Correlation between a Samu-Center 15 response quality and medical dispatching assistants workforce - The QRAARM Study

Introduction: The rate of occupancy of SAMU-Center 15 telephone lines determines the fluidity of the call management and therefore the capacity to respond to the emergency. The availability of medical dispatching assistants (ARMs) and emergency physician is crucial. We questioned the impact of the number of ARMs on the handling of calls in a Samu-Center 15. Methods: The rate of on-hook calls (by the caller) after 15 seconds was used as the primary end-point. It was analyzed according to ARM's "real" workforce. The theoretical number of ARM was taken as a reference. Two analyzes were carried out, the first covering 672 periods of 1/4 hour of week 51 of the year 2016 (during an influenza epidemic) and the second covering 3,624 periods of one hour out of the five first months of 2017. Results: In the first period, the median number of on-hook calls after 15 seconds was 1 (0-3) per 1/4 hour. It varied from 0 (0-1) to 3 (1-5) depending on the number of ARMs to which it was perfectly inversely related (P < 0.001). In the second period, the median number of on-hook calls was 4 (1-8) per hour. It varied from 2 (1-6) to 10 (6-16), depending on the number of ARMs to which it was perfectly inversely related (P < 0.001). Conclusion: The rate of calls hung up after 15 seconds was perfectly correlated with the number of ARMs. Over one year, the estimated number of lost calls was close to 50,000! Consideration of ARMs membership is an absolute necessity.