In February 2020, Italy was the first country in Europe to come into contact with Covid19. The pandemic hit Italy unexpectedly: from the identification of "patient 1", the sequence of events was fast, intense, sudden. Within a few hours, the 112 PSAPs in Lombardy, the first affected region, were flooded with requests for information and help both for Covid and for regular medical assistance.
Beta 80 Group is the largest CAD supplier in Italy and our CAD is used in all of Lombardy's 112 and EMS PSAPs. In this very delicate period, we assisted AREU, the regional emergency agency, in finding a new way to manage calls. This meant that the CAD had to readjust and change. We were in an extraordinary situation with no points of reference.
What were the steps we followed and how did the CAD adapt?
Managing the Covid19 call flow: the first 112 PSAP filter
In just one day, we needed to find a way to address the rapidly evolving crisis. The solution was to introduce a new triage filter, structured to quickly evaluate Covid cases and separate them from the rest.
In normal times, 112 PSAPs only collect basic information (caller ID, location, and emergency nature) and let the II Level dispatcher investigate and classify the call. The new filter helped immediately classify the call as Covid related, to manage it in a different way, freeing the EMS PSAP from an unnecessary workload.
The first version of the filter separated requests for information from real emergencies. The former was directed to a new PSAP, which acted as an information service provider. Recalibration of calls and the new PSAP setup took less than two days.
Thanks to our CAD flexibility, we were able to quickly redesign the triage filter, including the new interview tree. After development, we immediately included it in the operational procedures. Call takers used it effectively and without interruption in the service. The filter has been continuously revised and improved, reaching 15 versions.
Managing the emergency: the EMS PSAP Filter
Thanks to the new 112 PSAP filter it was possible to sort non-urgent calls. Over time, however, the number of emergency calls reporting breathing difficulties increased. The CAD had to be adapted quickly to avoid the collapse of the EMS system in Lombardy.
This time, thanks to the web-based nature of our CAD, we were able to create a new dedicated temporary EMS PSAP, to manage and distribute calls of different priorities and perform medical triage at the II Level, leaving dispatchers with only the cases that really needed an ambulance.
The EMS PSAP was manned by volunteer doctors, who received specific training on CAD, in just one day, using e-learning. It was the first time in Italy this training was carried out 100% remotely.
The Covid dedicated hotline - the third filter
Swift action in the midst of a pandemic outbreak is not easy, but it is essential. A special hotline for the most serious cases, detected in the 112 interviews, was thus established. Top priority was given to the calls from the hotline, relating to Covid and other severe medical emergencies.
This change in call flow and protocol meant that the CAD needed a new 112 call filter to better classify the call. This new filter let call takers perform a more in-depth analysis of the situation, with very accurate medical questions. It also separated Covid calls from others.
The high severity evaluation would forward the call to the EMS PSAP or, in the most serious cases, to the hotline.
Cases of medium severity were sent to the EMS PSAP during the night shift (when call traffic was low) or recorded and sent to a support center during the day. The support center would call back within 24 hours to follow up on the request.
Prepared for the unexpected: Life 1st, Beta 80 Group's CAD Software
Life 1st, Beta 80 Group's CAD reacted well to the emergency, showing itself to be flexible, agile, and "prepared for the unexpected".
The establishment of new filters and protocols in the very first hours, made it possible to save lives, limit damage and ensure the continuity of the emergency service, without affecting the level of efficiency.
Here are the 3 most important outcomes:
- II Level EMS PSAPs were relieved of the pressure of the huge number of calls and were able to focus on the most critical cases.
- Thanks to a more rational and distributed system, the number of emergency vehicles dispatched was reduced by 15%.
- Response times in 112 PSAP improved significantly, from 10 minutes to 12 seconds (compared to 5 seconds pre-Covid)