Nurse Navigator Programs Help ‘Overburdened’ 911 Dispatchers

• More than 20 nurse navigation programs have been implemented across the country in coordination with 911 emergency dispatch centers to free up emergency responders for the most severe cases. 
• More than 86% of EMS personnel who responded to a 2023 Lexipol survey reported staffing challenges in the past three years. 
• Nurses trained in emergency response evaluate the caller and help determine next steps for treatment, including potential referral to virtual or mobile care and transport via rideshare or leased basic-life support unit. 

Programs that divert non-emergency 911 calls to teams of nurses have gained traction throughout the United States.

Just last month, Santa Clara County, California, established a nurse navigator pilot program in partnership with Global Medical Response (GMR). 

“A caller not needing ambulance response will be presented with more innovative and thoughtful avenues toward treatment, from a licensed nurse with professional experience, specially trained for telephone triage,” Darryl McClanahan, Regional Director of GMR, stated in a news release. “Oftentimes the solution can be an option that’s closer to home, where medical treatment can be sought and received faster than through a visit to a hospital emergency department.”

More than 20 nurse navigation programs have been implemented across the country — including in Wake County, North Carolina; Shawnee County, Kansas; and El Cajon, California— to free up emergency responders for the most severe cases. 

Why Establish Nurse Navigator Programs? 

The American Medical Response (AMR), a subsect of GMR, established its nurse navigator programs with the goal of allowing 911 dispatchers to route “low-level” calls to practitioners who can “give callers medical advice or help them set up an urgent care or telehealth appointment,” according to Oregon Public Broadcasting (OPB).

“Unfortunately, a lot of folks don’t know of the options that are out there to get the treatment that they need without having to go to an emergency room,” Rocco Roncarati, regional director for American Medical Response’s operations in Southwest Washington, told OPB.

A 2023 Lexipol survey, which gathered insight from police officers, EMTs, paramedics, and firefighters, also suggested there are staffing shortages among first responders, “creating significant recruitment and retention challenges, suboptimal levels of resourcing, and increased negative impact on communities.” 

More than 86% of EMS personnel reported staffing challenges in the past three years, along with the following findings: 

• 53% say their department doesn’t have enough personnel available to respond to 911 emergency calls in its service area; 
• 47% agree their department’s response to critical 911 calls has increased; and 
• 52% agree their department’s response times to non-emergent EMS calls have increased. 

Bill Conway, Clackamas County (Oregon) Office of Public Health Emergency Services manager, stated in a news release that the county’s EMS system is “overburdened.” The county established its nurse navigation program in September. 

“Ambulance transport to an emergency department is not the best resource for many non-life-threatening 911 requests for service,” he said. “The Nurse Navigation Program will provide the appropriate care for these requests, leaving 911 ambulances available to respond to life-threatening emergencies.” 

How Does the Program Work?

Trisha Adcock, 911 communications director in Santa Clara County, told NBC Bay Area that her dispatchers answer about 1,100 calls per day with about half of them “medical in nature.” 

Dispatchers ask callers a “pre-scripted series of questions” to determine if they need immediate emergency services or if they can be routed to a nurse. If a nurse is deemed appropriate, the call is routed to a national call center based in Texas. McClanahan said the nurses are licensed to practice in California, speak multiple languages, and understand the local resources. The program will be evaluated at a later date to determine if it will become a permanent fixture of the dispatch center. 

Those non-emergent calls with a licensed nurse, according to GMR, lead to one of the four scenarios: 

• Self-care and/or primary care; 
• Referral to virtual or mobile care; 
• Referral to alternate destination; or  
• Transport via rideshare or leased basic-life support unit. 

A nurse navigator program currently is under consideration in Honolulu, with Hawaii News Now reporting that the program could redirect upwards of 9,000 emergency calls annually. Officials told the outlet that nurses would get permission from callers to coordinate a rideshare, which wouldn’t be too different “than if you took an Uber rideshare out to dinner.”

The Bottom Line

Nurse navigator programs, which would divert non-emergency 911 calls from first responders to licensed nurses, have been gaining traction. Proponents believe the programs can help alleviate pressure on the emergency dispatch system and free up first responders to go out on calls that are a higher priority. 

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