ST. GEORGE – The St. George Communications Center, or “dispatch” as it is more commonly known, handles emergency dispatch services for most of Washington County. It was the subject of testimony during recent hearings between Dixie Ambulance and Gold Cross Ambulance, as its data was used by Gold Cross against Dixie Ambulance, and Dixie Ambulance retaliated by calling dispatch data’s reliability and system into question.
Dispatch representatives were not called to testify
Dispatch representatives were not called to testify or respond to issues raised.
Dispatch maintains its data is reliable and verifiable; that data entered by Dixie Ambulance and Hurricane Fire in alternate systems is, at the least, not externally verifiable; and that for any anomalies to be dispositive, they must be factored in proportion to the volume of data produced.
Was St. George dispatch made a scapegoat for Dixie Ambulance, defending against challenges made to its own services in the hearings? Dispatch management said they feel they were.
Background
The hearings arose as a result of a June 2011 application by Gold Cross Ambulance, a Salt Lake City company, to the Utah Bureau of Emergency Medical Services and Preparedness, seeking to take over 911-ambulance service in the St. George area. In order to take over the state license/contract for the area, Gold Cross seeks to prove that Dixie Ambulance is not meeting state requirements.
An administrative hearing was held over several days in early December.
During that hearing, data from the records management system used by St. George dispatch was both introduced and challenged.
St. George News met with Cindy Flowers and Justin Grenier, manager and assistant manager, respectively, of St. George Communications Center. Flowers has been in dispatch supervision since 1999, and succeeded Jeff Dial as manager when he passed in February 2012. Grenier has served in various roles in the dispatch center for eight years.
Participants in the system
Before 2007, Washington County public safety entities had three separate systems, Grenier said. The sheriff’s office had one, Hurricane City had one and the City of St. George had one. In 2007, all public safety entities came together under one system; fire, emergency medical services, law enforcement, Utah Highway Patrol, all included – except, Dixie Ambulance and Colorado City-Hildale, who have not opted in to the common system to date. Dispatch does track Dixie Ambulance via radio recording.
Unmanned dispatch station at the St. George Communications Center, St. George, Utah, Dec. 11, 2012 | Photo by Sarafina Amodt, St. George News
The Spillman system
The Spillman CAD (computer-aided dispatch) system is a public safety software system provided by Spillman Technologies, Inc., a Salt Lake City company, used by dispatch centers, law enforcement and EMS agencies throughout Utah and other states. It includes two components: records management and mobile.
• The records management system, Grenier said, is a program for tracking response times, doing reports, writing your after action reports, probable cause statements, booking reports, and so on.
• The mobile system, Grenier said, is in-vehicle. “It’s where your GPS is plugged in, this is where you can run a license plate, check to see maybe if someone has hepatitis, that threatens officers, and … all kinds of safety stuff.” It provides information on locations of other public safety units as well as providing mapping and tracking, even so far as recording the speed a vehicle travels.
All of the participating agencies utilize both, except Hurricane Valley Fire District, which only uses the mobile system. Again, Dixie Ambulance and Colorado City-Hildale agencies do not use either component of the Spillman system.
Response times
One of the phrases on the walls of the St. George Communications Center, St. George, Utah, Dec. 11, 2012 | Photo by Sarafina Amodt, St. George News
Response time is determined from the time dispatch pages, Flowers said, to the time the responder arrives on scene.
Gold Cross collected data from the dispatch center and created a study showing Dixie Ambulance was not meeting industry standards in its response time and argued that Dixie Ambulance was violating state law because of it. To counter this claim, Dixie Ambulance lawyers scrutinized the source used for the study: the dispatch records. It essentially claimed that dispatch personnel and equipment failed to accurately record response times.
Recording of data
When a 911 call is received, Flowers said, it is immediately time-stamped; it is dispatched within 90 seconds of receiving the call –medical (Dixie Ambulance, for example) is dispatched first every time. The units then report when they arrive on scene, dispatch inputs the time as received in “real time,” thereby establishing the response time. Dispatchers recite the time each time they make a call to a unit, Flowers said. And all conversations between dispatch and responders throughout an incident are recorded.
Dixie Ambulance personnel testified to use of phone books for mapping, recording call times and patient data with pen and paper. They said they then input the data into a state-run database called Polaris that collects the information for the Bureau of Emergency Medical Services and Preparedness.
Tony Randall, president of Dixie Ambulance, said during the hearing that his agency doesn’t use computers in its vehicles because he considers them a liability. Lawyers for Gold Cross argued this method was unreliable and lent to recording errors in response times.
“That may be why there are times where our data and (Dixie Ambulance’s) data (don’t agree),” Flowers said. Further discrepancy may occur if a vehicle clock or a watch used by personnel keeping handwritten records is inaccurate.
St. George dispatch said it can verify time data input because it maintains a radio recorder over every call, every ongoing incident, including those who do not utilize the Spillman mobile system, “so when it comes down to knowing whose times are correct,” Grenier said, “unlike any other agency in this argument, I can play the tape back, it time stamps everything … it’s completely automated and there’s no way to edit or change it – that’s ironic because there isn’t a coinciding mechanism for Hurricane (Valley Fire District which uses a different records management system, with data input after the fact) and the other side (Dixie Ambulance, which uses the Polaris system for data input after the fact) to verify any (of their time stamps).”
A view of the St. George Communications Center from above, St. George, Utah, Dec. 11, 2012 | Photo by Sarafina Amodt, St. George News
Job priorities
Whereas the first job of public safety and EMS responders is the emergency, dispatch’s primary job is to dispatch and record the data in “real time.”
