Quality Assurance for NextGen Multimedia PSAPs

If your Public Safety Answering Point (PSAP) is one of more than a thousand that now take 9-1-1 SMS texts, you know firsthand that times are changing. But text-to-911 is just the start. With FirstNet launched, and Next Generation 9-1-1 (NG9-1-1) underway, a bigger transformation is on the horizon.

NG9-1-1 and FirstNet are ushering in a new era in data-rich multimedia communications for public safety, and with it, unprecedented change. Together, they will enable the seamless exchange of broadband-rich multimedia communications between the public, 9-1-1 and first responders. The convergence of these networks in the PSAP will dramatically enhance public safety communications. But it will also introduce new complexities for 9-1-1 telecommunicators who will need to coalesce and manage more data. 

Rennie

"FirstNet and NG9-1-1 each bring their own benefits to public safety – but the combination of the two is even more powerful," said John Rennie, General Manager, NICE Public Safety. "Information will move between the general public, 9-1-1, and first responders more quickly, in greater detai​l, and without alteration. Compared to today's verbal message chains, this is a huge step forward."

Rennie points out that FirstNet and NG9-1-1 are complementary halves of one whole: "NG9-1-1 is not just about getting information to the PSAP. In some ways, NG9-1-1 data is even more relevant for medical, police, fire and emergency rescue personnel – because they will rely on this information for a clear picture of what's happening. One example is video. NG9-1-1 will deliver video into the 9-1-1 center, but public safety broadband (FirstNet) will be the mechanism for pushing that video out to first responders. To put it another way, FirstNet will help deliver on NG9-1-1's promise and potential. The PSAP will be central to that."

In this increasingly dynamic and disruptive environment, proactive quality assurance (QA) will be a key ingredient of telecommunicator success.

On the Road to NG9-1-1: Text-to-911

Text_to_911_Conversation

If NG9-1-1 is the road ahead, text-to-911 is the first step to getting there. PSAPs are adopting interim text-to-911 solutions in growing numbers. According to the latest FCC text-to-911 Master PSAP Registry more than 1,400 PSAPs are now equipped to handle SMS texts, up from just over 100 PSAPs three years ago.

Additionally, in areas that now have text-to-911, the number of texts continues to grow as awareness of the service builds. For example, in Indiana dispatchers receive an average of 500 to 600 text-to-911 messages daily; in Elkhart County, Indiana, text exchanges have increased eight-fold since the county started taking texts four years ago.

The uptick in SMS 9-1-1 texts comes as no surprise. According to the 2017 National 9-1-1 Progress Report over 80 percent of calls to 9-1-1 are now placed on cellular phones. With the vast majority of 9-1-1 calls now occurring over mobile phones, it's not a stretch to envision 9-1-1 texts gaining popularity.

According to a NICE survey of thousands of people nationwide, given the choice, 16 percent of millennials said they would text 9-1-1 instead of calling if either option was appropriate in the ​​situation. These generational trends mean that SMS texts are bound to continue to grow. Millennials recently eclipsed Baby Boomers as the U.S.'s largest age group, numbering 83.1 million, and this does not even account for the up-and-coming mobile-native Generation Z.

So what's the implication for PSAPs? For starters, PSAPs that are currently taking 9-1-1 texts or planning to do so, need to put solutions in place to ensure that all of these texts are recorded and preserved, just as they do for 9-1-1 calls today. Even if the volume of texts is small, protocols for processing 9-1-1 texts need to be in place as well as quality assurance (QA) programs for reviewing handling of text communications.

Eric Parry, ENP, chair of the NENA Development Standards Committee Quality Assurance Working Group that developed the APCO/NENA ANS 1.107.1.2015 Quality Assurance and Quality Improvement (QA/QI) standard for PSAPs, says that 9-1-1 centers looking to perform QA on 9-1-1 texts are braving new territory, because there is no current industry-wide standard.

"I'm not aware of any official standard with regard to quality assurance when it comes to the new technology," said Parry. "I think that's probably going to be the next thing that needs to be addressed. We need to take the foundational elements of quality assurance and apply them to the new technology. The good news is that you have organizations like NENA and APCO that are trying to envision what's going to be needed down the road for call processing. We have standards that define how calls should be answered, how fast they should be answered, what information is pertinent and needs to be collected. All of these things need to be synthesized into the new technological capabilities."

