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12 octobre 2021 1
Fondation Urgences Sant辿
Fabrice Dami, MD, MBA
Medical Director
Lausanne medical dispatch, Switzerland
Attending physician, Emergency department, Lausanne University Hospital
Fabrice.dami@chuv.ch
Remote dispatch from another country:
a Case Study
12 octobre 2021 2
Fondation Urgences Sant辿
No conflict of interest
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Fondation Urgences Sant辿
Geographical Context (1/3) - Switzerland
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Fondation Urgences Sant辿
Geographical Context (2/3) - Lausanne
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Geographical Context (3/3)  Lausanne &
Neighbouring France
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Swiss Economical Context
- Higher income
- Higher costs (rent, insurances, all goods)
- Many cross-border workers (Swiss, French,
other nationals)
- Increased buying power
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Lausanne medical dispatch
 30 dispatchers
 Half of them living in neighbouring France,
across the Geneva lake
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Challenge / Risk
 First wave COVID arrives: France and
Switzerland may close their borders
 Critical Staff cannot travel to work
 Lausanne medical dispatch unable to pursue
its mission
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Solutions Considered
 Keep (volunteering) dispatchers in
Switzerland (hotel rooms): for how long?
 Train spare paramedics (eg. not being able
to work on the field anymore due to medical
conditions) into dispatchers
 Set up remote working stations
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Solutions Implemented
 2 hotel rooms were booked for a month
 3 paramedics were trained for call taking
 Remote working stations were set to face
border closure and/or quarantine of
asymptomatic dispatchers
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Remote working stations
 CAD and phone systems were tested in
private homes.in France! (in the
operational directors basement!)
 Political issue: State Health authorities were
not informed
 Technical issue: communication between
dispatch in Lausanne and remote stations?
Radio? Dispatch of incoming calls between
the main dispatch and remote stations?
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Fondation Urgences Sant辿
Remote working stations: what worked, what did not
 Remote: treated all back office and incoming calls from
professionnals (automatic deviation from phone server).
 Remote: no treatment of emergency calls
 Remote: no recording of calls available (working on
mobiles), no radio (Polycom)
 Implementation of a chat between main dispatch and
remote places (Slack)
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Conclusion
 We were ready but did not have to use any of all the backup
solutions set in place (remote, hotel rooms, new trained
dispatchers)
 This is prehospital care: be creative as usual
 During crisis the objective is to pursue the mission at any cost
 Risks have to be taken (no information on State authorities)
 Need to increase dispatchers salary to be able to hire Swiss
resident only
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Fondation Urgences Sant辿
Questions ?
CONCLUSION

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EENA 2021: Remote call-taking (2/3)

  • 1. 12 octobre 2021 1 Fondation Urgences Sant辿 Fabrice Dami, MD, MBA Medical Director Lausanne medical dispatch, Switzerland Attending physician, Emergency department, Lausanne University Hospital Fabrice.dami@chuv.ch Remote dispatch from another country: a Case Study
  • 2. 12 octobre 2021 2 Fondation Urgences Sant辿 No conflict of interest
  • 3. 12 octobre 2021 3 Fondation Urgences Sant辿 Geographical Context (1/3) - Switzerland
  • 4. 12 octobre 2021 4 Fondation Urgences Sant辿 Geographical Context (2/3) - Lausanne
  • 5. 12 octobre 2021 5 Fondation Urgences Sant辿 Geographical Context (3/3) Lausanne & Neighbouring France
  • 6. 12 octobre 2021 6 Fondation Urgences Sant辿 Swiss Economical Context - Higher income - Higher costs (rent, insurances, all goods) - Many cross-border workers (Swiss, French, other nationals) - Increased buying power
  • 7. 12 octobre 2021 7 Fondation Urgences Sant辿 Lausanne medical dispatch 30 dispatchers Half of them living in neighbouring France, across the Geneva lake
  • 8. 12 octobre 2021 8 Fondation Urgences Sant辿 Challenge / Risk First wave COVID arrives: France and Switzerland may close their borders Critical Staff cannot travel to work Lausanne medical dispatch unable to pursue its mission
  • 9. 12 octobre 2021 9 Fondation Urgences Sant辿 Solutions Considered Keep (volunteering) dispatchers in Switzerland (hotel rooms): for how long? Train spare paramedics (eg. not being able to work on the field anymore due to medical conditions) into dispatchers Set up remote working stations
  • 10. 12 octobre 2021 10 Fondation Urgences Sant辿 Solutions Implemented 2 hotel rooms were booked for a month 3 paramedics were trained for call taking Remote working stations were set to face border closure and/or quarantine of asymptomatic dispatchers
  • 11. 12 octobre 2021 11 Fondation Urgences Sant辿 Remote working stations CAD and phone systems were tested in private homes.in France! (in the operational directors basement!) Political issue: State Health authorities were not informed Technical issue: communication between dispatch in Lausanne and remote stations? Radio? Dispatch of incoming calls between the main dispatch and remote stations?
  • 12. 12 octobre 2021 12 Fondation Urgences Sant辿 Remote working stations: what worked, what did not Remote: treated all back office and incoming calls from professionnals (automatic deviation from phone server). Remote: no treatment of emergency calls Remote: no recording of calls available (working on mobiles), no radio (Polycom) Implementation of a chat between main dispatch and remote places (Slack)
  • 13. 12 octobre 2021 13 Fondation Urgences Sant辿 Conclusion We were ready but did not have to use any of all the backup solutions set in place (remote, hotel rooms, new trained dispatchers) This is prehospital care: be creative as usual During crisis the objective is to pursue the mission at any cost Risks have to be taken (no information on State authorities) Need to increase dispatchers salary to be able to hire Swiss resident only
  • 14. 12 octobre 2021 14 Fondation Urgences Sant辿 Questions ? CONCLUSION