time-on-task that will be required to implement various staffing options as a result of this study. The detail of the timestamp definitions and how they are utilized in the analyses equations is provided in Attachment D.
F. Variation of Call Counts by Day of Week and Hour of Day
The entries in the Livingston County CAD are organized with each incident being represented by its own record. The incident records were consolidated for FIRE, EMS, LAW, and ADM by hour of year for analyses. A sample record from this consolidated data is presented in Table 15 below. For CY 2012, a leap year, there are 8,784 hourly records.
Table 15. Sample Record of Manual Incidents Consolidated by Hour of Year CY 2012 Hour of Year Incident Records [ Count / hour ] CAD Hour of Year Month Day Incident Records FIRE EMS LAW FEL Day 2012 6 12 20 Manual 1 2 10 13 Spawned 0 0 8 8 Total 1 2 18 21 9"#0-!#11',%" 0.0219 0.3817 0.3814 0.7850 [ hours/hr]
Records were then examined regarding the distribution and standard deviation of combined response functions of FIRE + EMS + LAW activity (FEL) by day of week. The results are presented in Table 16 below.
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Table 16. Combined Fire+EMS+LAW Incident Counts by Day-of-Week for CY2012. Average No. Standard Day of Week Incidents Deviation Mon 171 + 106 Tues 162 + 99 Wed 163 + 98 Thurs 166 + 104 Fri 188 + 115 Sat 175 + 97 Sun 159 + 95
Looking at the average of call counts for each day of the week, Sundays appear to be the “slow” day. However, the standard deviations for all of the averages for every day of the week are so pronounced that no meaningful reduction of staffing on Sundays could be reliably implemented. Based on these observations, incident data for the analyses in this report were consolidated on a day-by-day basis without regard for day of week or day of year. 16
In addition, a two-tailed t-test methodology was applied in order to determine whether or not the differences from hour to hour are random or predictable. The t-test results showed that the changes from hour to hour could be relied upon in the design of a staffing model. Attachment E is a table indicating the changes for combined FIRE, EMS, and LAW call counts by hour of day for CY2012 and the t-test for significance outcomes.
Figure 7 below presents the average counts and standard deviations by hour of day for CY2012 as a vertical bar chart with error bars showing the magnitude of one standard deviation about these averages.
16 The analysis was also conducted for CY2013 and part-year 2014 and had the same conclusion.
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Figure 7. Average Call Counts & Standard Deviation by Day for Combined FIRE, EMS, LAW Incidents
The hour of day analyses will be combined with other workload data to determine whether staffing could be increased or decreased for certain periods during a shift. Operationally, these variations will determine how a dispatch supervisor must manage on-shift relief staffing.
G. Incident Count and Call Types
In many CAD systems, the number of incident records logged into the CAD is directly indicative of the number of calls flowing into the dispatch process and is directly indicative of the workload on the dispatch operators. In Livingston County Central Dispatch, there were 184,200 incident records for CY2012 but only 61,871 required human intervention or time-on- task. Only 34% of the activity in the CAD required manual intervention by the call taker/dispatcher.
Incidents logged into the Livingston CAD that have call processing times of 00:00:00 or zero seconds are auto-generated (no call-taker/dispatcher intervention needed) and those with call processing times of one to five seconds were self-initiated by field personnel and required little call taker/dispatcher intervention. Central Dispatch staff refers to these two classes of CAD incident records as having been “automatically spawned” and as noted they
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represent zero to five seconds workload per incident. 17
Table 17 below displays the distribution by response function and compares the combined total of all manual and auto-generated incident records to manual incident records.
Table 17. Livingston County 911 Incident Records and Response Function for CY 2012 Combined Manual + Auto- Manual Created % of Incidents Requiring 6 Response Generated Incident Record Incident Records Seconds or More Function Count Only Dispatcher Time FIRE 3,130 2,212 70% EMS 25,551 15,207 60% LAW 144,548 44,452 31% ADM 10,971 0 0% Total 184,200 61,871 34%
Much of the aut0-generated activity for LAW is generated by officers notifying that they are working a minor incident such as a traffic stop. An incident record is auto-generated but does not require call taker/dispatcher time.
A count of 184,200 incident records is important as it gives a measure of the workload on the field responders. However, a grasp of the distinctions between the counts of manually processed incidents records, counts of automatically spawned incident records, and counts of field responses is essential to an understanding of the flow of workload to the Dispatch Center staff.
A histogram plot of all manually entered incident records (those requiring more than six seconds of call taker/dispatcher time) for CY2012 is presented in Figure 8 below. This is a combined plot that includes FIRE, EMS, and LAW response functions.
17 November 19, 2014 phone conversation with L. Harvey, Livingston County 911 Central Dispatch Operations Manager, and Chad Chewning, Livingston County 911 Central Dispatch Deputy Director.
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Figure 8. Distribution of Processing Times for All Manual Incident Records CY2012
Note: The width of the bins comprising the histograms is 5 seconds and the span of process intervals displayed is 0 - 600 seconds (0 – 10 minutes).
The combination of 122,329 auto-generated incidents and the 61,871 manual incidents reflects the total number of 184,200 incidents. Looking at outliers, 2,169 or 3.5% of the 61,871 manual incident records indicate processing times in excess of 6 minutes . The average processing time for manually entered incident records, even including the long duration outliers, is 133 seconds or one minute 13 seconds as indicated in Figure 8 above.
Livingston 911 staff expressed the perception that the common processing time for manual incidents is often six to eight minutes (360 to 480 seconds). However, the detailed analysis of dispatch processing times for all response functions shows that this perception does not conform to the data actually logged into the CAD as noted above.
The impact that long duration outliers have on dispatch processing operations is understated if we only look at counts of incidents rather than additive time-on-task. The long duration outliers comprised 14% of the call taking/dispatch processing time. The conclusion is that for Livingston County 911, long duration outliers contribute to, but definitely do not dominate the call taker/dispatcher workload.
It is important to understand the average time needed for call taking and dispatching of resources for FIRE, EMS, and LAW. This is a critical component of total personnel workload but not the only component. Other workload items include radio traffic with field personnel, nuisance calls, outgoing calls, etc. These components will be addressed as part of the options modeling later in the report.
Histogram plots were constructed to reflect the average processing times for each of the three disciplines. This information forms the key component in the options modeling. The histograms are provided in Figures 9, 10 and 11 below. For each response function, the
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downward pointing arrows indicate the average processing time, which were tabulated after excluding the auto-generated incidents in the 0-5 second bin. The vertical scale was kept the same to better permit a comparison of the relative amount of activity associated with each response function.
Figure 9. Distribution of Processing Times for FIRE Manual Incident Records CY2012
Note: The width of the bins comprising the histograms is 5 seconds and the span of process intervals displayed is 0 - 600 seconds (0 – 10 minutes).
Figure 10. Distribution of Processing Times for EMS Manual Incident Records CY2012
Note: The width of the bins comprising the histograms is 5 seconds and the span of process intervals displayed is 0 - 600 seconds (0 – 10 minutes).
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Figure 11. Distribution of Processing Times for LAW Manual Incident Records CY2012
Note: The width of the bins comprising the histograms is 5 seconds and the span of process intervals displayed is 0 - 600 seconds (0 – 10 minutes).
The histograms show that the average processing times for manually entered incidents are as follows:
FIRE: 95 seconds or one minute 35 seconds EMS: 176 seconds or two minutes 56 seconds LAW: 121 seconds or two minutes one second
As noted previously, the average time needed for call taking and dispatching of resources is a critical component of total personnel workload, but not the only component. All components will be addressed as part of the options modeling analyses.
VI. Dispatch Operations
A. Flow of 911 Emergency Incidents
The flow of a 911 emergency incident is usually viewed from the perspective of the 911 caller and the field responders. This viewpoint is often represented schematically by the timeline presented in Figure 12 below. Here, the timestamps are numbered and the time intervals are named for an EMS incident that involves a patient transport. Typically, FIRE and LAW incidents are less complex because they do not involve time intervals T 6 and T 7.
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Figure 12. Flow Of An EMS Incident – Perspective of Caller and Field Responders
The complexity of the schematic in Figure 12 above makes it difficult to analyze operations inside the dispatch center. Analysis of dispatch operations is better served by a change of perspective to that of the dispatch center as reflected in Figure 13 below.
Figure 13. Flow Of A 911 Incident – Perspective of Dispatch Center
The four functions in the figure above are critical components for developing and assessing dispatch models.