​​Parry says that some elements of case entry are the same for texts, such as verifying the location and call back number, and the caller's name and nature of the emergency. Where things get stickier is when texters make statements that are open to interpretation. With a voice call, there can be a dialogue back and forth so questions can be resolved quickly. With texting, it's more complex – and this is all the more reason that 9-1-1 texts need to be QA'ed.

Sherrill Ornberg, ENP, RPL, QA Director for the Denise Amber Lee Foundation and a member of the APCO/NENA QA/QI standards working group, agrees with Parry that it's important to QA 9-1-1 texts, but admits that the concept really hasn't caught on just yet. "I wish I could say 'yes,' but the reality is we're still really trying to get PSAPs to understand the importance of quality assurance for the current technology," she said. "I have not had any interactions with any PSAPs that have asked for help setting up quality assurance for 9-1-1 texts, but I'm sure that's coming."

The lack of a widely accepted industry standards isn't keeping some PSAPs, like the Greenup County (KY) E-911 Center from forging ahead. Located in the far northeastern corner of Kentucky, Greenup is the primary answering point for thirteen fire departments, eight police agencies and two EMS agencies. Greenup recently deployed an 'over-the-top' texting solution and plans to start taking texts this summer. "We're very excited about it," said Garth Wireman, Quality Assurance/Training Program Director, Greenup County (KY) E-911 Center. "I'll be creating separate evaluation forms in NICE Inform Evaluator to review and score the text calls that come in."​​

The Frederick County (MD) Department of Emergency Communications which serves as the Public S​​afety Answering Point for all 9-1-1 emergency and non-emergency requests for assistance in Frederick County, also recently started taking 9-1-1 texts and plans to record and review them. "It's important to record and evaluate all communications, whether they're radio, text or 9-1-1 calls," said John Woelfel, Director of the Frederick County Department of Emergency Communications. "We need to make sure our telecommunicators are doing the right thing."

Weld County (CO) Regional Communications also recently launched text-to-911 service and is planning to integrate review of text-to-911 calls into its QA program using NICE Inform Evaluator. 

"We recently started taking text calls and our plan is to conduct quality assurance on text calls soon," said Weld County Education and Quality Improvement Manager Robert Olsen. Olsen said he was fortunate to participate in training at the IAED Navigator conference earlier this year where he learned how to review text calls, protocols for texting, and expectations for QA. "We now have a standard operating procedure on how to handle 9-1-1 texts and our QA process is under development."

Weld also uses Priority Dispatch's ProQA Paramount software and is considering its future deployment options now that the software supports SMS texting. Priority Dispatch released a new version of its text-to-911 standard (Universal Standard 26), in April of this year. The standard is embedded in the ProQA Paramount software which enables telecommunicators to relay SMS-compatible, protocol-based texts messages containing Case Entry Questions, Key Questions and Dispatch Life Support (DLS) instructions, including lifesaving PAIs and safety warnings, to 9-1-1 texters. The software currently interfaces to over 350 CAD systems. Without a direct interface to CAD, telecommunicators must manually type instructions and questions. For the sake of time and efficiency, they can shorten the text, but only in a way that does not alter the protocol's intent or meaning. 

​"Even if it's clear that the call-taker understands and is comfortable communicating with shortened text, they're still required to follow the intent of the protocol, interrogate the caller, and provide appropriate instructions if it is safe and possible to do so," said Brian Dale, Associate Director of Medical Control and Quality Processes for IAED.

"For us it's all about identifiable and reasonable," added Dale. "Can I identify what their performance should have been? And if they didn't follow the protocol exactly was it reasonable? We didn't want to make it a Draconian standard that says you must exactly follow step one, step two, step three, because we really don't know precisely yet how emergency dispatchers will interact if they cannot right click and push texts through SMS. We also didn't want to be vague and ambiguous. Things are either done correctly, not done, or done (but not done correctly). There is also NAS or not as scripted, which means they altered questions or instructions, but did it in a way that didn't change the intent."

Dale, who helped create and deploy the IAED's first ED-Q curriculum/program back in the late 90's, says the standard is starting to garner some interest.

