9.4 The 20 Points of Accreditation & ACE Certification

9.4 The 20 Points of Accreditation & ACE Certification

Quick Answer: The Accredited Center of Excellence (ACE) designation, awarded by the International Academies of Emergency Dispatch (IAED), is the premier global benchmark for high-performing 9-1-1 dispatch centers. To achieve ACE status, an agency submits an Accreditation Self-Assessment Study documenting all of the IAED's Twenty Points of Accreditation. The performance standard is expressed as a distribution of case review results, not a single average: compliance levels must sit at or above accreditation levels for at least the three months immediately preceding the application (with six months of monthly data supplied), with no more than 10% Partial Compliance, 10% Low Compliance, and 7% Non-Compliant, each deviation type capped at 3%, and a Determinant Drift Report showing under-response and over-response each at no more than 5%. The IAED bases the whole process on generally accepted medical dispatch practice standards from NAEMSP, ASTM International, ACEP, USDOT, NIH, and the AMA, and ACE aligns municipal dispatch practice with ASTM F1258, ASTM F1560, and NENA-STA-020.

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The ACE Distinction: Why Accreditation Matters

While thousands of public safety communications centers utilize the Medical Priority Dispatch System worldwide, only an elite percentage attain the distinction of being an Accredited Center of Excellence (ACE). Earning ACE accreditation is the dispatch equivalent of a hospital receiving Magnet status or Joint Commission accreditation.

ACE signifies that an emergency dispatch agency does not merely own protocol software, but maintains a fully functioning, medically directed, continuous quality improvement ecosystem. In an accredited agency, dispatch decisions are scientifically standardized, telecommunicators receive ongoing education and supportive peer review, and prehospital emergency care begins the instant the telephone is answered.

Multi-Discipline Accreditation: The "Triple Crown"

The IAED accredits communication centers across four disciplines: EMD (Medical), EFD (Fire), EPD (Police), and ECNS (Emergency Communication Nurse System). An agency already holding ACE in one discipline may face a site evaluation when it applies in another. Agencies that achieve concurrent accreditation in Medical, Fire, and Police are awarded the prestigious IAED Triple Crown, representing the pinnacle of multi-agency public safety communications.

Tangible Operational and Legal Benefits of ACE

• Unassailable Legal Immunity Defense: In civil liability lawsuits alleging dispatch negligence, plaintiffs routinely attempt to argue that the 9-1-1 center operated under substandard local customs. ACE accreditation proves in court that the agency adheres strictly to peer-reviewed international standards established by the IAED, ASTM, and NENA.
• Optimized Field Resource Utilization: Maintaining high compliance in Chief Complaint selection and Final Coding eliminates subjective dispatcher guessing, drastically reducing unnecessary lights-and-siren ("hot") ambulance runs and reserving Advanced Life Support (ALS) paramedic units for true medical crises.
• Maximized Prehospital Survivability: Verifiable adherence to Dispatch Life Support standards — evidenced by the three mandatory Pre-Arrival Instruction cases the Academy re-audits — drives earlier telephone CPR initiation, higher bystander defibrillation rates, and improved neurologically intact survival for sudden cardiac arrest victims.

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The Twenty Points of Accreditation

The IAED publishes the Twenty Points as a list of things the Accreditation Self-Assessment Study must formally document and describe. Each point has sub-points requiring specific attached evidence — floor plans, meeting minutes, certificate lists, policies, schedules, reports, and signatures.

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Points 1–4: The Center, the Protocol, and the People

• Point 1 — Communication center overview and description: Total active calltaking and dispatching stations plus supervisory or standby positions, a floor plan showing each workstation, and a list of any current accreditations and their accrediting bodies.
• Point 2 — MPDS version and licensing confirmation: The MPDS protocol version number, the ProQA Paramount version, the AQUA version, and the ED-Q Performance Standards edition, together with a policy committing the agency to implement the most recent versions within one year of release.
• Point 3 — Current Academy EMD certification of all personnel who process emergency calls: A list of every EMD with hire date, last certification date, next recertification date, and Academy member number.
• Point 4 — Instruction and case review by certified personnel: All EMD certification courses are conducted by Academy-certified instructors, and all case review is conducted by Academy-certified ED-Qs, with names, recertification dates, and member numbers supplied for each.

Points 5–10: The Quality Improvement Engine

• Point 5 — Full activity of quality improvement committee processes: Agendas and minutes for the Dispatch Review Committee (DRC) and Dispatch Steering Committee (DSC) — at least two DRC meetings and one DSC meeting in the six months before the application — plus the membership and objectives of the Quality Improvement Unit, DRC, and DSC.
• Point 6 — IAED quality assurance and improvement methodology: A written description of how cases are randomly selected, the minimum number reviewed monthly, any focused case review practices (cardiac arrest, choking, childbirth), and how performance is checked, tabulated, tracked, and shared with each employee and posted by shift and center.
• Point 7 — Consistent case evaluation meeting the Academy's minimum expectations: The minimum case evaluation requirement is derived from annual call volume per discipline using the ACE Calculator in AQUA or the Academy website, with the total calls received and total cases reviewed in the preceding six months.
• Point 8 — Historical baseline QA data: A baseline Agency ACE Performance Report and Determinant Drift Reports from the initial implementation of structured Academy QA processes.
• Point 9 — Monthly average case evaluation compliance levels: Six months of monthly compliance data, at or above accreditation levels for at least the three months immediately preceding the application, plus a Determinant Drift Report showing under-response and over-response each at no more than 5%.
• Point 10 — Independent Academy verification of case evaluation technique: 25 case review audio files and an AQUA merge file — 22 purely random calls from the month immediately preceding the application (not cases flagged for feedback) plus 3 cases involving Pre-Arrival Instructions, one from each of the three preceding months.