B. Approach To Analyses/Workload Quantitation
In order to analyze dispatch operations at Livingston Central Dispatch, it is first necessary to catalog the various functions that must be executed in order to conduct the business of the Dispatch Center. After the functions are cataloged, the workload imposed by each function must be quantitated. It is only after this quantitation step, that the power of Erlang analyses can be applied to understand the dynamics of workload, staffing, and performance.
The components that comprise the total workload flowing to the dispatch staff are listed in
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first column of Table 18. The source of the information used to quantitate each component is listed in the second column.
Table 18. Components of Total Dispatch Workload Component of Workload Source of Information Temporal distribution of emergency incidents Historic CAD Incident processing interval Total interval from Historic CAD Automatically spawned records Historic CAD NFPA Standards modified for a medium performing Call Intake system Assessment/Prioritization Analogy to other medium performing systems Assignment By Difference Historic CAD for Pre-Arrival Interval and Pre-Arrival Instructions analogy to EMS systems worldwide Nuisance Calls Cassidian Aurora phone reports and historic CAD Outgoing Calls Cassidian Aurora phone reports Reverse Erlang analysis based on Cassidian Aurora Radio Traffic phone reports, IDR staffing documents, and analogy to other emergency systems
Detailed descriptions of sources of data, assumptions, and calculations required to quantitate the components of total workload are presented in Attachment F.
VII. Describing Current Model & Recommended Options
There are various functions that must be executed in order to conduct the business of any emergency service dispatch center. These are presented in Table 18 above. However, to get to the essence of the dispatch models, it is sufficient to focus on only four critical functions:
Call intake Call assessment/prioritization Unit assignment Radio support to responders
All models for the organization of a dispatch center must provide for the execution of these functions.
The distinctions between various models and the recommended options hinge upon which personnel perform which of these functions.
Three common models are described and analyzed in this report. The three models described include the current dispatch model used most frequently by Central Dispatch and the two recommended options models. In all three models, additional staff will be required. The three models are named as follows:
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Current – Vertical Dispatch Model Option 1 – Caller Centric Model Option 2 – Responder Centric Model
The models are described in the following sections.
A. Current – Vertical Dispatch Model
Central Dispatch most often operates in the Vertical Dispatch mode. Central Dispatch prefers to operate under a Responder Centric model, but call load frequently overwhelms the dispatch staff and they revert to the Vertical model which places emphasis on picking up the next 911 call as a priority.
In this model, each dispatch staffer executes all of the dispatch functions on an as needed basis. The functions include call intake (determining discipline), assessment of acuity, response prioritization, and assignment of response units for all three disciplines. The dispatchers also provide radio support to the field units as the response to the incident progresses. In addition, these positions are also tasked with providing medical pre-arrival instructions to callers in the case of life threatening EMS incidents. When operating in this mode, field personnel radio communications are frequently put on hold because answering the next incoming 911 call must be given priority.
The Vertical model is not consistent with industry best practices. The needed specializations by discipline that are required to maintain effectiveness of call intake, dispatch, and radio support functions are abandoned. Everyone rotates through doing everything on an ad hoc basis. Answering the next incoming 911 call has priority. The dispatch staff succeeds in maintaining a very high percentage of immediate answers on the next incoming 911 call, but radio support to responders of ongoing incidents gets curtailed, potentially compromising responder safety.
For these reasons, FITCH highly recommends that Central Dispatch move away from the Vertical Dispatch Model as its default operating model and fully implement either the Responder Centric or Caller Centric Dispatch Model. This can only be accomplished with additional staff.
B. Option One – Caller Centric Dispatch Model
A call intake specialist in this model answers the incoming 911 call, determines the physical location of the incident, and determines the discipline, FIRE, EMS or LAW, required to respond to the incident. The intake specialist then transfers the call and incident information to the appropriate dispatcher/radio operator.
The dispatcher/radio operator position is dedicated by discipline, FIRE, EMS or LAW. This position assesses the acuity of the call, assigns a response priority, selects a response unit, and notifies the response unit. They also provide radio support to the field unit as the response to the incident progresses. The dedicated EMS dispatcher/radio operator is also
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tasked with providing medical pre-arrival instruction to callers in the case of life threatening EMS incidents.
C. Option Two – Responder Centric Dispatch Model
The call taker position in this model answers the incoming 911 call, determines the physical location of the incident, and determines the discipline, FIRE, EMS, or LAW, required to respond to the incident. They then assess a FIRE, EMS, or LAW acuity and set a FIRE, EMS, or LAW response priority. The incident information (not the caller) is then transferred to the appropriate radio operator for unit assignment. For high acuity, life threatening, EMS incidents, the call taker remains on the line with the caller and provides medical pre-arrival instructions.
The radio operator position in this model is specialized by discipline, FIRE, EMS, or LAW. They notify the units selected to respond to an incident. They also provide radio support to the field units as the response to the incident progresses.
D. Distinctions Between Dispatch Options
Table 19 below summarizes the three models of dispatch operations and identifies which positions handle each of the four critical dispatch functions.
Table 19. Allocation of Functions to Personnel: Vertical, Options 1 and 2 Dispatch Functions Dispatch Models 1 Assessment / Unit Intake Radio Support Prioritization Assignment Vertical (Current) Dispatch Staffers
Caller Centric Call Intake Dedicated FIRE, EMS, & LAW (Option One) Specialist Dispatchers/Radio Operators
Responder Centric Dedicated FIRE, EMS, & LAW Call Takers (Option Two) Radio Operators
1 In emergency services literature the “caller centric” model may be referred to as “conditional” and the “responder centric” model as “amalgamated”.
Attachment G provides two tables with extensive detail of the individual functions for each position operating in the three different dispatch models.
An important distinction between Option 1 – Caller Centric Model and Option 2 - Responder Centric Model is what happens to a caller internal to the dispatch center:
In the Responder Centric model, the caller remains connected with the initial call taker; however, the call taker is not specialized in FIRE, EMS, or LAW. Radio operators who are specialized in specific disciplines handle unit assignments and are focused on communication with field responders.
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In the Caller Centric model, the caller is transferred between the initial call taker and the dedicated dispatcher/radio operator. This dispatcher is specialized in assessing acuities and setting response priorities of FIRE, EMS or LAW incidents. A caller with a medical emergency talks to a dispatcher who specializes in EMS and can readily provide pre-arrival instructions using MPDS protocols. This dispatcher/radio operator is expected to be emergency medical dispatcher (EMD) certified.
In both models dispatch personnel use medical priority dispatch for EMS calls and would provide the pre-arrival instructions as needed. The primary difference in specialization happens more for police and fire calls that, rely on experience based dispatching. The more specialized the personnel are, the better they are at handling police and fire calls.
Table 20 below again summarizes the distinctions and states the advantages and disadvantages of each option.
Table 20. Distinctions Between Options – Advantages and Disadvantages Option 1 – Caller Centric Option 2 –Responder Centric
During assessment of acuity and prioritization, After intake of the call, the 911 caller is the 911 caller talks to a call taker who is not transferred to a dedicated dispatcher who specialized in any single discipline. This 911 Caller specializes in assessing acuity and generalized call taker must also provide medical assigning priority to a single discipline, pre-arrival instructions on high acuity EMS FIRE, EMS, or LAW. incidents. During the progress of an incident, field Both field responders and callers share responders talk to dedicated radio operators Field access to dispatchers/radio operators who are specialized in a single discipline, FIRE, Responder specialized in a single discipline, FIRE, EMS, EMS, or LAW. or LAW.
Each dispatcher must be proficient in assessing acuity of only a single discipline. This is particularly useful in areas such as Caller hears a single voice. No internal transfer law enforcement where the system is is required. Field responders get a high level of Advantages experience based and does not have strict radio support. protocols to follow. Field responders get radio support from dedicated radio operators. The caller hears two voices as the call is transferred internally from call taker to Call taker must be a generalist in assessing dispatcher; there is the possibility that the acuity of complaints for FIRE, EMS, and LAW. caller may be queued before a dedicated Dis- This generalist must also provide medical pre- dispatcher is able to pick up the internal Advantages arrival instructions that meet protocols for life- transfer. That field responders and callers threatening incidents. share access to the radio operators is a
disadvantage only if this model is understaffed.
The Caller Centric model can be criticized because the dispatcher/radio operator must place a higher priority on accepting the next call being transferred from the call taker than on conducting radio support of incidents in progress. While this situation is an acute problem in
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current operations, the Erlang analyses shows that the issue will almost completely disappear when adequate staffing levels are allocated to the dispatch function in this model.
