9-1-1; What Is Your Emergency?

Saturday, October 17, 2009

Fill-Ins for Call-Ins: Policies for Filling Schedule Gaps

Taken from Public Safety Communications Magazine/ October 2009
Written by Bob Smith, director of strategic development for APCO International

It's 0300 hrs, and you're the senior person on duty when that dreaded call comes in: "This is Mike from day shift, and I'm not going to be able to make it in today. I'm sick." At this point, several things run through your head. Who's on call? Who's in charge of dayshift today? And most worrisome of all - will I have to work a double?

Shift work is a fact of life in public safety comm centers. The services we provide aren't restricted to Monday through Friday 0800 to 1700 hrs but must be available around the clock. In the fast-paced, dynamic world of today's comm center, it's important to ensure enough people are on duty at any given time. Understaffing is a risky business. It affects the ability of an agency to handle telephone and radio traffic, increases liability, decreases quality of service and affects staff in a multitude of other ways.

So how do we prepare for those calls? How do we ensure that we have adequate staffing on a shift even if someone calls in? And how do we do this without breaking the bank in overtime?

Well, one way to prepare for these types of situations is to establish a "Call-In" policy. A policy that dictates who will be called when an employee calls in or otherwise fails to show for work without prior notice. There are different variations of this type of policy, including:

On-call policies: This type of policy designates a person or persons to be on call for a specific period of time to come into work when someone calls in sick. This person or persons can be issued a pager or cell phone so they can be easily contacted during their on-call period. This position can be rotated among employees to spread out the responsibility and to ensure one or two people aren't bearing the brunt of the burden.

Previous shift call-back: Many agencies have a policy that requires off-going shifts to be available for call-back for a designated period of time. Example: If your agency works three eight-hour shifts designated day, evening and night shifts, then the day shift staff would be on call for evening shift call-ins and evening shift would be available for night shift call-ins and so on. This option can be troublesome because fatigue can be an issue for people assigned to work double shifts. This can be further complicated in agencies that work 10- or even 12-hour shifts.

Random call-back: This type of policy is quite common. It basically designates all off-duty personnel as available for call-in at any time for any shift. Employees may be issued pagers or required to have 24-hour contact information on file with the agency. When someone calls in, a roster of off-duty employees is produced and someone begins to go through the list until a "volunteer" is found to cover the shift. This type of policy is only effective if off-duty personnel answer the phone or return calls. It can also be abused by routinely starting with the people who are most likely to come in or the ones who will be easiest to contact.

Double shifts: The least popular method to cover call-ins and the one policy most likely to increase staff burnout and liability due to fatigue and decreased staff morale. This method requires that an employee on the current shift stay over to cover the oncoming shift shortage. Again, there are several shortfalls to this method and if it is used, it should be a last resort.

Regardless of which method is used to cover call-ins, the person selected as a stand-in must be carefully chosen. Often, the thought process is such that any body in the seat is better than nobody at all. This isn't necessarily true. A person with inadequate experience, training or skill level can indeed be more troublesome than having a hole in your staffing for a particular shift.

Often, the person selected is the lowest person in the chain of command. This isn't always a wise choice. Can a newly hired employee effectively cover this shift? Can they handle the workload? How much of a learning curve will there be if a night shift person is called in to work day shift? All of this must be considered when drafting a call-in policy.

The bottom line: Illnesses and family emergencies happen. People will need to miss work, and usually it will be with little to no notice. Agencies must be prepared to handle these types of events. Whether your agency uses one of the examples listed here, a combination or something totally different, a policy must be in place to ensure that staffing levels for all shifts are adequate every day. Any holes in the schedule can increase liability and affect the delivery of service to the community you serve.

Pandemic Influenza: Is Your PSAP Prepared?

Excerpts taken from Emergency Number Professional Magazine/September 2009
Written by Anthony Oliver, MPH, Public Health Fellow in the Department of Transportation's Office of Emergency Medical Services (Washington, DC) and Richard Alcorta, MD, state EMS Medical Director for the Maryland Institute for Emergency Medical Services Systems and a Board Certified Emergency Medicine physician

9-1-1 facilitates single point access to Emergency Medical Services (EMS), law enforcement and fire services. Including 9-1-1 in planning and response efforts is essential to maintaining the Nation's health and safety during an influenza pandemic. A pandemic will likely cause 9-1-1 systems to experience increased demands for services while facing strains on resources (e.g. increased employee absenteeism, supply chain disruptions). The Federal government and others have developed resources to assist 9-1-1 communications centers prepare for a pandemic.

The public has been trained to call 9-1-1 when help is needed, whether the problem is small or large, urgent or not. The PSAP is a trusted source of information for the public and will be inundated with calls for help during a pandemic. Plans need to ensure that PSAPs have current, factual information regarding the events affecting their communities, that they have resources to update that information as changes arise and that they can effectively communicate that information to the public.

