This report counts, per provider, how many calls came in dispatched as Critical or Emergent (eDispatch.05 = 2305001 or 2305003) but were assessed as Lower Acuity (Green) at first patient contact (eSituation.13 = 2813005). These are the calls where dispatch said "this is hot" and the provider said "this is not."

How to use it
- Open Operations → Provider Quality → Downgraded Incidents.
- Pick a window — 3 or 6 months gives a meaningful sample.
- The grid lists each provider with a downgrade count.
Why this matters
Downgrades are not inherently wrong. Dispatch information is incomplete by definition — they assess by phone, the provider assesses in person. Most downgrades are the EMD card guessing high.
What you are looking for is patterns:
- One provider downgrading at a substantially higher rate than peers may be assessing differently — possibly under-triaging.
- Calls that were downgraded and then deteriorated en route are the worst-case scenario. The medical director should review these case-by-case.