"When agencies ask me about our new standard for text-to-911 and doing QA on 9-1-1 texts, I always say that just because individuals are using a different technology [text-to-911], doesn't mean they expect less service," said Dale. "I strongly suggest that they follow the intent of the standard, especially if they're an accredited center."

Dale says Priority Dispatch is continuing to refine the standards and is hoping to establish a relationship with California-based Crisis Text Line to better understand how people communicate via text in crisis situations. "We're in an era where we don't have enough information to write the full story yet," said Dale. "We have initial chapters written but we don't have enough clarity to know what the final version will be."

Even Bigger Changes Brewing on the Horizon

If text-to-911 is causing a stir, even bigger changes are brewing on the horizon.

Since its launch earlier this year, more than 2,500 public safety agencies across the country have subscribed to participate in the FirstNet, nearly doubling the network's adoption from FirstNet's last update in July. Think of FirstNet as a future pipeline, not only for pushing information out to first responders, but also as a conduit for information flowing in and out of PSAPs – the future nerve centers of public safety.

​NG9-1-1, while not as far along, is also picking up steam. Just last year, Senators Nelson (D-FL) and Klobuchar (D-MN) introduced legislation (S.2061 - Next Generation 9-1-1 Act of 2017) to make the transition to NG9-1-1 a national priority by expanding existing federal grant programs to help state and local governments deploy IP-based 9-1-1 systems that are multi-media capable. Furthermore, the NG9-1-1 coalition is still inching toward its goal of 'true NG9-1-1' (voice video, text and data) for all 9-1-1 centers nationwide by 2020. 

More states are also deploying ESInets (emergency services IP networks). The ESInet is the centerpiece of NG9-1-1. At last count, 20 states had at least one operational ESInet, with a total of 1,300 ESInet-connected PSAPs, and the same number of states had adopted statewide NG9-1-1 plans (up from 9 in 2012).

"For decades, emergency call handling has been through voice, and there has been very limited data outside of voice being shared between telecommunicators, first responders and the general public," said Rennie. "FirstNet and NG9-1-1 are going to create a framework that changes that, and this will make the PSAP's role a lot more complex."

Rennie compares the future PSAP to an air traffic control environment where one specially-trained person is screening and filtering information coming in to determine what's critical, what's supplemental, and what's background noise, while another individual (the dispatcher) is orchestrating the response activities and passing along relevant information to first responders.

"At the end of the day, someone needs to be filtering the data so first responders are getting accurate and relevant information – but not more information than they need," he said.

The APCO Report, Project 43: Broadband Implications for the PSAP, spells out the types of information that future specially-trained telecommunicators might be required to handle, ranging from automated alarms and building and floor plans, to photos and videos from citizens, surveillance camera systems, drones and body-cams.

Public Safety Broadband networks will also enable connectivity to more sensors and devices through the Internet of Life Saving Things (IoLST). Vehicle telematics is just one example. Beyond notifying that a crash occurred, an ACN (Automatic Crash Notification) system could provide vital information. Did the car roll over? How many passengers were in it? Were they wearing seatbelts? Did the airbags deploy? All critical details for deciding what type of emergency response resources and equipment are needed.

MMS texts will also add to the onslaught of information. "Someone in the PSAP is going to have to go through each MMS call – and if it involves video, that complicates things even further in my opinion," said Ornberg. "What is the video of? What is the timeline of the video? Where was it taken? Who will decide what information is useful? PSAPs are going to have to have somebody on staff specifically trained to handle these types of calls, and this is going to have a significant impact on staffing levels."

According to APCO's Project 43 Report these new data sources will also necessitate new standard operating procedures and enhanced training to ensure that telecommunicators know what procedures to follow; and quality assurance to ensure they're following them correctly. A recently released standard APCO ANS 1.115.1-2018 (known as the APCO Standard for Core Competencies, Operational Factors and Training for Next Generation Technologies in Public Safety Communications) also put a stake in the ground by identifying specific operational and training factors that PSAPs need to consider in the future with respect to the receipt, processing, dispatch and utilization of multimedia systems and data.