Influenza (also known as the flu) is a contagious illness which causes more than 200,000 hospitalizations and about 36,000 deaths annually. Influenza viruses can change into new and mutant viruses, against which no one has immunity, making the entire population susceptible, even if previously vaccinated or infected with other strains. Seasonal influenza outbreaks usually cause large increases in the need for medical care. An influenza pandemic occurs when a new strain develops which can easily be transmitted from person-to-person in a population with very little or no immunity. A pandemic is a worldwide disease outbreak, occurring in many different countries. If a pandemic occurs, there will be a surge in the demand for both hospital and prehospital resources. One way to reduce the flu's impact is the development of plans to lessen the demand for services on hospitals and prehospital systems.

History has shown that an influenza pandemic has the potential to seriously impact the Nation's health care system, economy and social structure. Recognizing the importance of 9-1-1 in accessing the nation's healthcare, and its potential to reduce the resource demand during a pandemic, the White House Homeland Security Council directed the creation of guidance to assist 9-1-1 call centers in preparing for pandemic influenza in May 2006. The National Strategy for Pandemic Influenza: Implementation Plan instructed the Department of Transportation and its Federal partners to develop model statewide protocols which address (1) the provision to information to the public, and (2) facilitation of caller screening and (3) assistance with priority dispatch of limited EMS resources. The Office of Emergency Medical Services and the National 9-1-1 Office worked with the National Association of State EMS Officials to develop and disseminate two documents: EMS Pandemic Influenza Guidelines for Statewide Adoption and Preparing for Pandemic Influenza: Recommendations for Protocol Development for 9-1-1 Personnel and Public Safety Answering Points (available at www.pandemicflu.gov and www.ems.gov) first made publicly available in May 2007. Additionally, more than 6,500 CD-ROM copies of both guidelines were disseminated to PSAPs nationwide in January 2008.

Is Your PSAP Prepared?

Scientists believe that an influenza pandemic is inevitable - a "when" not an "if" proposition. To provide adequate 9-1-1 services during a pandemic, it is necessary to prepare, just as 9-1-1 prepares for other mass casualty incidents. This preparation may be particularly important for a pandemic because once an entire region or state is affected, mutual aid may not be possible. It behooves each 9-1-1 service to prepare itself, and to become actively involved in its local and State pandemic planning process.

Implementing infection control practices along with influenza-like illness screening can also result in decreased PSAP absenteeisn. Anecdotal reports from PSAP directors in Washington State showed a 60 percent reduction in sick leave after infection control procedures were instituted. One manager commented that it was the first time staff had available sick leave going into summer, and that employees did not have to use vacation time in lieu of sick leave. Additionally, one manager noted that the cost of infection control supplies was recovered in a reduced need for overtime.

Preparing PSAPs for an influenza pandemic is a critical component in ensuring demand for healthcare services is met for the community. Planning and preparing for pandemic influenza can reduce absenteeism in the emergency services workforce, distribute resources effectively and decrease demand on 9-1-1, EMS and hospital resources. Is your PSAP prepared?

Six Simple Steps to Ensure the Effectiveness of Emergency Notification Technology

Taken from Emergency Number Professional Magazine/September 2009
Written by Hal St. Clair, Director of Advanced Technologies for Dialogic Communications Corp.

By exercising a few simple emergency notification guidelines, public safety operations can dramatically improve any crisis communications strategy.

For today's public safety operations, emergency notification technology is no longer a luxury. It is a necessity. As more sheriff's offices, fire departments and emergency management agencies implement these communications systems, so too are they seeking guidance to ensure their effectiveness. This article will provide six crucial steps for improving the integrity and reliability of any emergency notification system, whether on-premise, hosted or hybrid.

#1. Educate People on Your Use of the Technology
You and your family sit down to dinner. The phone rings. You pick up, only to hear an automated, "hello." Assuming it's another telemarketing call, you hang up. It's a common scenario. Only this time, the call is from your PSAP's emergency notification system, attempting to let you know of a hazardous materials spill out on Route 9.
To know emergency personnel and local residents will react appropriately to these calls, educate them on the system's use beforehand. Activate "sample" notification scenarios, letting people hear how calls sound and ways to interact with them. Broadcast information about your use of the technology on local public access TV channels and radio. Launch an all-out public awareness campaign by mailing flyers community-wide and encouraging locals with unlisted numbers or cell phones to register for notifications during community events or online.
As simple as it sounds, also train people to say "hello" when they receive a call from numbers inside your area code or directly from your operation. Most emergency notification systems are programmed to recognize a standard ring-back tone and "listen" for an actual voice before delivering the message. When these systems encounter silence, they assume no one is on the line and terminate the call, often resulting in non-delivery.

