Abstract
BACKGROUND AND OBJECTIVES: Amid the escalating frequency and severity of disasters, the role of prehospital emergency dispatch centers in delivering a swift and effective response has become increasingly critical. Despite their pivotal role, there is a paucity of qualitative evidence, particularly from developing nations, concerning the multidimensional challenges these centers face during crises. This study aimed to identify the determinants affecting the performance of emergency dispatch centers during disaster response in Iran. METHODS: This qualitative study was conducted between October 2024 and May 2025, employing an inductive approach with conventional qualitative content analysis. Data were gathered through semi-structured interviews with 20 participants, selected from diverse geographical regions and professional roles. Data analysis occurred concurrently with data collection, and analytical rigor was established through member checking and independent coding by multiple researchers. RESULTS: A total of seven main categories and 19 subcategories influencing the performance of dispatch centers during disasters were identified. These categories include: (1) leadership and command (2), Resources and Logistics (3), Operations Management (4), Dispatch Assessment and Decision-Making (5), Call Management (6), Contextual and Environmental Factors, and (7) Enhancement of Functional Coordination. These factors, both independently and interactively, constitute the operational framework for an effective response in disaster situations. CONCLUSION: An effective dispatch response during disasters emerges from the dynamic interplay among a multi-level command structure, resilient resources, rapid decision-making, and organizational coordination. While the findings are rooted in the Iranian context, many of the identified concepts are transferable to Emergency Medical Services (EMS) systems in other countries. Enhancing dispatcher training, fortifying communication infrastructures, and reinforcing coordination protocols are crucial interventions for improving the preparedness and resilience of health systems in the face of disasters.