Nursing CE Central
If a 911 caller in the Washington, D.C., area isn’t having a life-threatening emergency but still needs care, chances are they’ll be patched through to a nurse.
This is a result of the Right Care, Right Now program, a nurse triage line established in 2018 that’s the subject of a “Nature Human Behavior” study published in 2024.
Dr. Ryan Moore, a professor at American University’s School of Public Affairs, and Dr. Rebecca Johnson, a professor at Georgetown University’s McCourt School of Public Policy, worked with The Lab @ DC to analyze the Right Care, Right Now program. They found a decrease in emergency department visits within 24 hours of a 911 call and a decrease in ambulance dispatches, among other data.
“This is such an exciting project; it demonstrates the very large social impacts that deep, meaningful collaborations between policymakers and academics can have when we join forces for high-quality research,” Moore stated in a Georgetown University news release.
Under the Right Care, Right Now nurse triage program, callers explain their symptoms to a dispatcher, who evaluates whether they need immediate attention or can be transferred to a registered nurse for further non-emergency evaluation.
“When the program started, policymakers said that decreases in emergency department or ambulance utilization or increases in primary care utilizations would be considered successes. The program met those goals,” The Lab @ DC’s website stated. “The program now operates 24 hours a day, and as of August 2022, nurses have triaged more than 52,000 calls through the program. [D.C. Fire and EMS Department] FEMS estimates that the program has referred more than 20,000 911 calls to resources other than the emergency department.”
Between April 2018 and February 2019, more than 6,000 D.C. callers received either a “business as usual response or further triage” when contacting emergency dispatch.
Among the findings were:
The authors determined that the short-term effects “suggest that nurse-led triage of non-emergent calls can safely connect callers to more appropriate, timely care.”
Sam Quinney, The Lab @ DC’s director, said that while publication in academic journals is not the “primary motivation,” it can highlight the quality of work being done.
“The publication of our results in a prominent journal should give District residents confidence that important decisions about their city are being informed by the best available scientific methods,” Quinney stated in the release.
Though The Lab @ DC stated that Washington, D.C., was the first area to include nurses in the “911 call loop,” EMS1 reported in 2014 that officials in Louisville, Kentucky, launched “one of the nation’s first 911 nurse triage programs.” Similar programs also can be found dating back to the early aughts.
The Kentucky program began in April 2010 and in three years expanded from one nurse taking “a handful of non-urgent 911 calls a few days a week” to three nurses on 12-hour shifts every week, EMS1 reported.
“For 30 years, no matter what your problem was, we only offered one solution: a trip to the emergency department,” Kristen Miller, chief of staff of Louisville Metro EMS, told EMS1. “What business stays in business when they ignore customer need and only offer one product? We need to be adjusting our solution to the customer need.”
In 2022, the Las Vegas Fire and Rescue (LVFR) emergency communications center hired its first full-time registered nurse, but had been working with seven part-time RNs already. LVFR uses the Emergency Communication Nurse System (ECNS), a system developed “as a logical, feasible, and economical approach to EMS resource allocation,” according to Audrey Fraizer’s 2022 article in “The Journal of Emergency Dispatch.”
Fraizer also noted other EMS organizations throughout the U.S. and Canada — including the Regional Emergency Medical Services Authority in Reno, Nevada, and Northwell Health Services in New Hyde Park, New York — implemented the ECNS and saw improvements in patient care and reduced costs for both patient care and EMS services.
The collaboration between 911 dispatch centers and registered nurses can help improve patient care and reduce emergency medical service costs, according to a study of the “Right Care, Right Now” triage program in Washington, D.C. Such programs allow for medical emergencies to be handled by the proper responders and transfer non-emergency calls to nurses, who then help determine the best course of treatment — should any be needed. Several nurse triage programs exist throughout the United States and Canada.
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