By Lori Stone, Senior Public Safety Advisor (DC, DE, MD, VA, WV)
As part of our Roadmap Engagements, the First Responder Network Authority’s (FirstNet Authority) Public Safety Advocacy (PSA) team was pleased to recently hold a Mission Critical Services Workshop in Fairfax County, VA.
Public safety officials from across the DC Metro area joined us for an event to learn more about the current and future efforts surrounding the recently announced FirstNet Authority Roadmap. The goal of the planned Roadmap is to help advance and evolve the FirstNet network. We are highly focused on ensuring the Roadmap captures public safety’s most critical communications needs.
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Abstract

Introduction: Public Safety Answering Point (PSAP) quality can have life-or-death implications. The quality of service provided by PSAPs is inconsistent due to the lack of mandatory standards of care at the national, state, and local levels. Public demands and duties placed on PSAPs have grown due to technological changes, civil cases alleging negligence, and the emergence of national recommended standards of care, yet governments at all levels have been slow to create governance structures to reinforce adherence to standards.
Methods: This article focuses on the question: How do PSAP leaders measure performance based on their definition of quality? The method used is directed content analysis, including analysis of interview and focus group data.
Results: As a result of this study, a new six-dimensional model for quality emerged. Participants defined PSAP quality as achieving balance across a continuum of nuanced variables because a single 911 call may have “99 tasks that need to be done.” Telecommunicators must: (a) Be fast AND accurate, (b) Use their judgement AND follow the protocol, and (c) Utilize all available technology AND prepare for that same technology to fail.
Conclusion: PSAP leaders should consider instructing new employees with the sixdimensional model to set expectations of performance while avoiding the perception of false dichotomies. This model should also be considered when implementing new quality improvement programs or procedures. By considering the totality and complexity of quality definitions, PSAP leaders can allow for reasonable variation and thus curb anxiety and frustration among their employees.

Topics:emergency dispatch|evidence-based management|leadership|public saftey answering points|quality improvement|standard of care

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Abstract

Introduction: Rapid identification of sudden out-of-hospital cardiac arrest (OHCA) and delivery of bystander chest compressions in patients with ventricular fibrillation are key elements in the chain of survival. However, time to bystander compressions can be greatly affected by a wide variety of barriers, some beyond an EMD’s control.
Objectives: The aim of this study is to identify and quantify the impact that barriers have on the time taken to achieve bystander compressions for suspected OHCAs. Methods: This retrospective, quantitative cohort study was conducted by auditing audio recordings of 911 emergency calls, spanning November 25, 2014 – August 29, 2018, in which EMDs initiated bystander CPR.
Results: A total 496 audio recordings were reviewed, and 311 were excluded for various reasons. Therefore, 185 audio recordings were included in the study. Of these, in a majority (73.0%, n=135) of the calls, a bystander experienced at least one barrier to performing CPR. Overall, the elapsed median time to bystander compressions was significantly different for barrier versus non-barrier calls (272 seconds and 200.5 seconds, respectively). Time to bystander compressions for a baseline call was 171 seconds. Not surprisingly, as the number of barriers encountered during a call increased, the time to bystander compressions also increased significantly.
Conclusion: New instructions and modified scripting of protocols should be investigated to guide trained and certified EMDs in managing a wide variety of barrier types. Future studies should specifically investigate whether modified or new instructions reduce time to bystander compressions and/or increase survival from OHCA.

Topics:Barriers|Bystander CPR|Cardiac arrest|Cardiopulmonary resuscitation|compressions|DD-CPR|EMD|OHCA|Out-of-Hospital Cardiac Arrest