Points 11–16: Policy, Education, and Response Assignments

• Point 11 — MPDS orientation and case feedback for field personnel: The field orientation process and materials, the number of Field Responder Guides distributed, the EMD case feedback methodology, and a blank field feedback form with distribution dates.
• Point 12 — Local policies and procedures for MPDS implementation: Policies covering implementation and application of the MPDS, Medical Director approval of all protocols including ProQA "Restricted Settings" and "Special Definitions," protocol compliance, quality improvement, CDE requirements, performance management and remediation, customer service, language translation, and a policy that only EMD-certified personnel process emergency medical calls.
• Point 13 — Continuing dispatch education documentation: CDE schedules and topics for the past six months, EMD attendance records, and a draft CDE schedule for the next six months.
• Point 14 — Secondary Emergency Notification of Dispatch (SEND) orientation: Documentation that SEND Protocol information has been distributed to all police and fire dispatchers and to other agencies that routinely forward emergency calls, with attendance records and training materials. SEND is the short, scripted set of questions a non-medical dispatcher uses to recognise a life threat and hand the call to an EMD.
• Point 15 — Established local response assignments for each MPDS Determinant Code: The process for developing response assignments, a full list of every determinant code with its local assignment, and Dispatch Steering Committee minutes verifying approval.
• Point 16 — Maintenance and modification of local response assignments: Documentation of how assignments are regularly reviewed and how changes are approved.

Points 17–20: Data, Medical Direction, and Commitments

• Point 17 — Master Dispatch Analysis Report: The incidence of every Chief Complaint, every individual determinant code, and every determinant level (Ω, A, B, C, D, E) for the six months immediately preceding the application.
• Point 18 — Appointment and involvement of the Medical Director: Name, address, licence number, and jurisdiction of licensure; the documentation appointing the Medical Director; and the approved roles and responsibilities of the Medical Director within the dispatch system.
• Point 19 — Agreement to share non-confidential EMD data: Written verification signed by the agency's senior executive agreeing to share data with the Academy for the improvement of the MPDS, and to submit quarterly compliance summary reports electronically.
• Point 20 — Agreement to abide by the Academy's Code of Ethics and Code of Conduct: Written verification signed by the senior executive, plus the date, location, and verification of the prominent posting of both codes in the center.

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The Numerical Compliance Thresholds for ACE

The ACE performance standard is a distribution of case review results, not a single average score. An agency cannot offset a persistent tail of poor calls with a large number of excellent ones:

The Demonstration Window, Verification, and Term

• Six Months of Data, Three Months at Standard: The applicant submits monthly average case evaluation compliance levels for the six months preceding the application, with compliance at or above accreditation levels for at least the three months immediately preceding it.
• Independent Academy Verification: The agency supplies 25 case review audio files and an AQUA merge file for the Academy to re-audit: 22 purely random cases from the month before the application — explicitly not cases marked for feedback — plus 3 cases involving Pre-Arrival Instructions, being the first PAI case reviewed in each of the three preceding months. The agency must also state its process for random selection.
• Site Evaluation: A site evaluation is required for all first-time accreditations and may be required for re-accreditations at the option of the Board of Accreditation.
• Three-Year Term, No Automatic Renewal: ACE accreditation is granted for three (3) years. It does not renew automatically — each accredited center must reapply at the end of its term. During the term, the agency uploads monthly Compliance Reports to the ACE portal on a quarterly basis (due 15 April, 15 July, 15 October, and 15 January). Failure to report, or failure to meet compliance levels, places the agency in Remediation Status.

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Alignment with Industry Consensus Standards: ASTM & NENA

The Twenty Points do not exist in isolation. The IAED states that its accreditation process and the MPDS protocols themselves are based on generally accepted medical dispatch practice standards published by the National Association of EMS Physicians (NAEMSP), ASTM International, the American College of Emergency Physicians (ACEP), the U.S. Department of Transportation, the National Institutes of Health, and the American Medical Association, among others. Three of those documents matter most to an EMD:

1. ASTM F1258: Standard Practice for Emergency Medical Dispatch

Published by the American Society for Testing and Materials (ASTM), ASTM F1258 establishes the individual scope of practice for emergency medical dispatchers. It defines the operational requirements for structured interrogation, telephone triage, delivery of pre-arrival instructions, and medical oversight. ACE accreditation verifies that an agency's telecommunicators practice strictly within the boundaries mandated by ASTM F1258.

2. ASTM F1560: Standard Practice for Emergency Medical Dispatch Management

ASTM F1560 focuses on the administrative and managerial obligations of an emergency dispatch agency. It mandates that public safety organizations provide active physician medical direction, structured continuous quality improvement programs, statistically valid call sampling, ongoing continuing education, and risk management procedures. The management-facing Points — QI committees, case review methodology, CDE documentation, local policies, and Medical Director appointment — are the operational reflection of ASTM F1560.

3. NENA-STA-020: NENA Call Processing Standard

Developed by the National Emergency Number Association (NENA), NENA-STA-020 establishes operational parameters for 9-1-1 call answering speed, call transfer mechanics, location verification protocols, and caller management techniques. ACE accreditation validates that an agency's call processing workflows align with NENA's national emergency communications benchmarks.

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The Twenty Points of Accreditation: Evidence Reference Matrix