Another concern voiced by industry experts is the pressure these new data sources will place on already-stressed telecommunicators, and the emotional toll. "Imagine that telecommunicators are now seeing the crime, or the result of the crime, instead of just taking the call about the crime, or dispatching first responders to the crime; that's going to induce and elevate stress to a whole new level," said Ornberg.

Too much data could also have the unintended effect of creating more questions than it answers.

"If somebody sends me a picture or a short video clip of a structure that's on fire, that makes certain pieces of information obvious," said Dale. "But there are many other pieces of information I'd want to confirm. Getting to the complete picture is going to involve using the media along with additional interrogation to make sure we're not making subjective snap decisions based on a ten second video."

"That means as NG9-1-1 rolls out, we'll probably have to develop a multimedia 9-1-1 standard as well, which says 'here are the things you can discern from multimedia, and here are the things you need to confirm,'" added Dale. "Just because I see a structure, it's on fire and people are standing outside, doesn't mean there isn't anyone still trapped inside, or that there are no injuries. The call-taker should never take a picture or video at face value."

Additionally, as the APCO Project 43 Report points out, "The increased scope of broadband-based information will enable a more effective response, but is also likely to claim more time to process. Agency quality assurance programs need to take this into consideration as they revise processes and quality standards." 

Quality Assurance: No Longer a Nice-to-have

In the face of such enormous change, quality assurance will no longer be a nice-to-have; it will be a need-to-have.

The recently released APCO ANS 1.115.1-2018 standard for Next Gen 9-1-1 centers strongly recommends that agencies review their current quality assurance policies to ensure that any new functions and job responsibilities arising from NG9-1-1 will be covered by their QA program.

"Having a formal, consistent quality assurance and improvement program in place is important today, but it's going to become vitally important going forward," said Patrick Botz, Director of Engagement for NICE Public Safety. "QA can't be an afterthought or something we do at the end of each month."

"When considering texts, there's a whole learning curve for telecommunicators," said Ornberg. "There's a brevity to text communications, sometimes there are things that are implied, and you have to read between the lines. For some telecommunicators, it will be like learning a new language."

Fast forward to NG9-1-1 and FirstNet, and telecommunicators are going to be barraged with even more unfamiliar information – some of it may be distressing to look at, some of it may be extremely valuable and give a lot of insight, and some of it may be a complete distraction. "That's where quality assurance is going to be extremely helpful in understanding what happened during an event, what the operator saw, and what the operator should have seen but missed," said Rennie. "PSAPs have had decades of experience on the voice side, but they don't have decades to learn the new processes that are coming with multimedia. Without QA to understand how telecommunicators are adapting, they'll be constantly trying to fix things that went wrong."

Audio's just a piece of the picture

The very nature of how QA is conducted will need to change in next-gen environments as well.

For example, it will no longer be sufficient simply to review the audio recordings of a 9-1-1 call, because audio alone won't provide the complete picture.

Until now, QA focused on listening to the 9-1-1 call, but this will change with NG9-1-1 and FirstNet, as telecommunicators will be required to handle text, video, images and many other types of data.

PSAPs will need technology that can capture and record everything so they can review how the telecommunicator managed these new data inputs. Voice recordings will be just a small piece of a much larger picture.

"It's not simply about recording," said Rennie. "It's about what you're going to do with it afterwards. By capturing the complete incident lifecycle you can understand how your agency performed, what went wrong and what went right, and make process improvements."

Chad Breaux, IT Technician with the Jefferson Parish Sheriff's Office, agrees: "When we looked at how technology's evolving and the data that will be coming into our PSAP in the future, we realized that it would be important to be able to capture the full picture from all of those different sources, whether it's a text call, a monitoring device, a crash notification, all of the things that Next Gen is going to deliver to us. With NICE Inform Elite, we feel we're on the right path, in terms of bringing all our data into one place, being able to get the full picture, and then effectively using that information to hone the skills of our telecommunicators."

Seeing Things from the Telecommunicator's Vantage Point

Screen recording will also be an essential element of QA in the future.

New data sources will play into the decisions that telcommunicators make, and sometimes those decisions will be called into question. That means it's critical to be able to reconstruct incidents from the telecommunicator's vantage point. That's where screen recording comes in.