Curtailment of radio support of incidents in progress is a condition that can occur in all models. Curtailment of radio support of incidents in progress is a symptom of a model being understaffed. It is not an inherent deficiency of the model.
VIII. Modeling Current Operations
Based on on-site interviews, the dispatch teams in Central Dispatch aspire to operate in a “Responder Centric” dispatch mode with a team leader, one call taker, and one radio operator for each of FIRE, EMS, and LAW, or total of five. When workloads spike, the mode of operation transitions to a “Vertical” dispatch model in which all members of the dispatch team rotate through all functions on an ad hoc basis.
A. Responder Centric Operations
To gain insight into the details of current operations as the dispatch team transitions between modes, the Consultants conducted Erlang analyses of workload for both the “Responder Centric” and the “Vertical” dispatch models. The detailed Erlang tables with complete descriptions of workloads for these models are presented in the first four tables within Attachment H.
Central Dispatch currently reports an immediate 911 call pick–up of zero to six seconds for 97.7% of calls received and Central Dispatch’s performance is deemed equivalent to “Immediate Answer” for purposes of the Erlang mathematics. Thus, to interpret the outcomes of the Erlang anslyses, a probability of immediate answer of 97.7% was used to judge whether a model was displaying adequate or inadequate performance.
The results of the Erlang analyses for the desired “Responder Centric” dispatch mode are summarized in Table 21 below. The analysis is based on a personnel configuration of one call taker and three radio operators and the team leader is included in the analysis.
Table 21. Erlang Analyses of Dispatch Workload With Current Staffing In The Responder Centric Dispatch Model Call Taker FIRE Radio Operator EMS Radio Operator LAW Radio Operator On-Shift Staffing On-Shift Staffing On-Shift Staffing On-Shift Staffing Base Peak Base Peak Base Peak Base Peak 1 1 1 1 2 Weighted Average Weighted Average Weighted Average Weighted Average Probability of Probability of Probability of Probability of Immediate Answer [%] Immediate Answer [%] Immediate Answer [%] Immediate Answer [%] 69.59 99.28 96.61 52.13 91.40
One call taker is insufficient to achieve a 97.7% probability of immediate answer. The probability of immediate answer for the radio operators has a slightly different meaning. In
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the “Responder Centric” mode of operations, an incident is transferred from the call taker to the radio operator. Here, the probability of immediate answer is whether the radio operator is immediately available to accept the transfer.
The probabilities of immediate answers summarized in Table 20 as derived from the detailed Erlang tables in Attachment H show that the call taker’s performance is inadequate at all hours of the day. The FIRE radio operator’s performance is adequate at all hours of the day. The EMS radio operator’s performance is adequate only from 0100 until 0900. At all other hours of the day it is inadequate. The LAW radio operator’s performance is inadequate at all hours of the day. Even if the team leader abandons supervisory functions and assumes a LAW radio workstation, the performance of LAW radio remains inadequate at all hours of the day.
It is clear that Central Dispatch, in its current configuration of one team leader, one call taker, and three radio operators, is not able to function adequately in the Responder Centric model on a continual basis. In order to keep up with the workload and answer that next 911 call, they must abandon this model, pull the team leader in to assume console duties and shift to the Vertical dispatch model in which functional specializations are abandoned.
B. Vertical Operations
Workloads in Erlang analyses are input as averages. In the real world, there are statistical fluctuations about these averages. Workloads may fluctuate towards low values and make it possible for the dispatch team to operate in a “Responder Centric” mode for short periods of time. Such a condition is transitory and is not the norm.
When the workload returns to the normal average, which invariably happens, the dispatch teams are compelled to operate in a “Vertical” dispatch mode in which all team members rotate through all functions on a random basis. Specialization of functions within the team is abandoned in the interest of answering the next incoming 911 call. The complete Erlang table for operation of the dispatch center in “Vertical” mode is presented in the last table within Attachment H.
The performance of a dispatch team with four members on-duty is adequate only between 0100 and 0800 hours. At all other times of the day, adequate performance is achieved only by having four team members as well as the team leader on duty at workstations. Supervisory functions by the team leader are necessarily abandoned.
C. Comparison of Current Operational Models
On the face of it, what has just been described in the analysis of current operations at the Dispatch Center appears odd. There are two modes of operation with exactly the same total workload and the same dispatch team, yet “Vertical” works, just barely, and “Responder Centric” does not.
This comes about because the connection between the requests for services, the size of the dispatch team, and probability of immediate answer is highly non-proportional. This
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characteristic of queuing processes is especially magnified when the size of the dispatch team is small, as is the case at Central Dispatch.
When the mode of current operations changes from “Responder Centric to “Vertical”, all of the workloads that had been separated by function are “swept into a single pile” and all of the team members are “swept into a single pool” of incident processors. In these circumstances, the non-intuitive statistics of queuing processes manifest themselves and an improved probability of immediate answer is actually achieved.
If immediate answer of the 911 call was the only metric, then a “vertical” mode of dispatch operations would be judged a success. The downside to a “vertical” mode of dispatch operations is that all specialization of dispatch functions is abandoned.
The most critical functions in processing the dispatch of an emergency incident are assessment of acuity and radio support. The skills required to perform these two functions are significantly different for each of FIRE, EMS, and LAW incidents. That all members of the dispatch team will be proficient in all six skills is wishful thinking.
Operating in a “vertical” mode of dispatch operations increases the chances that things will go wrong. Neither callers nor field responders can receive consistent treatment. Patient outcomes on EMS incidents and responder safety can be negatively impacted.
IX. Optimal Staffing for Recommended Options
Two principle metrics drive staffing levels in dispatch centers:
1. The number of incidents per unit of time (call volume) that flow through the dispatch center, and 2. The performance level that the dispatch center is expected to achieve.
Call volume is an external metric that is imposed upon the dispatch center, while expected performance is a matter of local policy. Decisions regarding what performance level to strive for should be thought of in the context of fiscal responsibility that is balancing what the community can afford with what the community expects.
In order to develop the models presented in this report, FITCH used high performance standards that are published by NENA (National Emergency Number Association) and NFPA (National Fire Protection Association). Meeting these high performance standards will require increases in staffing over current levels. The two options that FITCH developed for Livingston County 911 Central Dispatch should be interpreted as maximum performance levels and maximum staffing levels.
Recommendations for staffing of the two options are based on the same Erlang analyses that consider the total workload for Central Dispatch personnel. The detailed analytics for each Option are presented in attachments as noted in the text.
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A. Option 1 – Optimal Staffing for Caller Centric Model
After a detailed analysis of the workload flowing through the Dispatch Center, the Consultants recommend a dispatch team of 10 individuals for the Caller Centric Model as follows:
1 Supervisor 2 Call Intake Specialists 1 FIRE Dispatcher/Radio Operator 2 EMS Dispatcher/Radio Operators 4 LAW Dispatcher Radio Operators (1 with LEIN responsibilities18 )
Call Intake Specialist The workload flowing to the call intake specialists is such that one intake specialist cannot handle it, yet two specialists represent a slightly overstaffed condition. Operationally, this condition is desirable because it provides a small cushion for on-shift relief staffing as team members rotate between on-duty and on-break.
FIRE Dispatcher/Radio Operator Only one staffing position is required to support the FIRE dispatch function. The utilization of the FIRE dispatch position is very low simply because of the low number of FIRE incidents flowing through the Dispatch Center.
EMS Dispatcher/Radio Operator The workload flowing to the EMS dispatcher/radio operators is such that one staffing position cannot handle it, yet two positions represent a slightly overstaffed condition. Operationally, this condition is desirable because it provides a small cushion for on-shift relief staffing as team members rotate between on-duty and on-break.
If the staffing of the EMS dispatch function goes from two down to one, the probability of an immediate pick-up on the next call transferred from the intake specialist falls dramatically. The dispatch team leader must insure reliable on-shift relief staffing for the EMS dispatch function so that queuing between the call intake specialist and the EMS dispatcher/radio operator does not occur.
LAW Dispatcher/Radio Operator One of the LAW dispatcher/radio operators will have responsibility for interfacing between the field responders and the Michigan Law Enforcement Information Network (LEIN).