By Dave Buchanan, Executive Director of Public Safety Advocacy
The latest stop along our public safety roadmap led the First Responder Network Authority (FirstNet Authority) to Atlanta, Ga., last week for a regional forum with the Police Executive Forum (PERF). As a policy and research organization for the nation’s law enforcement community, PERF is delivering a series of forums that explore the adoption of FirstNet by police and other public safety users around the nation.
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By April Ward Senior Media Relations Advisor First Responder Network Authority
Hattiesburg, Mississippi’s AAA Ambulance Service subscribed to FirstNet to help connect its 24-hour emergency and non-emergency medical transport service. FirstNet is helping the ambulance service to seamlessly communicate as they serve the 1.2 million residents living across 16 counties in southern Mississippi.
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By Richard Mirgon, Public Safety Consultant
Once again we have an article in another publication claiming to differentiate between “fact” and “fiction” with an individual portraying to be a FirstNet expert and claiming that they understand what the differences are between FirstNet and Verizon’s “me too” public safety offering. In this recent article this “expert” either clearly demonstrated their lack of understanding of FirstNet or they are intentionally trying to support Verizon by providing inaccurate information with the goal of muddying the waters, creating confusion with public safety.
One point that this article was trying to make is that there is nothing special about FirstNet’s Band 14 and that since Verizon has Band 13 they are the same since they are both in the 700 MHz band. They are not. Yes, they share many of the same characteristics because they are in the same band, but there are two very distinct elements that make the D Block unique which Verizon cannot replicate. First, Public Safety owns Band 14 by Congressional action assigning it for public safety use which is managed by the FirstNet Authority on behalf of public safety. Verizon owns Band 13 and it is clearly nothing more than commercial spectrum. What is key here is that there is significant oversight on how the D Block spectrum is used. It is dedicated to public safety and can be used on a secondary basis to help pay for the FirstNet network.
Another element that is missing is “where is Verizon building out Band 13? Is it being deployed with public safety in mind or is it just another part of their spectrum holdings being deployed without concern for public safety needs?”
The second key issue is that Band 14 is authorized for High Power User Equipment known as HPUE. Band 13 is not licensed for this feature. (For more information go to https://urgentcomm.com/2019/03/18/high-power-user-equipment-hpue-can-help-bridge-band-14-coverage-gaps-in-rural-in-building-locations/) Verizon does not have the ability to provide key beneficial features to public safety that come with HPUE because they can’t do it. Both points are significant.  The fact that this “expert” disregarded these points indicates he either doesn’t realize their importance or he has decided to omit their significance.
The other point this “expert” tried to make is that Verizon’s “private core” for public safety is the same as the FirstNet core. This is categorically incorrect. It may have similar functions, but they are not the same and the differences are critical to public safety. The FirstNet core is dedicated to public safety and built for public safety.  Only primary public safety users and extended primary are allowed on this core. This FirstNet dedicated core is not shared with commercial users. When you have a partitioned core like what Verizon has done, you are sharing that computer power and that physical resource. It is not unlike having someone else use your home Wi-Fi. The more users on the network, the slower it gets. You wouldn’t share your home Wi-Fi with the public. Why would public safety want to share vital care services with the public? That is exactly what Verizon is doing. Also, would you want commercial users polluting your network with their information and jeopardizing your security? You wouldn’t and Verizon clearly states in their FCC filing (Nov 9th, 2012 Verizon response to Docket No. 12092850-2505-01) that public safety shouldn’t do it. Let me quote a specific statement in Verizon’s filing. They say that FirstNet “should not share core network components, i.e., the IP Multimedia Subsystem (IMS) and Evolved Packet Core (EPC), as doing so would undermine its ability to provide secure, high priority communications for first responders.” I find it disingenuous that Verizon now tries to tell public safety that sharing core is okay when their own public record states otherwise.
This expert is clearly wrong. He may be an expert in certain aspects of technology, but definitely not an expert in FirstNet and public safety communications. Everyone should take note that the same points this “expert” is making are the same talking points Verizon has been using for the last six months. Anyone who has been following this subject for several years can easily see this is nothing more than a Verizon prompted article. And let me make one thing clear. I am not contending to be unbiased. I am very biased in support of public safety and FirstNet. As a former first responder and one of the handful of public safety leaders who fought for the legislation, I am offended by the fact that Verizon is intentionally trying to confuse public safety and the facts around FirstNet.
FirstNet is about public safety and meeting public safety needs. FirstNet is not just about a network. It is about public policy, governance and providing a mechanism for public safety to have a voice in public safety broadband.  If Congress had not created FirstNet at our request, public safety would still be getting average service as just another wireless user. If it hadn’t been for AT&T stepping up to take the risk to commit to a 25-year contract, Verizon would be treating public safety as just another commercial user. In fact Verizon is treating public safety as just another user by doing nothing more than sharing commercial services and labeling it as public safety.
Let’s not ever forget Verizon had their chance and they walked away from public safety. The lame argument stated in this article about Verizon not bidding because they didn’t need 700 MHz spectrum is a smoke screen. After months of being criticized for not bidding, they came up with this marketing pitch that they didn’t need the spectrum.  Verizon didn’t want to be locked into a 25-year commitment, they didn’t want to build dedicated resources, they didn’t want to take the risk and now they are coming up with fancy dialog to try and hold onto public safety customers. The ONLY reason they offer commercial service labeled as public safety like services today is to keep from losing customers. Let’s also not forget they have abandoned the public safety 911 ESI market and left many PSAPs stranded. How’s that for public safety dedication?
The views and opinions expressed in this article are solely those of the author and do not necessarily reflect the official policy or position of this company or any company with whom the author may be associated.
Richard Mirgon is a Public Safety consultant focused on FirstNet. He is a Past President of APCO International and has over 35 years of public safety and first responder experience. For more information about the author please go to http://www.next-paradigm.com/about/