The purpose of this study was to describe and analyze how and why contradictions recurrently arise regarding how incoming emergency calls at dispatch centers should be assessed, sorted, and handled. The study is based on data from documents, study visits, and interviews with representatives from dispatch operators in a Swedish context. The results identify competing alarm and healthcare logics that are incompatible, which leads to contradictions between the national and regional approaches and, consequently, makes collaboration more difficult and affects the precision of emergency call assessment.

The study also shows that the assessments of emergency calls are governed more by which logic is applied than by the assessor’s formal competence. The study highlights the importance of feedback and subsequent analysis from the health service to the initial call assessment stage, which can improve the alarm logic’s weaknesses with over-triage, without extending the response time. We also focused on the mechanisms required to develop and maintain a long-term sustainable alarm function.