The hour-by-hour Erlang table in Attachment I for this function shows that three staffing positions are adequate for most hours of the day. However, from 3 p.m. until 11 p.m., a fourth position should be added to the LAW dispatcher/radio operator function as on-shift peak staffing. At other times during the day, this fourth LAW staffing position could serve as relief staffing to the LAW dispatch function.
18 Law Enforcement Information Network
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The dispatch team leader must insure reliable relief staffing for the LAW dispatch function during shift so that queuing between the call intake specialist and the LAW dispatcher/radio operator function does not occur. The fourth LAW staffing position could serve as on-shift relief staffing to the LAW dispatch function at non-peak times.
A possible solution to the on-shift relief-staffing problem posed by the EMS dispatch function would be to have the fourth LAW staffing position also serve as relief staffing to the EMS dispatch function. How this would be implemented during a shift is a decision best left to the team leader.
Table 22 below summarizes the on-shift staffing for the Responder Centric dispatch model. It indicates a base staffing level and a peak staffing level (base + one). Comments are added regarding the adequacy of staffing changes of plus or minus one.
Table 22. Optimal Staffing for Option 1 – Caller Centric Dispatch Model On-Shift Staffing Function Staffing Level Base Peak Supervisor 1 Supervisory functions only Call Intake Specialist 1 2 1 seriously inadequate; 2 adequate FIRE Dispatcher/ 1 2 1 overstaffed; 2 overstaffed Radio Operator EMS Dispatcher/ 1 2 1 seriously inadequate; 2 adequate Radio Operator LAW Dispatcher/ 3 4 3 adequate; 4 necessary Radio Operator
Optimal staffing is indicated in the highlighted cells at nine plus one Supervisor. The commentary may be useful to the supervisor in managing on duty and on break rotations during a shift.
B. Option 2 – Optimal Staffing for Responder Centric Model
After a detailed analysis of the workload flowing through the Dispatch Center, the Consultants recommend a dispatch team of 10 individuals for the Responder Centric Model as follows:
1 Supervisor 3 Call Takers 1 FIRE Dispatcher/Radio Operator 2 EMS Dispatcher/Radio Operators 3 LAW Dispatcher Radio Operators (1 with LEIN responsibilities)
Call Intake Specialist The workload flowing to the call taker is such that two staffing positions cannot quite handle it, yet three staffing positions represent a slightly overstaffed condition. Operationally, this condition is desirable because it provides a small cushion for on-shift relief staffing as team members rotate between on-duty and on-break.
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FIRE Dispatcher/Radio Operator Only one staffing position is required to support the FIRE radio operator function. The utilization of the FIRE radio operator function is very low simply because of the low number of FIRE incidents flowing through the Dispatch Center.
EMS Dispatcher/Radio Operator The workload flowing to the EMS radio operators is such that one staffing position cannot quite handle it, yet two positions represent a slightly overstaffed condition. Again, operationally, this provides a small cushion for on-shift relief staffing as team members rotate between on-duty and on-break.
LAW Dispatcher/Radio Operator One of the LAW dispatcher/radio operators will have responsibility for interfacing between the field responders and the Michigan Law Enforcement Information Network (LEIN). At least three LAW dispatcher/radio operators are needed to handle the workload.
The hour-by-hour Erlang table in Attachment J for this function shows that three staffing positions are adequate for most hours of the day. However, from 4 a.m. until 7 a.m., staffing of the LAW radio operator function can be reduced to two. Regardless, the supervisor must insure reliable on-shift relief staffing so that queuing between the call taker and the LAW radio operators does not occur.
Table 23 below summarizes the on-shift staffing for the Responder Centric dispatch model. It indicates a base staffing level and a peak staffing level (base + one). Comments are added regarding the adequacy of staffing changes of plus or minus one.
Table 23. Optimal Staffing for Option 2 – Responder Centric Dispatch Model On-Shift Staffing Function Staffing Level Base Peak Supervisor 1 Supervisory functions only Call Taker Specialist 2 3 2 inadequate; 3 overstaffed FIRE Radio Operator 1 2 1 overstaffed; 2 overstaffed EMS Radio Operator 1 2 1 inadequate; 2 overstaffed LAW Radio Operator 2 3 2 inadequate; 3 adequate
Optimal staffing is indicated in the highlighted cells at nine plus one supervisor. The commentary may be useful to the supervisor in managing on duty and on break rotations during a shift.
X. Comparison With ISO Recommendations
It is instructive to compare the recommendations of the FITCH staffing analyses to the Insurance Services Office (ISO) report for the City of Pinckney and Putnam Township (located in Livingston County) dated April 2013. 19 As the consolidated dispatch center for the County,
19 “Public Protection Classification Summary Report, Pinckney FDS and Putnam TS FDS, Michigan”, Insurance Services Office, Inc., April 2013.
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ISO ratings were applied to the Livingston County 911 Central Dispatch Center.
Ten percent of a community’s overall score is based on how well the communications center receives and dispatches fire alarms. The ISO classification summary in Table 24 below provides a Call Volume Matrix for public safety answering points that perform call taking and dispatching. Alarms are defined as, “A signal or message from a person or device indicating the existence of an emergency or other situation that requires action by an emergency response agency”. For 150,001 – 200,000 annual number of alarms, the ISO recommendation is one supervisor plus seven dispatchers.
Table 24. ISO Call Volume Matrix
There are two caveats regarding direct application of these numbers to Livingston Central Dispatch.
First, the eight needed telecommunicators in the ISO matrix represent dispatch staff that are to be “on-duty and awake.” 20 Some level of overstaffing is obligatory when dealing with a Dispatch Center that uses 12-hour shifts to account for dispatch staff unavoidably being “on- break”.
Second, these numbers are provided by an agency that focuses on FIRE dispatch. The specialized workloads associated with dispatch functions for EMS and LAW are not a prime
20 “Public Protection Classification Summary Report, Pinckney FDS and Putnam TS FDS, Michigan”, Insurance Services Office, Inc., April 2013.
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consideration of the Insurance Services Office. The workload imposed by pre-arrival instructions is unique to EMS dispatch and the volume of radio traffic required for LEIN documentation and officer safety is unique to LAW dispatch.
Thus, the actual on-shift head count required in a Dispatch Center dispatching all three disciplines, FIRE, EMS, and LAW, must be greater than the numbers in the ISO Call Volume Matrix.
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Attachment A
EMS Call Evaluation Process Attachment A: EMS CALL EVALUATION PROCESS
I. EMS Call EVALUATION PROCESS A. QA shall be provided by a random sampling of medical calls processed with the MPDS. 1. The random selection of these incidents shall be facilitated through the use of Priority Dispatch’s Export/Purge/Import software. 2. The auditing of these random calls will be facilitated with Priority Dispatch’s Advanced Quality Assurance Software (AQUA). 3. The calls selected through this random review will be reviewed by a certified ED-Q. 4. All calls will be evaluated in accordance with the standards and QA methodology set forth by the NAED. 5. Certified ED-Qs shall use the most current version of the NAED Medical Scoring Standards. 6. In accordance with NAED ACE standards, a percentage of incidents processed with the MPDS will be randomly reviewed each month. The exact percentage is generated off the annual call-volume and the NAED ACE “Case Review Calculator” and is approximately 3% (+/- .15%). B. Specific calls and incidents can be forwarded or identified for review. These calls will be reviewed to ensure compliance to our policies and procedures, or to provide specific information or directives to the staff, but will not be applied towards, or included in, our MPDS compliance scores or random monthly data. 1. Central Dispatch personnel shall forward their calls directly to the Medical CQI Supervisor for review. 2. Operations and EMS Personnel shall forward their calls to the Medical CQI Supervisor via email or through the use of the Field Feedback Form. 3. These incidents will be triaged and reviewed within a timely manner. Feedback will be provided through the appropriate applicable QA/QI Committee. II. FEEDBACK A. Call processing feedback and compliance to the MPDS will be provided through AQUA’s Case Evaluation Records (CERs). In addition to the numeric deductions and overall score, the ED-Q is responsible for providing a thorough and objective narrative through the Comments Section of the CER following Central Dispatch CER Comments Template. 1. Each ED-Q should review the CER prior to printing to ensure that it has been completed and completed accurately. 2. Each ED-Q is responsible for printing the CERs they generate and then placing them in the Emergency Tele-Communicator’s (ETC) mailbox. 3. Completed audits should then be moved to the appropriate AQUA Folder. B. In accordance with Central Dispatch Policy #______, Section ___, the ETC shall review the CER, sign it, and return it to the CQI Department within fourteen (14) calendar days. 1. The completed and signed CERs will then be reviewed by the Medical CQI Supervisor to identify any need for follow-up feedback or 1:1 call review with a member of the QIU. 2. The Medical CQI Supervisor is responsible for keeping the signed CERs in a confidential and locked filing cabinet for a period of six (6) months for reference. C. If the ETC has immediate questions, they can review their CER with a Communications Supervisor, Supervisor Lead, or Communications Training Officer (CTO). D. For a more personal or thorough review of the CER, or to challenge a comment or scoring deduction, the ETC should schedule a 1:1 review with an ED-Q, preferably (though not required) with the same ED-Q that audited the call. E. Each ETC has the right to question or appeal the ED-Qs feedback or directives. The incident will then be reviewed at the Weekly VRECC QIU Meeting. Any outstanding questions or procedural issues will be decided by a simple majority vote of the QIU ED-Qs. The Medical CQI Supervisor will have the “tie- breaking” vote. F. Efforts will be made to supply feedback to the infrequent call takers (typically primary dispatchers). These will be calls that do not come up in the random 3%. The goal is a minimum of 2 case evaluations per month for all.
