Triage Nurses Assisting DC 911 Dispatchers

D.C. has the highest rate of 911 calls in the U.S., and 1 in 4 of those calls is not an actual emergency — instead, it’s a twisted ankle, or a cough or a rash. A new triage program aims to improve those numbers by diverting needs that aren’t urgent to medical care that doesn’t involve an ambulance or an emergency room.

Dr. Robert Holman, medical director of the D.C. Fire and EMS Department, got the idea for the program two years ago when he realized the city’s system was getting backlogged with non-emergency calls.

Heard on NPR’s All Things Considered, during a practice session, trainee Ogechi Ukachu, a registered nurse who has previously worked in an ER, clicks through a series of questions.

“Are you having any difficulty breathing or catching your breath?” she asks the training exercise’s pretend caller, who has complained of a sore throat. “Do you hear any weird sounds when you’re breathing — like whistling?” No, and no, the caller tells her.

It’s not an emergency, Ukachu determines, so instead of having the dispatcher send an ambulance, Ukachu gets to work finding the caller an appointment with a primary care provider who can see the patient that day.

On her computer, based on the information the caller has provided, Ukachu can see whether the patient already has a relationship with a doctor or clinic, or, if not, which community health clinic is closest. She can also see nearby clinics’ schedules for the day, so can make the patient an appointment.

The triage nurses can even coordinate free rides for people who are on Medicaid — including a stop at a pharmacy if needed.

City health agencies, 22 primary care clinics, contractors, and unions were all involved, under the coordination of the D.C. Fire and EMS Department.