WATCH: Health Services defends changes to ambulance response protocols

VANCOUVER – The BC Emergency Health Services (BCEHS) is defending its decision to downgrade some medical emergencies from Code 3 to Code 2.

When you dial 9-1-1 in need of an ambulance, you’re likely hoping paramedics will be there as quickly as possible.

Since last October paramedics have been responding to fewer calls, labelled Code 3, which means using lights and sirens.

In recent weeks fire chiefs and politicians from Vancouver, Coquitlam, New Westminster, Burnaby and Port Coquitlam have appeared on Unfiltered with Jill Krop, raising their concerns about this new RAP, or Resource Allocation Program.

On Tuesday the people responsible for this latest RAP held a technical briefing to update the public on how they believe the program is working.

Dr. William Dick, the vice president of medical programs, appeared on Unfiltered with Jill Krop on Wednesday to address the concerns of the public about the extended wait times for Code 2 calls, which are considered routine and no lights and sirens are used.

At the BCEHS briefing Dick defended its RAP, saying they are seeing an improvement of 29 seconds on average in response time for Code 3 calls.

“Those improvements that we’re already seeing, in getting to those critically ill patients, is really, it’s a great thing,” said Dick on Unfiltered.

He said they made this move to be the most cost effective they can and to provide the best care they can to the patients.

“We did a complete look at our outcomes, how patients were when we got to them, and to the hospital, it was very robust,” he said.

Dick said when making these decisions they looked at hundreds of thousands of cases of how patients were when paramedics arrived, how quickly they got to them and how they were when they arrived at the hospital.

“I approach this from a scientific and a medical point of view and I want to ensure patient safety and I want to ensure that what we are doing is right,” he said. “And am I open to criticism? Yes. Am I open to modifying the process? Yes. When it’s valid, when medically driven and its scientific, absolutely.”

“I also want first responder data.”

Speaking on Unfiltered on Wednesday, Burnaby councillor Colleen Jordan said they have had Code 2 calls that have taken more than an hour for a response from BC Ambulance.

She said there have been 11 occasions since they started documenting the cases, where it took more than an hour for the paramedics to arrive on scene after the fire department arrived.

“In addition to that we have 67 calls that were more than half and hour,” she said. “So Dr. Dick may say that the immediate ones are being reduced, but there is a problem in the system in that those lower priority calls, in their view, are not getting serviced anywhere near adequately as far as we’re concerned.”

Coquitlam Mayor Richard Stewart said council is finding a very similar situation in their city relating to the Code 2 calls.

“Some of those calls are serious,” Stewart said on Unfiltered. “Our fire department is sitting there, our fire department responds as many do, and tries to reassess the situation, calls BC Ambulance, tries to get them to understand the severity of the situation. In many cases our fire department has sat there for an hour waiting for a response.”

Wynne Powell, the BCEHS board chair, said the board was approached in late October to change the RAP. “As a person who has led many large outfits, you soon get to recognize when the data is very compelling,” he said. “What was not so compelling, we the board felt that the management, the previous management, the former president and the former COO who are no longer employed by us, we didn’t feel that they had done a strong enough communication process as the board to talk to the first responders and to be transparent and open to them as necessary.”

“As the doctor has identified there is some coordination challenges and we are working on that.”

He said the whole concept is get the appropriate service and the appropriate time to the person that needs it when they have called for an ambulance.

Dick said the key thing to remember is that they have to manage their resources to get to the sicker patients, in order to provide the best level of care.

“If I say ‘well everything’s Code 3, lights and sirens’, how do I determine who those illest, most sick patients are?” asked Dick.