III. STANDARDS A. The standards for each MPDS category are the NAED ACE thresholds: Case Entry: 95% Key Questions: 90% Post-Dispatch Instructions (PDIs): 90% Pre-Arrival Instructions (PAIs): 95% Chief Complaint Accuracy: 95% Final Coding Accuracy: 90% Total Compliance Score: 90% Customer Service 90%
B. Customer Service standards will be in accordance with the NAED Universal Customer Service Standards as well as Central Dispatch Call Processing Performance Standards. C. The standards for Call-Processing Times (Emergency Calls Only) and Total Incident Call-Processing Times (Emergency Alarms Only) will be based on Central Dispatch historic baseline thresholds are currently evaluated at one hundred twenty seconds (two minutes). D. The standards for Dispatch Delays will be in accordance with Central Dispatch Policy ______, Section _____. 1. Queue to Assign shall not exceed thirty (30) seconds. Our goal will be compliance to the ninetieth percentile (90%). E. As there is no current published standards or ACE thresholds for ECHO calls, Central dispatch “goal” is based upon the NFPA 1221 Standard of sixty (60) seconds.
Attachment B
EMS Functions by Fire Agencies
Attachment B: EMS Functions by Fire Agencies
Table 1. Fire Agency Call Count of EMS Functions 1/1/2012 through 9/30/2014 Response Agency Response Function Nature of Incident Count FIRE EMS ABDOMINAL PAIN 183 FIRE EMS ALLERGIC REACTION 160 FIRE EMS ANIMAL BITE 15 FIRE EMS ASSAULT 44 FIRE EMS ASSIST AMBULANCE FIRE 318 FIRE EMS ASSIST EMS 11 FIRE EMS ASSIST PD 145 FIRE EMS BACK PAIN 61 FIRE EMS BREATHING PROBLEM 1,330 FIRE EMS CARDIAC/RESPIRATORY ARREST 712 FIRE EMS CHEST PAIN 922 FIRE EMS CHOKING 73 FIRE EMS CO MEDICAL NEEDED 5 FIRE EMS CONVULSIONS/SEIZURES 609 FIRE EMS DIABETIC PROBLEM 379 FIRE EMS DROWNING 50 FIRE EMS EXTRICATION – VEH/AGR/INDU 149 FIRE EMS FALL 2,426 FIRE EMS HEADACHE 55 FIRE EMS HEART PROLEM 428 FIRE EMS HEAT/COLD EXPOSURE 22 FIRE EMS MEDICAL EMERGENCY 327 FIRE EMS MENTALLY/EMOTIONALLY UNSTABLE 5 FIRE EMS OVERDOSE/INGESTION 344 FIRE EMS PERSONAL INJURY ACCIDENT 1,576 FIRE EMS POISONING 1 FIRE EMS PREGNANCY/CHILDBIRTH/MISCARRY 59 FIRE EMS PRIORITY TRANSPORT 1 FIRE EMS PSYCH 142 FIRE EMS SICK PERSON 1,322 FIRE EMS SNOWMOBILE ACCIDENT 2 FIRE EMS STABBING 4 FIRE EMS STROKE 345 FIRE EMS SUICIDAL SUBJECT 91 FIRE EMS TRAUMATIC INJURY 313 FIRE EMS UNATTENDED DEATH 77 FIRE EMS UNCONSCIOUS/FAINTING 1,584 FIRE EMS UNKNOWN ACCIDENT 770 FIRE EMS UNKNOWN MEDICAL PROBLEM 372 TOTAL 15,773
There is a group of 434 incidents that are logged into the CAD as “MUTUAL AID TO OTHER FD OR EMS”. Clearly, these incidents involve either FIRE or EMS functions. However, the data from the CA372D that was made available to the Consultants did not permit distinguishing which was which. The Consultants chose to proportionately assign these mutual aid incidents to either a FIRE function or an EMS function. For the period January 1, 2012 through September 30, 2014, there are 9,941 responses involving a FIRE functions (12%) and 70,679 responses involving EMS functions (88%) provided by a FIRE agency. Thus, the 434 mutual aid incidents were assigned to either a FIRE function or an EMS function in the same ratio: 53 FIRE and 381 EMS. The assignments to these groups were made randomly so as to not introduce any systematic bias to the tallies of dispatch intervals.
Attachment C
Erlang-C Mathematics & Assumptions
Attachment C: Erlang-C Mathematics and Assumptions
Agner Krarup Erlang was a Danish mathematician, statistician and engineer who invented the field of telephone networks analysis while working for the Copenhagen Telephone Company from 1908 through 1929. The concepts and mathematics introduced by Mr. Erlang have stood the test of time. In the modern world, these methods are used to analyze queuing processes in systems as diverse as shoppers using grocery store checkout cashiers to data packet switching through Internet routers at megahertz frequencies. The goal of Erlang’s queuing analyses is to determine how many service providers should be made available to satisfy users, without over provisioning.
For Erlang’s analyses to apply to a system, two conditions must be met: 1.) Users arrive more or less at random intervals; 2.) Users receive exclusive service from any one of a group of service providing elements without prior reservations.
The flow of calls through the Livingston County Communications Center conforms to these requirements. Thus, Erlang analyses are valid for evaluating the flow of calls through the Livingston County Communications Center.
There are several versions of Erlang analyses depending on the exact model of the traffic flowing through the system. The specific model applicable to the Livingston County Communications Center has users either being served immediately or waiting in queue until a call taker becomes available. The specific mathematical embodiment of this analysis is referred to as the Erlang-C equation.
Erlang analyses must be conducted over a selected interval of time. In the case of emergency service communications centers experiencing the number of calls seen at Livingston, this interval is most appropriately one hour. Little insight would be gained by viewing each hour of the year as a special case. The need is for the analyst to consolidate individual hours into groups that present a valid picture of the way the system functions. The consolidation process appropriate to Livingston has been described above in this Report.
The Erlang C formula calculate the probability that an arriving call will be queued rather than being immediately served. Three common sense parameters go into the Erlang C calculation: the average arrival rate of calls during the hours being considered, the average length of time the dispatcher spends processing each call, and the number of dispatchers on duty.
For these analyses, traffic through the Livingston County Communications Center must be expressed in units of “erlangs”. E : Offered traffic in units of erlangs Eqn 1 h : Average call arrival rate in units of calls per hour : Average call processing time in units of hours per call
To avoid confusion, the reader should be advised that many of the time parameters appearing in the tabular data presented later in this report will be formatted as decimal hours rather than as hours:minutes:seconds, hh:mm:ss. For example, 15 minutes, 00:15:00, will appear as , 0.250 hr.
The probability that an arriving call will be queued rather than being answered immediately is calculated from the expansion of the Erlang C formula.
Eqn 2 E: Offered traffic (from Eqn 1) N: Dispatchers on duty
The probability that a call will be answered immediately, PA , then becomes: Eqn 3 Absolutely rigorous application of an Erlang-C analysis requires that three additional conditions be met: That callers never hang up while being held in queue, That all calls begin and end within a single time interval, and That callers never call back after having hung up while in queue.
When these conditions are not met, as will be the case in the real world, then the Erlang-C formula predicts that slightly more call takers should be used than are really needed to maintain a desired level of service. Thus, the Erlang-C analysis should be viewed as providing an upper bound to the needed number of call takers required to service a given flow of incoming traffic.
