How the City of Alexandria Uses Call Assessment for Continuous Improvement
The Alexandria Department of Emergency Communications serves as the Public Safety Answering Point for all emergency services (including law enforcement, fire service, and emergency medical dispatch) within the city. The City of Alexandria is a Washington, D.C., suburb, located in northern Virginia, with approximately 151,000 residents.
The Department of Emergency Communications consists of sixty employees dedicated to 911 dispatch as well as emergency and non-emergency call handling through a computer-aided dispatch system, E911 telephone system, and municipal radio operations. Alexandria upgraded its call-handling support by incorporating Total Response’s computer-aided call-handling (CACH) software in 2015.
Adding PowerPhone’s Total Response call assessment process to Alexandria’s operations was a top priority for Systems Administrator Robert Bloom when he joined the agency in 2016.
At the time, Alexandria tracked call assessment data with a static Excel spreadsheet. While this provided some insight into overall call performance, Bloom was frustrated that, due to the static nature of the spreadsheet, it could not be used to score calls evenly because there was no mechanism to account for unique questions related to each call.
“If you use static questions for all calls, there is a strong possibility that you will miss important questions that should have been asked,” said Bloom, “whereas automated processes make it easier and more efficient to track different questions throughout the varying call types. You’re going to ask very different questions for a burn call than for a chest pain call. Sorting and categorizing the questions by chief complaint takes the mystery out of performing call assessment.”
In addition, Alexandria’s Medical Director J. Benji Marfori, MD, FACEP, explained, “You cannot improve outcomes without measuring performance. When variances occur, we must ask ourselves if the problem is with the person or the process. We cannot expect our personnel to achieve goals for which we have not adequately trained them. Quality Assurance must be viewed as process improvement rather than disciplinary action. We all have room to improve. The system needs to constantly evolve to include new threats and conditions.”
Alexandria performs call assessment through the CACH Assessor Module, which allows supervisors to select call records against predefined criteria.
Bloom was drawn to PowerPhone Total Response call assessment’s automation and flexibility, especially its ability to sort and categorize calls by chief complaint. “Before using PowerPhone, supervisors used a static spreadsheet to score calls after they were reviewed,” Bloom said. “When using PowerPhone, the questions and scoring change as the situation changes, providing clearer insights into actual call-handling performance.”
In Alexandria’s Department of Emergency Communications, CACH is installed on ten workstations, allowing supervisors to pull reports for each employee, along with a computer-aided dispatch (CAD) report and each call’s accompanying audio. Each employee has a personal assessment record stored in a separate folder on a dedicated hard drive. Employees may access their own data at any time.
Supervisors review priority calls first, then a set number of calls every month for each dispatcher. New employees are monitored more closely, and veteran employees are monitored more when necessary.
Assessment provides a score or rating that measures how effectively each call was managed in relation to expected standards.
Scores are generated by completing configurable assessment templates that focus on specific aspects of each call including: verifying the caller’s number and location, the telecommunicator’s communication skills, performance at each stage of the call (pre-dispatch, dispatch, and post-dispatch), issuance of pre-arrival instructions (when necessary), and script relevance to the call.
Senior staff also perform agency-wide reviews in monthly meetings with the Medical Director to set call-handling priorities and adjust their call assessment focus.
Leadership routinely chooses a new aspect each month for greater inspection, such as determining whether dispatchers are overusing the “Unknown Medical” and “Sick Person” call types as the chief complaint.
Alexandria rejuvenated their QA operations with Total Response call assessment by automating data collection, revealing deeper insights into their call-handling effectiveness, and clarifying expectations for every call type.
After identifying areas for improvement, staff conduct training to strengthen future handling of related incidents. Training exercises reinforce agency standards, increase dispatcher confidence, and raise overall service quality with a culture of continual improvement.
One of the biggest improvements, says Bloom, comes with a more detailed review of each telecommunicator’s performance. “Telecommunicators who are asking the incident-specific questions not listed on the old Excel spreadsheet are now getting credit for it. Conversely, the data will also reflect if any of the incident-specific information is omitted.”
Additionally, collected data guides the agency’s tracking and training priorities. Bloom points to the example of discovering through assessment that some telecommunicators were confused about when to categorize a call under the “Falls–Back Injury” chief complaint. Supervisors used the accumulated data to justify additional training on the subject and quickly saw significant improvement in their performance metrics for related calls.
This tactic has proven so effective that Bloom credits call assessment with identifying “nearly 100% of non-certification or recertification training topics; our training is tailored to what our needs are.”
Alexandria’s success with call assessment has inspired the Department of Emergency Communications to explore extending the features and benefits of CACH to the handling of non-emergency calls. For example, the department would utilize the CACH Script Builder to create protocols for handling common non-emergency inquiries. Not only will this encourage telecommunicators to answer these inquiries with greater consistency, supervisors will also be better equipped to track these interactions and monitor performance in relation to predefined standards.
Total Response’s proactive approach to call assessment reduces agency liability and risk by documenting adherence to defined standards and building pathways for improvement. Assessment also provides crucial insights for the City of Alexandria to monitor its performance against the individual agency’s standard of care, make informed adjustments to that standard, and take actionable steps for improvement through call training.