Ornberg agrees: "Today, when you're QA'ing a 9-1-1 call or dispatch, you're predominantly listening with your ears at what is being said and you're looking for cues and the order of things. Was this done or wasn't this done? But when you start moving into things like video, the visual things – it's going to be important to be able to see what the telecommunicator was seeing as you're QA'ing the call."

Limited Resources, Targeted QA

With limited resources and budgets, many PSAPs find it difficult to make QA a priority, and chances are that's not going to change. Given QA is now a need-to-have, PSAPs are going to need to be more strategic about how they apply QA resources.

"A lot of quality assurance today involves picking incidents essentially at random," said Rennie. "In the future, PSAPs are going to need to be more focused on reviewing incidents that are more likely to be problematic. We need to recognize that PSAPs are limited in the time they have available to spend on quality assurance. Fortunately, technology can help PSAPs focus in and target specific types of calls for review."

​Botz explains how: "Today, targeting QA to specific types of incidents is not easy. First you have to go into CAD and look for them, then you have to go back to the recorder and find the calls. By integrating CAD and recording, the selection of desired calls can be completely automated, eliminating half the time it takes to complete a QA review. You simply decide on the types of calls you want to review, by CAD incident type and/or priority, and set up QA rules to schedule them for review."

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​QA: Beyond the 9-1-1 Center

As FirstNet and NG9-1-1 take hold it's possible that the very essence of what's recorded and QA'ed may also change.

"It may also come into play that first responders in the field have a similar level of device recording that provides insight on what actions were taken on information after it left the PSAP," said Rennie. "Authorities need to be able to see what first responders saw in the heat of the moment, and synchronize and reconstruct what they saw and did over different devices in different locations. This would enable authorities to better understand how they acted on information, to drive best practices going forward."

Another forthcoming change with NG9-1-1 is that PSAPs will become virtualized through ESInets. "The silo effect of the single PSAP is going to gradually erode and go away," Parry explained. "Today most PSAPs aren't too concerned about what's happening in someone else's jurisdiction, but that's going to change with the ability to move calls and data from PSAP to PSAP."

In fact, one of the key i3 requirements involves providing logging and recording as a core service of the ESInet. This encompasses both multi-media recording and event logging. Essentially, the key steps in processing a call must be logged (including external events, not just events within a single PSAP), along with all relevant call content, including voice, text or video.

This would make it possible to retrace everything that happened to a call. How did it reach PSAP A? Why didn't it reach PSAP B? Was it diverted to an alternate PSAP because of an overflow situation?

"This ability to capture a true cradle-to-grave incident recording may also change how PSAPs view and implement QA in the future, as incident handling becomes virtualized too," said Botz.

The Quality Assurance and Improvement Connection

According to Ornberg, quality assurance is essential for identifying training gaps. She has seen telecommunicators that have flown through training and scored very well on their DORs, but still had critical errors when they went 'live' on the floor.

"Whether it involves new technology or current technology, quality assurance and training go hand in hand," she said. "QA identifies those areas where telecommunicators are excelling at following policies and procedures, need improvement, or had critical failures. Without QA, there is no way that any manager can know what their staff is doing. You may think you know, but I can guarantee you don't."

Next generation QA systems can help PSAPs identify telecommunicator knowledge gaps by enabling supervisors to review and score handling of complex calls. Supervisors can then provide needs-based coaching and training based on those results.

Additionally, some of the most effective learning occurs by example. There is a vast difference between reading about something and experiencing or seeing it first-hand. Next generation QA solutions will enable PSAPs to use complete incident recordings as learning and training tools. A supervisor can pinpoint where a telecommunicators handling of an incident went extraordinarily well or swerved off course, and then use these real-life examples for one-on-one coaching or classroom training.

Summary

While the convergence of NG9-1-1 and FirstNet are going to provide many opportunities for improving public safety, it's also going to flood PSAPs with many different types of unfamiliar data that need to be received, processed and acted upon.

As the APCO Project 43 Report states "PSAPs of the future will be a nerve center, managing data-rich communications via broadband technology with 9-1-1 callers and first responders."

As the PSAP's role evolves, Quality Assurance is going to be more essential than ever and PSAPs should take steps to start preparing now.

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