While this limitation of Erlang C analysis exists, in practice, it results in a negligible increase to the number of dispatchers predicted for Livingston. The flow of offered traffic through the Livingston system is modest and the number of dispatchers required is small. Dispatchers can be added to or subtracted from the system only in integer increments. Under these circumstances, incrementing the number of dispatchers by +1 will always result in such a large increase in answering probability that it overwhelms the propensity of a simple Erlang C analysis to slightly increase required number of dispatchers.
Attachment D
CAD Time Interval Definitions
Attachment D: CAD Time Interval Definitions
In the data exported from the CAD that was provided to the Consultants, five timestamps were included for each incident. The names of these timestamp fields are: [calltime], [MedPriStart], [timefini], [MedPriCompl], and [firstarrv]. The events being logged into these timestamp fields were verified with Lisa Beth Harvey, Livingston County 911 Central Dispatch, Operations Manager and Steve Hoyer as being the following:
[calltime] timestamp logging when the incident record is initiated in the CAD. For auto-generated and self-initiated traffic, this is the record creation time. For phone traffic, this is call ring-in.
[MedPriStart] timestamp logging when the dispatcher begins medical prioritization of EMS incidents.
[timefini] timestamp logging when the dispatcher sends the incident for assignment of a response unit. For FIRE and LAW response functions, this is the time at which the dispatcher is finished with the incident record.
[MedPriComp] timestamp logging when the dispatcher completes the medical prioritization data entry for EMS incident records.
[firstarrv] timestamp logging when the responding unit arrives at scene.
The dispatch processing interval for FIRE and LAW response functions was calculated as the difference between the [calltime] and [timefini] timestamps.
[process interval] = [timefini] - [calltime] Eqn. 4
The dispatch processing interval for EMS response functions calculated using [calltime] as the beginning of the interval and either [timefini] or [MedPriComp] as the end of the interval, whichever occurs later.
[process interval] = [timefini] - [calltime] Eqn. 5 but, when [MedPriComp] > [timefini] [process interval] = [MedPriComp] - [calltime] Eqn. 6
The consultants anticipate expanding dispatch responsibilities to include “pre-arrival instructions” for emergency medical service requests having echo-delta priorities. The load on the dispatch center depends on the duration of the pre-arrival instructions. A reasonable completion time for pre-arrival instructions is when the first EMS responding unit arrives at scene. Thus, the interval for pre-arrival instructions is calculated as the difference between the [firstarrv] timestamp and the [timefini] timestamp.
[prearrival] = [firstarrv] – [timefini] Eqn. 7
A tabulation of intervals from call received to first-arrived at scene, shows a number of records having delayed timestamps for first arrived at scene.
Table 1. Distribution of Pre-Arrival Intervals For Incidents Requiring EMS Responses CY2012 Pre-Arrival Intervals Count 00:00:00 … 00:14:59 20,081 00:15:00 … 00:29:59 4,153 00:30:00 … 00:59:59 818 01:00:00 … 02:29:59 499 Total 25,551
The Consultants chose to consider pre-arrival intervals in excess of 00:59:59 as being long duration outliers specific to CY 2012 and atypical of any subsequent year. Applying this criterion excludes 499 records, 1.95%, from the dataset and retains 25,052 records, 98.05% as valid contributors to this dataset.
Pre-arrival instructions need to be provided for only echo-delta (life threatening) calls. The time interval for pre-arrival instructions will be calculated using actual arrival intervals for EMS incidents experienced in Livingston County during CY 2012. Since Livingston does not currently log formally assessed ProQA determinants of acuity into the CAD, no historical echo-delta designations of EMS responses are available. Fortunately, the proportion of EMS responses that fall into the echo-delta category is essentially invariant at 15% across all EMS systems in the world. Consultants chose to use this 15% proportionality to calculate the added load on the dispatch processes incurred when pre-arrival instructions will be provided.
[prearrival workload] = 0.15 * ( [firstarrv] – [timefini] ) Eqn. 8
Attachment E
FIRE + EMS+ LAW Call Counts by Hour of Day
Attachment E: Fire + EMS + Law Incident Counts by Hour of Day
Table 1. Combined FIRE, EMS and LAW Counts by Hour of Day CY2012 1 Hour Manual Incident Records of Average Std Dev t-Test for Day [ Counts / Hour ] [ ± Counts / Hour ] Significance 2 23:00 6.25 3.52 00:00 4.84 3.03 11.62 01:00 3.78 2.46 10.39 02:00 3.42 2.29 4.10 03:00 2.75 2.12 8.21 04:00 2.37 2.98 3.98 05:00 2.79 2.45 4.17 06:00 3.93 2.44 12.61 07:00 5.28 2.77 13.99 08:00 6.40 2.91 10.67 09:00 6.97 3.34 4.92 10:00 7.68 3.39 5.71 11:00 7.87 2.95 1.62 12:00 8.33 3.01 4.18 13:00 9.16 3.13 7.31 14:00 10.02 4.01 6.47 15:00 10.25 3.96 1.56 16:00 10.83 4.17 4.66 17:00 10.95 3.89 0.94 18:00 10.81 3.68 9.43 19:00 9.49 3.6 4.91 20:00 8.83 3.54 3.56 21:00 8.36 3.59 5.01 22:00 7.70 4.05 10.25 23:00 6.25 3.52 44.57
1 The t-tests for significance of differences are made pairwise between successive hours. All hour-by hour changes in the averages show a 99% probability of being real rather than being due to random chance.
Attachment F
Quantitation of Workloads
Attachment F: Quantitation of Workloads
Temporal Distribution of Incidents The hour-by-hour temporal distribution of manually entered incident records and of automatically spawned incident records was taken from the historic CAD. Incidents requiring FIRE, EMS, and LAW functions were individually tallied for each hour of the year. The emphasis on “functions” is important because workload flowing to the dispatch staff depends on more on the function required to respond to an incident than on the type of agency responding to the incident.
There are four ancillary workloads that contribute to total workload flowing to the dispatchers. These are nuisance calls, outgoing calls, radio traffic, and pre-arrival instructions. In the case of these workloads, data was not available to compile actual hour-by-hour temporal distributions. The approach was to first total an annual time-on-task for each of these workloads and then to allocate these four totals on per incident bases. These average workloads per incident were then added to other workloads for a specific incident. In this way, the ancillary workloads included in Erlang calculations are given an hour-by-hour temporal distribution that mimics the actual temporal distribution of incidents logged into the historic CAD.
Average Incident Processing Intervals The total incident processing intervals were taken from the historic CAD. The detailed calculation of intervals from the timestamps in the CAD is described in Attachment __. The frequency distribution of processing intervals was plotted as histograms in Figure ##, Figure ##, and Figure ##, above. Average incident processing intervals specifically for FIRE, EMS, and LAW were taken from these histograms. These averages automatically include the impact of long duration outliers actually present in the Livingston system on the respective processing functions.
Automatically Spawned Records Incidents logged into the CAD with processing intervals of zero are auto-generated, while those with processing intervals of one to five seconds are self-initiated. Central Dispatch staff refers to these two classes of incident records as having been “automatically spawned”. Spawned FIRE, EMS, and LAW incidents were individually tallied for each hour of the year.
Average Call Intake Intervals No timestamps logged into the Livingston CAD demarcate the time interval specifically needed for intake of a call.
The Consultants assume that the Livingston County 911 Dispatch Center will ultimately strive to meet the National Fire Protection Association’s standards for call intake expected of a high performance system, as indicated in the table below.
Table 1. NFPA Performance Standard for Call Intake 1 Step Action A call taker at the 911 Dispatch Center answers the incoming call, identifies whether it should 1 be medical, police or fire that handles the call, and transfers the call to a dispatcher. NFPA 1221 Section 6.4.5 Performance Standard: Less than 30 seconds for 95% of calls
1 NFPA 1221: Standard for the Installation, Maintenance, and Use of Emergency Services Communications Systems, 2013 Edition. 1
The NFPA Standard for the call intake interval is couched in terms of a 95 th %-tile interval. As discussed above, Erlang analyses require that processing intervals be input as averages (effectively 50 th %-tiles). For purposes of this report, the interval at the 50 th %-tile was calculated from the 95 th %-tile value by dividing by the appropriate single-sided Z-score, 1.65, taken from a cumulative standard normal table of areas under the normal distribution curve. 2 Thus, NFPA 1221 Section 6.4.5 requires that call intake be completed in an average of 18.2 seconds.
