PP18 Lost in transmission: risk negotiation in emergency medical dispatch

<h3>Background</h3> Accurate Emergency Medical Dispatch (EMD) of enhanced and critical care (ECCH) is essential for providing support to those who need it the most ensuring rapid intervention, equitable access, and cost-effective use of resources. But dispatch has also been recognised as the weakest link in the chain of response. The decision-making pathway of the stakeholders involved in the dispatch process is under-researched despite its significance. Our ongoing research looks into risk negotiation among operational and clinical teams involved in the process. <h3>Methods</h3> Our project is a cross-sectional, multi-method study led by an interdisciplinary team comprising medical professionals and sociolinguists. We collected four complementary datasets: audio recordings of the original emergency calls, audio recordings of spoken interactions between teams, Sequence of Events records, and policy documents and guidelines concerning ECCH. We analysed the data taking an Interactional Sociolinguistics approach, an established theory and methodology to examine patterns of language use in complex settings. We focused specifically on investigating communication practices that flag risk and show risk uptake. <h3>Results</h3> Risk negotiation, outside the caller-call handler dyad, is poorly understood. Our analysis indicates that: there are multiple risk points for information loss along the trajectory of dispatch decision making. Communication practices in this context have not been landscaped before; although they either impede the information flow, hence the accurate and speedy uptake of risk indicators; or promote interactional cohesion which facilitates the uptake and cascading of risk, enhancing dispatch decision making. <h3>Conclusion</h3> Interdisciplinary research contributes to risk assessment in EMD. Interaction analysis identifies risk points and can translate to evidence-based training that support the work of human actors involved in the dispatch decision making and the potential of AI systems. The findings of this work should also inform policy and enhance the regulatory frameworks that underpin the performance and evaluation of ECCH teams.