#2. Conduct Partial and Full System Tests on a Regular Basis
An emergency notification system is only as good as the data that resides within it. Therefore, it is imperative for public safety operations to routinely carry out both partial and full system tests. As a general rule, select a small group of people, preferably your own personnel, to automatically notify once each month via all designated methods (e.g., home phone, Blackberry, e-mail, etc.) in order to determine any data errors or potential communications issues. If possible, also conduct regularly scheduled tests to small geographical areas throughout your community. Finally, conduct a full system test once per quarter, or at a minimum, twice each year. Together, these measures will help your operation correct any potential hardware, software or telephony issues before they arise.

#3. Avoid the Blacklist
During the course of a week, you probably receive hundreds of unwanted e-mails regarding special events, company promotions or worse. Fortunately, the companies and/or individuals behind these campaigns often find themselves blacklisted, slowing, suspending or rejecting their access to certain e-mail servers. However, for public safety operations that send a large number of notifications via e-mail, this poses a potential problem.
Typically, the first sign of trouble comes with "bounce-back" e-mails. Often these include technical reasons for the return, but others will not. It all depends on your IT department's setup and software.
If you suspect you have been blacklisted, there are a number of resources online from which you can run automated tests against your IP address. These include www.spamhaus.org, www.spews.org and www.dsbl.org. You might also consider directly contacting the domain blocking your e-mails in order to resolve the problem.
To avoid being blacklisted in the future, confirm the validity of the e-mail address in the "form" field of your e-mails. Also, continually remove invalid e-mail addresses from your contact data, as too many can cause Internet Service Providers (ISPs) to flag your e-mail account as a source of SPAM.

#4. Know Your Communications Capacity
It's Mother's Day. You pick up the phone and dial your mom's number, only to hear "We're sorry. All circuits are busy. Please try your call again later." The same holds true during large-scale disasters, where your area's phone grid may become overloaded or even completely shut down. Do you know how many simultaneous phone conversations your particular community, office or county is able to support? Do you fully understand the availability (or lack) of cellular service in your area? Did you know there are limitations to the number of SMS/text messages providers can support at any given time? Clearly, there are a number of factors influencing or limiting your ability - or capacity - to communicate during certain situations.
For public safety operations using an on-premise emergency notification system, it is imperative to strategize on the front end in order to avoid any issues on the back end. This includes allocating a certain number of inbound and outbound phone lines or toggling between the two, shortening a call's duration (i.e., greeting, message, prompts and farewell) and determining the most effective sequence for contacting certain groups of individuals (e.g., page first, then e-mail, call home, etc.).
For those operations using offsite (hosted) emergency notification services, the amount of phone lines available is determined by the vendor. While this number is generally far greater than those associated with on-premise systems, capacity is still limited by your area's communications infrastructure. For example, a small town may only have 200 phone lines in its entire grid. During peak hours, 150 of them could be in use at any given time, leaving only 50 available for emergency notification.
To counter this potential problem, consider using alternative means for communication, including cell, e-mail and SMS/text messaging. But remember, these methods have limitations too. Also take into consideration the restrictions of your own PBX, voicemail system and paging service. Multiple attempts will more likely ensure the delivery of your message.
Finding a balance may be tricky, but as evidenced by the technology's widespread use, it is certainly not impossible.

#5. Have a Backup Plan in Place
Depending on the situation, your telecommunications infrastructure may be severely impacted or rendered inoperable. As with all public safety systems, redundancy measures should be in place for your operation's emergency notification system. This will enure communications with first responders, area residents, local authorities, community volunteers and others do not fail, even in worst-case scenarios.
Redundancy is most often delivered through remote hosting center. These facilities provide public safety operations secure access to hundreds, and in some cases, thousands of phone lines 24/7/365. Use of this infrastructure, whether for secondary or primary purposes, may be subject to a subscription fee, per-call charges or both.
Another option for redundancy involves the shared use of emergency notification systems between local or regional operations. Though less costly, this method does require a great deal of communication, collaberation and coordination on behalf of the participating parties. It may also not be feasible in the event of a large-scale disaster affecting two or more groups.

#6. Open the Lines of Communication
In an emergency, you must not only be able to push information out and into the hands of personnel and the community-at-large, but also manage the influx of calls post-notification. The use of an inbound "bulletin board," if available with your system, will easily address this communications need.
As part of your notification message, briefly instruct recipients to call a designated phone number for additional incident-related details. Record and update this information as often as necessary. Activate subsequent notifications as the situation escalates or improves to keep everyone in the loop and further reduce the number of incoming calls.

The Bottom Line
The benefits of adopting the six steps identified here are two-fold. First, public safety operations using emergency notification technology will improve the efficiency and reliability of their system. Second, they will reap the numerous benefits of knowing they have taken all the right steps to ensure their communities are safe and informed.