An Examination of the Nature of Prank Calls To The National Ambulance Service (NAS) and Mitigation Strategies

Abstract

Emergency Medical Services (EMS) are in place to provide prompt, life-saving interventions at moments of crisis. In Ghana, the National Ambulance Service (NAS) has been assigned the responsibility for this critical role in the provision of national healthcare. However, its ability to undertake the task is constantly under threat from the growing scourge of prank calls on the national emergency line. Though prank calls may appear to be harmless or trivial behavior, their cumulative impact is considerable: they waste scarce resources, delay the response to genuine emergencies, discourage frontline personnel, and undermine the public's faith in the emergency care system. This study, therefore, sought to examine the character, impacts, and control of prank calls in Ghana's EMS environment, addressing a poorly served gap in the literature. The research was guided by three questions of inquiry: (1) what is the nature and pattern of prank calls received by NAS? (2) How do prank calls affect NAS personnel operations, morale, and public trust? And (3) what community factors influence the incidence of prank calls, and how can they be minimized? To answer these questions, a qualitative approach was used. Semi-structured interviews of NAS dispatch officers, on-duty EMTs, and residents across five urban districts in Greater Accra were conducted. Thematic analysis using open, axial, and selective coding, as guided by Charmaz (2014) and Creswell & Poth (2018), was used. Findings were addressed through several theoretical frameworks: the Theory of Planned Behavior (Ajzen, 1991), Diffusion of Innovations (Rogers, 2003), Communication Privacy Management Theory (Petronio, 2002), Systems Theory (von Bertalanffy, 1968), Relationship Management Theory (Ledingham & Bruning, 2000), and Situational Theory of Publics (Grunig & Hunt, 1984). Findings revealed prank calls are not random or isolated but patterned behavior shaped by social, psychological, and structural forces. Dispatch officers indicated that they receive prank calls daily, with peaks on evenings, weekends, school holidays, and holiday periods, when there is idle recreation and minimal adult supervision. Types of prank calls involved silent calls, false emergencies, harassment, children's test calls, and misdialed non-emergency calls. This is an implementation of Rogers' (2003) Diffusion of Innovations theory, where prank calling, as with other social behavior, diffuses and is institutionalized among peer groups, particularly youth. Theory of Planned Behavior (Ajzen, 1991) also clarifies how pranksters' positive attitudes (viewing calls as entertainment), permissive social norms (peer approval), and low perceived risk (lack of sanctions) sustain the practice. The consequences of prank calls were observed to be grave. Operationally, prank calls redirected ambulances, wasted gasoline, accelerated vehicle wear and tear, and took up scarce resources that could otherwise be used for genuine emergencies. This resonates with Systems Theory (von Bertalanffy, 1968), which further posited that spurious emergency calls, mistaken inputs here, interrupt throughput and output of the emergency system, and total efficiency. Psychologically, prank calls were also causing frustration, burnout, and demotivation for EMTs and dispatchers alike, in accordance with international studies (Regehr & Millar, 2014). These findings are consistent with Relationship Management Theory (Ledingham & Bruning, 2000), wherein mutual trust and commitment are emphasized to sustain morale and organizational performance. Finally, prank calls undermined the credibility of NAS in the minds of citizens because delays in response created an image of inefficiency. Communication Privacy Management Theory (Petronio, 2002) explains how the violation of trust boundaries by citizens made them not grant trust to NAS, enhancing the reputational crisis even further. Prank calls at the community level were attributed to ignorance of impact, children experimenting, inadequate civic education, and ineffective deterrence by the police. Measures in mitigation were education campaigns, caller identification systems, and sporadic legal enforcement. Participants, however, identified loopholes in consistency and coordination. Recommended solutions were enhanced school outreach, community watchdog programs, required service penalties for criminals, and sophisticated call-filtering technologies. These are congruent with both Systems Theory (highlighting coordinated sub-systems) and DOI (Rogers, 2003), which proposes that just as prank calling has spread as an anti-social act, proper emergency hotline usage can spread positively in the form of community role models and institutional reward. Finally, prank calls are both a behavioral and systemic issue. They are driven by permissive cultural norms and lack of awareness as well as destabilizing functional effectiveness, subverting morale, and eroding public trust. The findings confirm and extend earlier studies of emergency hotline misuse (Wankhade, 2016; Ibrahim et al., 2018) and place the phenomenon in Ghana's underdeveloped EMS landscape. The study contributes theoretically through integrating behaviorist, organizational, and public communication theories to explain prank calling as a multi-dimensional phenomenon. In reality, it requires a multi-stakeholder response that includes grassroots awareness, technological invention, mobilization of the community, and persistent enforcement. Significantly, the study highlights that each prank call has life-threatening consequences, thus an imperative matter of public safety that requires persistent scholarly, policy, and community attention.