“This is the most basic convention in public safety,” Grenier said, “what time did you do what you said you just did – whether it’s run a license plate, or pull someone over to pull your gun or arrive on scene, a time stamp is so very basic.”
“Everyone else’s job … their times are an ancillary function to their job profession,” Grenier said; “what I mean by that is they’re a fireman, they’re an officer, they’re a deputy – their job is to do something else, our job is to record data and pass along information – that’s just what it comes down to – whether it’s a call or a radio transmission, we are in the job, just there looking at the screen to do it in real time – I would expect an ambulance company has to, to disregard the time frame to give themselves a few seconds to run up the stairs to get the baby breathing or save lives.”
Anomalies relative to volume of data
Grenier said that the incidents presented at the hearing were not factored in relative to the entire body of data: “… the data that we submitted per their discovery request was three years’ worth,” dating sometime around 2007-08. He said that there are about 28,000 instances per year.
“Whether they’re their fault, our fault, or whomever,” Grenier said, “that amount of data is not invalid because of one time, two missing times, where these guys didn’t transmit at that moment in time.”
User error?
In testimony given during the hearing, Chief Tom Kuhlmann, of Hurricane City Fire Department and EMS and chief of the Hurricane Valley Fire District, said he didn’t like the Spillman system and found it to be unreliable. He gave an example of entering the same data three times into the system, only to produce three separate results.
he spoke to Spillman representatives who said it was impossible for the computer to serve up three different results
Grenier said he asked Kuhlmann to reproduce his example and Kuhlmann had yet to do so. He also said that he spoke to Spillman representatives who said it was impossible for the computer to serve up three different results on the same data.
Flowers said she did not know why Kuhlmann would testify to concerns regarding dispatch services, she said he “has always been professional – this surprised us, he’s never had conversation with us personally, about his concern about our times, that maybe something’s wrong.”
Flowers said potential timing errors can occur when officers and EMS personnel don’t immediately tell dispatch they have arrived on scene: “If they didn’t say 23 (dispatch code for arriving on scene),” Flowers said, there may be a time lapse. “We do have instances where they don’t tell us they’ve arrived,” she said. “Or, it can happen that two units keyed up their radios at the same time,” Grenier said, and “we didn’t record it, maybe they didn’t say it, maybe we didn’t hear it.”
Grenier said these types of errors result from input given from the field, and not mistakes made by dispatchers.
Each time a dispatcher inputs information, they also input the time.
“A time stamp,” Grenier said. “We’re talking about nothing more complex than a time stamp.”
Other interests?
Hurricane Valley Fire District has also purchased another records management system that they like, Flowers said, but they have to keep Spillman mobile if they want to continue to see their calls and want dispatch to instant message with them.
“I have heard Kuhlmann say that he has had an association with another RMS (Records Management System),” Grenier said, “that he had worked with other companies.”
And if Gold Cross comes in, it comes with an EMS agency. Although the current territory sought does not include Hurricane, Flowers said that it could be a reason that Hurricane objects to Gold Cross and its technology – that if Gold Cross gets the contract for St. George, it could seek to expand into surrounding areas. Grenier said that just by Gold Cross coming in, efficiency is realized for its technological advantage, he said that Dixie Ambulance is in the stone ages.
Gold Cross testified that it would have one more ambulance than Dixie Ambulance has in the area.
“Doesn’t more ambulances translate into better quality of service?” Grenier said. “Does the math escape anybody?”
“However, it would not matter to us whether it was Dixie Ambulance or Gold Cross,” Flowers said repeatedly.
One of the phrases on the walls of the St. George Communications Center, St. George, Utah, Dec. 11, 2012 | Photo by Sarafina Amodt, St. George News
Dispatchers: the voice behind the call
During closing arguments at the hearing, Clifford Dunn, lawyer for Dixie Ambulance, said dispatchers might be stressed and overwhelmed by their jobs, lending to possible input errors on response times.
Heather Hallman, dispatch-training supervisor, said St. George dispatch is a little lower than the national turnover rate for dispatchers, which is just over two years. They tend to experience burnout from the stress the job creates, shift work and pay is a big issue, Flowers said. Yet, Hallman said, St. George dispatchers have a higher retention rate.
“Seems they really enjoy the job,” Hallman said. “We lose a lot of people because they move.” Others, she said, “get out here, and it’s in your blood and you’ll stay forever.”
Hiring and training
The hiring process for prospective dispatchers is three months long, Flowers said. The training process takes four-six months, conducted by certified instructors. Dispatchers are certified by the International Academies of Emergency Dispatch.
Assessment by Jerry Overton and Gary Esplin
Jerry Overton, the international chair of the International Academies of Emergency Dispatch, visited the St. George dispatch center for an hour during the week of the ambulance hearing. In testimony, he said that the dispatchers performed well and were “quite quick” in inputting data and relaying calls.
Lawyers in the ambulance hearing quoted Gary Esplin, city manager for the City of St. George, as saying “Dispatch has its problems.” When St. George News contacted Esplin for comment on the statement, he said he was quoted out of context.
“The dispatch center does a great job,” Esplin said. “We don’t hold calls, we dispatch them.”
If there were any problems to be had, Esplin said it was in the area of staffing, not performance: “It’s very difficult and challenging to keep (the dispatch center) fully staffed,” Esplin said, citing previous examples of stress and dispatchers finding jobs that offer better pay.
“I support them 100 percent,” Esplin said. “We do what I consider an excellent job for county dispatch … I don’t appreciate any other entities making disparaging comments about our dispatch.”
Neither Dixie Ambulance nor Kuhlmann were responsive to requests for comment by St. George News concerning the reported matters.
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