The 18.2 second average for call intake is the NFPA expectation for a high performance system. Since, the Livingston County 911 Dispatch Center will be newly transitioning to a system using dedicated call takers, the Consultants feel it is more realistic to expect the system to immediately achieve a somewhat slower average time interval for call intake. Accordingly, the call intake time for Livingston was extended by 133% to 24.2 seconds/incident.
Average Assessment/Prioritization Intervals No timestamps logged into the Livingston CAD demarcate the time interval specifically needed to assess the acuity of an incident and to assign a response priority to an incident.
A reasonable value for FIRE assessment/prioritization was obtained from Consultants’ archives. An average assessment/prioritization interval was taken from a medium performing FIRE dispatch system.
A reasonable value for EMS assessment/prioritization was obtained from Consultants’ archives. An average assessment/prioritization interval was taken from a medium performing EMS dispatch system that used a formal implementation of the MPDS protocols for ProQA determinants and set response priorities using these determinants.
A reasonable value for a LAW assessment/prioritization was based on literature reports for the high performance police dispatch system at Hialeah, FL. 3 In this system, the median call assessment and prioritization time for all chief complaints was 45 seconds. Since, the Livingston County 911 Dispatch Center will be newly transitioning to a system using dedicated call takers, the Consultants feel it is more realistic to expect the system to immediately achieve a somewhat slower average time interval for assessment and prioritization of LAW incidents. Accordingly, the LAW assessment and prioritization time interval for Livingston was extended by 133% to 59.9 seconds/incident.
Table 2. Assessment and Prioritization Intervals for Manually Entered Incident Records. Average Discipline Assessment/Prioritization Source Interval [seconds/incident] FIRE 52 Consultants’ Archives EMS 23 Consultants’ Archives LAW 59.9 Hialeah PD, Hialeah, FL
2 Cumulative Standard Normal Tables (Z-Tables),
2 Average Assignment Intervals No timestamps logged into the Livingston CAD demarcate the time interval specifically needed to assign units to an incident.
The average assignment intervals for each discipline were obtained by subtracting the average intake interval and average assessment interval from the total processing interval for each discipline as taken from the historic CAD. The results of these differences are presented below.
Table 3. Assignment Intervals for Manually Entered Incident Records Average Assignment Discipline Interval [seconds/incident] FIRE 18.8 EMS 20.9 LAW 36.9
The calculation of the average EMS assignment interval was more complicated. The Dispatch Center provides pre-arrival instructions to high acuity EMS incidents. The average time interval for these instructions also needed to be subtracted from the average total processing interval for EMS incidents to arrive at an assignment interval. The calculation of the pre-arrival interval is discusses immediately below.
Average Pre-Arrival Intervals For EMS incidents in the Livingston CAD, the duration of the pre-arrival instructions will extend from the timestamp when a response unit is toned-out to the timestamp when the first response unit arrives at scene, the “Pre-Arrival Interval”. The additional workload imposed on the dispatch staff on a per EMS incident basis is 15% of the sum of all of the EMS pre-arrival intervals in the system. The calculation of the average workload for pre-arrival instructions is specific to Livingston County because the count of EMS incidents and the summation of all EMS pre-arrival intervals for CY 2012 are both taken directly from the historic CAD.
Table 4. Calculation of EMS PreArrival Workload From CY 2012 CAD Data. Data Element Value Manually Entered EMS Incidents 15,207 Summation EMS Pre-Arrival Intervals 3,039.60 hr 15% Summation EMS Pre-Arrival Intervals 455.94 hr Average Pre-Arrival Instructions / EMS Incident 0.02998 hr / call Average Pre-Arrival Instructions / EMS Incident 107.94 sec / call
The 15% proportionality factor is a worldwide constant. The number of life threatening EMS incidents, those with Echo-Delta level determinants, as a percentage of all EMS incidents in any system are a constant. This percentage holds for EMS systems a far-flung as Pinellas County, FL to Hong Kong, China.
Average Nuisance Call Workload The manual incident records logged into the CAD do not capture all of the workload that will be flowing to the call takers. Most of the calls entering the Livingston County 911 Dispatch Center result in the manual creation of an incident record. These are “RESPONSE” calls. However, not all calls have this outcome. There are redundant calls, misdials, unintentional
3 calls, and prank calls that also flow into the Dispatch Center. For purposes of this report, these are collectively referred to as “nuisance” calls that require “NO-RESPONSE”. Determination of a NO RESPONSE function by the call taker is a legitimate part of the intake process and must be factored into the workload on the call takers.
The Cassidian Aurora Report titled “Call Duration” and dated 8/13/2014, provided counts of outgoing and incoming calls through the Dispatch Center from May 1, 2012 through December 31, 2012. However, these raw records of incoming and outgoing phone calls were subject to extensive double counting because the POTS telephone lines and the Centrex telephone lines were not correctly connected. This error condition persisted throughout this time period and was not corrected until just recently, on October 7, 2014.
In Table 6, the excess of incoming calls over manual incident records created in the CAD over this time span is taken as a measure of the number of redundant, misdialed, unintended, and prank calls. The NO-RESPONSE calls were apportioned by hour-of-day to parallel the temporal distribution of manually entered incident records as determined from the historic CAD. Workload imposed on the call takers by the NO-RESPOSE calls was calculated from the number of these calls multiplied by an average duration of 24.2 seconds.
Table 5. Incoming Calls From Cassidian Aurora Report for 5/1/2012 Through 12/31/2012 Calculation Step Value Total Calls 129,656 - Internal Calls -237 - Unknown -3,858 Incoming + Outgoing Calls 125,561 - Outgoing Calls -24,100 Incoming Calls 101,461 ½ X Correction for POTS - Centrex Error 50,730 Manually entered CAD incident records 5/1/2012 – 12/31/2012 43,404 Nuisance Calls 7,326 Intake Interval for determining NO RESPONSE 24.2 sec/call Ratio [ Nuisance Calls / Manual Incident Record ] 0.16879 Nuisance Call Workload / Manual Incident Record 4.085 sec/incident
Average Outgoing Call Workload Certain prank calls and hang-up calls impose the need to make call backs that constitute an additional workload on the call takers. In the table below, the average number of outgoing calls per day is Tabulated from the Cassidian Aurora Report titled “Call Duration” and dated 8/13/2014. The average duration of the outgoing calls is reported to be 78 sec/call. The outgoing calls were apportioned by hour-of-day to parallel the temporal distribution of manually entered incident records as determined from the historic CAD. Workload imposed on the call takers by the outgoing calls was calculated from the number of these calls multiplied by their average duration.
4 Table 6. Allocation of Outgoing Call Workload to Manual Incident Records Calculation Step Value Average Duration per Outgoing Call 78 sec/call Aurora Count of Outgoing Calls 24,100 ½ X Correction for POTS - Centrex Error 12,050 Days 5/1/2012 – 1231/2012 245 Annualized Outgoing Calls / Year [ 366 / 245 ] 18,001 calls/year Annual Duration Outgoing Calls 390.037 hours Manually Entered Incident Records / year 61,871 Average Outgoing Duration / Manual Incident Record 22.694 sec / Incident
Average FIRE, EMS, And LAW Radio Traffic Per Incident The dispatch processing intervals logged into the CAD comprise the largest single portion of the total workload on the dispatch staff, but do not provide the whole picture. The next major contributor to workload on the dispatch staff is the radio traffic between the Dispatch Center and the responder in the field as the response to an incident progresses.
No data that was made available to Consultants had a direct bearing on the amount of radio traffic experienced by the Dispatch Center. However, the effects of the radio traffic actually present in the system can be seen in the phone records.
Consultants were able to make a reasonable estimate of radio traffic using three pieces of indirect data that was provided to them by Livingston and one datum from Consultants’ experience. The first datum is the temporal distribution of incidents flowing into the Dispatch Center. The second datum is the composition of the dispatch staff on shift. The third datum is the reported percentage of calls that are picked up in 0 – 6 seconds.
The temporal distribution of incidents flowing into the Dispatch Center gives a count of each type of response required, FIRE, EMS, or LAW. It is Consultants’ experience that radio traffic engendered by FIRE : EMS : LAW incidents is approximately in the ratio of 2.0 : 1.0 : 3.5.
