Method Abstract: Agreement Between Dispatch and Pre-arrival Physician Assessment
DOI:
https://doi.org/10.31247/agnj.v3iS1.95Keywords:
Dispatch triage, Pre-arrival assessment, Overtriage, Undertriage, QualitätsmanagementAbstract
Objective In the Styrian emergency medical services (EMS) system, dispatchers decide on emergency physician (EP) deployment using the DIAS dispatch protocol (digital interactive query support system), while EPs independently form a pre-arrival judgment based on the dispatch information. This study aims to quantify agreement between these pre-arrival assessments and the retrospectively determined indication for EP involvement while identifying associated contextual factors.
Methods This prospective observational single-center study will include all missions of the physician response unit of the University Hospital Graz during a one-week period. For each eligible mission, original initial dispatch text, pre-arrival EP indication judgment of the responding EP based solely on dispatch information (yes/no), NACA severity score, and a structured feedback code describing core clinical parameters at EP arrival will be collected. After the mission, dispatch texts are then re-evaluated by participating EPs, who will provide binary indication judgments based on the standardized criteria provided by the Emergency Physician Indication Catalog (Notarztindikationskatalog, NAIK) of the German Medical Association. Agreement between the different assessments will be quantified. In addition, the study will evaluate contextual factors such as physician specialty, time of day, or provider experience. The expected sample size will be approximately 60 missions. The study uses fully pseudonymized data without altering patient care; participating EPs will provide informed consent, and ethics approval is obtained from the Medical University of Graz ethics committee.
Discussion For the first time, DISPATCH-EP will provide data on diagnostic accuracy of pre-arrival triage decisions by dispatchers and EPs, reveal overtriage/undertriage rates, and identify modifiable factors (e.g., dispatch keywords, time of day, physician specialty) to optimize physician-staffed unit deployment in the Styrian EMS system, sustainably enhancing systemwide patient safety and resource efficiency.
