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Alexandria, VA: Continuous Improvement Through Call Assessment

Agency Profile

The Alexandria Department of Emergency Communications serves as the Public Safety Answering Point for all emergency services (including law enforcement, fire service, and emergency medical dispatch) within the city. The City of Alexandria is a Washington, D.C., suburb, located in northern Virginia, with approximately 151,000 residents.

The Department of Emergency Communications consists of sixty employees dedicated to 911 dispatch as well as emergency and non-emergency call handling through a computer-aided dispatch system, E911 telephone system, and municipal radio operations. Alexandria upgraded its call-handling support by incorporating Total Response Emergency Call Handling Software in 2015.


At the time, Alexandria tracked call assessment data with a static Excel spreadsheet. While this provided some insight into overall call performance, due to the static nature of the spreadsheet, it could not be used to score calls evenly because there was no mechanism to account for unique questions related to each call.

In addition, Alexandria’s Medical Director J. Benji Marfori, MD, FACEP, explained,

You cannot improve outcomes without measuring performance. When variances occur, we must ask ourselves if the problem is with the person or the process. We cannot expect our personnel to achieve goals for which we have not adequately trained them. Quality Assurance must be viewed as process improvement rather than disciplinary action. We all have room to improve. The system needs to constantly evolve to include new threats and conditions.

Alexandria performs call assessment through the Total Response Assessor Module, which allows supervisors to select call records against predefined criteria.

In Alexandria’s Department of Emergency Communications, Total Response is installed on ten workstations, allowing supervisors to pull reports for each employee, along with a computer-aided dispatch (CAD) report and each call’s accompanying audio.

Supervisors review priority calls first, then a set number of calls every month for each dispatcher. New employees are monitored more closely, and veteran employees are monitored more when necessary.

Assessment provides a score or rating that measures how effectively each call was managed in relation to expected standards.

Scores are generated by completing configurable assessment templates that focus on specific aspects of each call including: verifying the caller’s number and location, the telecommunicator’s communication skills, performance at each stage of the call (pre-dispatch, dispatch, and post-dispatch), issuance of pre-arrival instructions (when necessary), and script relevance to the call.

Senior staff also perform agency-wide reviews in monthly meetings with the Medical Director to set call-handling priorities and adjust their call assessment focus.

Leadership routinely chooses a new aspect each month for greater inspection, such as determining whether dispatchers are overusing the “Unknown Medical” and “Sick Person” call types as the chief complaint.


Alexandria rejuvenated their QA operations with Total Response call assessment by automating data collection, revealing deeper insights into their call-handling effectiveness, and clarifying expectations for every call type.

After identifying areas for improvement, staff conduct training to strengthen future handling of related incidents. Training exercises reinforce agency standards, increase dispatcher confidence, and raise overall service quality with a culture of continual improvement.

Alexandria’s success with call assessment has inspired the Department of Emergency Communications to explore extending the features and benefits of Total Response to the handling of non-emergency calls. For example, the department would utilize the Total Response Script Builder to create protocols for handling common non-emergency inquiries. Not only will this encourage telecommunicators to answer these inquiries with greater consistency, but supervisors will also be better equipped to track these interactions and monitor performance in relation to predefined standards.

Total Response’s proactive approach to call assessment reduces agency liability and risk by documenting adherence to defined standards and building pathways for improvement. Assessment also provides crucial insights for the City of Alexandria to monitor its performance against the individual agency’s standard of care, make informed adjustments to that standard, and take actionable steps for improvement through call training.

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