The number of fully trained dispatchers and shift leaders was obtained from Lisa Beth Harvey, Operations Manager, as reported to the Consultants in the Informational and Data Request as document titled “911 Current Staffing Aug 5 2014.xls”. Currently, with 22 fully trained dispatchers/shift leaders available, the preferred composition of a dispatch team is one shift leader and four dispatchers. Four dispatchers per shift does not mean there are four dispatchers continuously at their task workstations. Personnel rotate between being “on duty” and “on break” with the net outcome that the effective number “on duty” is between 4 and 5.
The Cassidian Aurora Report titled “Call Count by Wait Time Range” and dated 10/15/2014 specified that 97.7% of all calls were answered within 0 – 6 seconds. The Consultants propose that 0 – 6 seconds in the real world is operationally equivalent to “immediate answer” in the mathematics of Erlang analysis.
The starting point for extracting radio traffic was to have all of the workloads listed in Table 1, above, flowing to the dispatch team as the “base case” workload. Reverse Erlang analyses were conducted using on-shift base-peak staffing of 4 – 5, this base case workload, and increasing increments of radio traffic. The best estimate of radio traffic is that value for which
5 the calculated probability of immediate answer matches the historically observed probability of immediate answer.
Average radio traffic of FIRE 50 sec, EMS 25 sec, and LAW 87.5 sec per incident, respectively, is required to satisfy the condition that the immediate answer probability brackets 97.7% when on-shift base-peak staffing is 4-5 and all other workloads are present.
In the absence of historic data, Consultants feel these are the best estimates available of radio traffic through the Livingston County 911 Dispatch Center. Average radio traffic of FIRE = 50 seconds/incident, EMS = 25 seconds/incident, and LAW = 87.5 seconds/incident were used in the calculations of workload on the FIRE, EMS, and LAW dispatchers respectively.
The 25 seconds / incident is explicitly a measure of the radio traffic between the EMS dispatcher and the EMS response unit. Pre-arrival instructions between the EMS dispatcher and the caller represent workload on the EMS dispatcher in addition to the radio traffic.
6 Table 7. Addition of Radio Traffic4 To All Other Workloads To Reproduce The Historically Observed Probability of Immediate Answer.
4 Average radio traffic of FIRE 50 sec, EMS 25 sec, and LAW 87.5 sec per incident, respectively, is required to satisfy the condition that the immediate answer probability brackets 97.7% when on-shift base-peak staffing is 4-5 and all other workloads are included.
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Attachment G
Personnel Functions by Operational Models
Attachment G: Personnel Functions by Operational Models
Table 1. Personnel Dispatch Functions By Model
Dispatch Models
Functions Required to “Responder “Vertical ” “Caller Centric” Operated Dispatch Center Centric” (Current) (Option One) (Option Two) Personnel Tasked with Dispatch Functions Call pickup Verify ANI/ALI for wireless callers Call Intake Dispatch Staffers Call Taker Manage nuisance calls Specialist Make outgoing calls Determine discipline(s) req’d as FIRE, EMS, or Call Intake Dispatch Staffers Call Taker LAW Specialist
FIRE Dispatcher/ Assess acuity FIRE Dispatch Staffers Call Taker Radio Operator EMS Dispatcher/ Assess Acuity EMS Dispatch Staffers Call Taker Radio Operator LAW Dispatcher/ Assess Acuity LAW Dispatch Staffers Call Taker Radio Operator
FIRE Dispatcher/ Determine priority FIRE Dispatch Staffers Call Taker Radio Operator EMS Dispatcher/ Determine priority EMS Dispatch Staffers Call Taker Radio Operator LAW Dispatcher/ Determine priority LAW Dispatch Staffers Call Taker Radio Operator
FIRE Dispatcher/ FIRE Notify FIRE agency with jurisdiction for incident Dispatch Staffers Radio Operator Radio Operator Dispatch EMS response unit(s) EMS Dispatcher/ EMS Provided by FIRE agencies Dispatch Staffers Radio Operator r Radio Operator Provided by EMS agencies LAW Dispatcher/ LAW Bid LAW response Dispatch Staffers Radio Operator Radio Operator
Provide FIRE radio support FIRE Dispatcher/ FIRE Specific to incident Dispatch Staffers Radio Operator Radio Operator Generic to FIRE functions Provide EMS radio support EMS Dispatcher/ EMS Specific to incident Dispatch Staffers Radio Operator Radio Operator Generic to EMS functions Provide LAW radio support LAW Dispatcher/ LAW Specific to incident & LEIN requirements Dispatch Staffers Radio Operator Radio Operator Generic to LAW functions Provide pre-arrival instructions specific EMS Dispatcher/ Dispatch Staffers Call Taker to Echo-Delta level EMS incidents Radio Operator
Table 2. Dispatch Models “Vertical” Dispatch Model “Caller Centric” Dispatch Model “Responder Centric ” Dispatch Model (Current) (Options One) (Option Two) Call Takers Call pickup Call Intake Specialist Verify ANI/ALI for wireless callers Call pickup Manage nuisance calls Verify ANI/ALI for wireless callers Make outgoing calls Manage nuisance calls Determine discipline FIRE, EMS, or LAW Make outgoing calls Assess acuity FIRE, EMS, or LAW Determine discipline FIRE, EMS, or LAW Determine priority FIRE, EMS, or LAW Transfer caller to dedicated dispatcher Transfer incident info to radio operator Dispatch Staffer Provide pre-arrival Instructions to caller Call pickup for Echo-Delta level EMS incidents Verify ANI/ALI for wireless callers FIRE Dispatcher/Radio Operator Manage nuisance calls FIRE Radio Operators Assess Acuity & Determine Priority Make outgoing calls Notify FIRE agency with jurisdiction Notify FIRE agency with jurisdiction Determine discipline FIRE, EMS, or LAW Provide radio support Provide radio support Assess acuity FIRE, EMS, or LAW Specific to incident Specific to incident Determine priority FIRE, EMS, or LAW Generic to FIRE functions Generic to FIRE functions Dispatch response unit(s) EMS Dispatcher/Radio Operator Notify FIRE agency with jurisdiction Assess Acuity & Determine Priority EMS Radio Operators EMS functions by FIRE agencies Dispatch EMS response unit(s) Dispatch response unit(s) EMS functions by EMS agencies Provided by FIRE agencies Provided by FIRE agencies Bid LAW response Provided by EMS agencies Provided by EMS agencies Provide radio support Provide radio support Provide radio support Specific to incident Specific to incident Specific to incident Generic to system management Generic to EMS functions Generic to EMS functions Provide Pre-Arrival Instructions specific to Echo-Delta level EMS incidents LAW Dispatcher/Radio Operator LAW Radio Operators Assess Acuity & Determine Priority Bid response Bid LAW response Provide radio support Provide radio support Specific to incident & LEIN requirements Specific to incident & LEIN requirements Generic to LAW functions Generic to LAW functions Callers first communicate with the Call Taker and Callers communicate only with the Call Taker. Notes then with the Dispatcher. Dispatchers also Radio Operators communicate only with communicate with responders by radio. responders.
Attachment H
Erlang Analysis: Models of Current Operations
Attachment H: Erlang Analyses: Models of Current Operations
Table 1. Responder Centric Model of Current Operations - Call Taker Workload
1 Table 2. Responder Centric Model Of Current Operations - FIRE Radio Operator Workload
2 Table 3. Responder Centric Model Of Current Operations - EMS Radio Operator Workload
3 Table 4. Responder Centric Model Of Current Operations - LAW Radio Operator Workload
4 Table 5. Vertical Model of Current Operations - Team Workload
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Attachment I
Erlang Analysis: Option 1 – Caller Centric Model
Attachment I: Erlang Analyses: Option 1 - Caller Centric Model
Table 1. Option 1 – Call Taker Workload in Caller Centric Dispatch Model
1 Table 2. Option 1 – FIRE Dispatcher Workload in Caller Centric Dispatch Model
2 Table 3. Option 1 – EMS Dispatcher Workload in Caller Centric Dispatch Model
3 Table 4. Option 1 – LAW Dispatcher Workload in Caller Centric Dispatch Model
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Attachment J
Erlang Analysis: Option 1 – Responder Centric Model
Attachment J: Erlang Analyses: Option 2 - Responder Centric Model
Table 1. Option 2 – Call Taker Workload in Responder Centric Dispatch Model
1 Table 2. Option 2 – FIRE Radio Operator Workload in Responder Centric Dispatch Model
2 Table 3. Option 2 – EMS Radio Operator Workload in Responder Centric Dispatch Model
3 Table 4. Option 2 – LAW Radio Operator Workload in Responder Centric Dispatch Model
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