By Frankie Wunschel and Daniel Bodah
The 911 emergency call line was first implemented in 1968, in Halleyville, Alabama, as a fire emergency number.1 The scope of 911 expanded over the years to include police and emergency medical responses. As the world and the 911 system have changed throughout the past 52 years, the goal of 911—to enhance public safety—has not. Although extensive changes have been made in the technological infrastructure of the 911 system (such as adding GPS, Computer Aided Dispatch [CAD], and the Enhanced and Next Generation 911 applications), there have been few advances in the call-taking and dispatching aspects of the system. Modernization is needed if 911 is to provide fully effective service. In recent years, a few alternative approaches to call taking and information processing have surfaced. One of these alternative approaches is known as Criteria Based Dispatch (CBD). CBD was developed in King Country, Washington, in 1989 and was initially developed for emergency medical services.2 Whereas the traditional 911 approach involves the call taker collecting as much information as possible—what is happening, as well as why—CBD focuses on “here and now” questions.3 CBD was constructed as a central triage guideline system focusing on two key areas to understand this here-and now framework: 1. The necessary level of care 2. The urgency of the need for care.4 CBD systems categorize multiple call types together and supply a list of corresponding questions for use during the call-taking process.5 These questions and prompts are guidance suggestions for the call taker, ultimately trusting that the call taker will exercise discretion to use them appropriately.6 The system was initially developed for medical emergency-based calls and utilizing symptom criteria similar to those utilized in medical offices and hospitals.7 CBD has since expanded and been used in multiple departments for fire-related calls as well. Although readily used for medical and fire emergencies, CBD has been introduced in only a handful of jurisdictions for police calls.8 As a movement across the country has begun demanding changes to policing and public safety, the need to revisit 911 call-taking and dispatching methods has become urgent. As discussed below, CBD has revolutionized the call-taking process for medical and fire calls to 911. This review of the literature on CBD frames how this approach could also lead to improvements in the policing space. Research on CBD is limited. The bulk of research has focused on understanding the structural components of the system and how they affect traditional 911 success metrics such as diagnosis accuracy, sensitivity, specificity, and over- or under-triage.9 CBD research is practically nonexistent in the context of its use in the United States, so international research must be used to fill this gap. CBD processes in the United States and Europe are largely the same, although European CBD has adopted a three-level urgency approach that is less robust than the U.S. version.10 In exploring the landscape of CBD literature, researchers at the Vera Institute of Justice (Vera) searched numerous academic databases, as well as the Internet, to identify academic, professional, and nonprofit reports and studies of CBD. The identified publications consisted of field explorations, scientific evaluation studies, training guides, news publications, and promotional materials. A wide range of literature types was used in order to gain a comprehensive understanding of the field and supplement the limited amount of formal research available. This literature review explores the literature on CBD with a focus on reviewing the potential benefits of CBD seen by those working in the public safety response sector. The literature review also highlights strengths and weaknesses of CBD, maps the comparative research on CBD with that on competing dispatch system Medical Priority Dispatch (MPD), and finishes with a discussion of the potential for using CBD to improve responses in the policing space and support appropriate diversion of 911 calls to nonenforcement responses.
New York: Vera Institute of Justice, 2020. 12p.
