An increase in the province’s aging population, coupled with the growing rates of chronic disease, is putting a strain on B.C.’s ambulance service. Communities in the Lower Mainland, like Maple Ridge and Pitt Meadows, have been saying they are facing a critical ambulance shortage that is putting lives at risk.
A new action plan released today by the British Columbia Emergency Health Services (BCHES) is hoping to assuage those concerns, as well as “renew and revitalize emergency services” in the province.
The plan comes on the heels of the Demand and Deployment Review, which was commissioned by the BCEHS Board of Directors and done by Operational Research in Health (ORH), and looked at more than 350,000 emergency responses provided by ground ambulances in Metro Vancouver and Victoria.
The first step of the plan involves adding eight additional ambulances and 34 full-time employees in the Lower Mainland.
Along with the data showing the Lower Mainland and Greater Victoria regions accounting for 85 per cent of all BCEHS’ calls, they are also responding to a high number of calls for transfers of patients with medical issues that are not urgent or life-threatening.
The data also showed these transfer calls for non-urgent or life-threatening patients are tying up paramedics for more than 30 minutes, as they wait to hand them over to the emergency departments.
“To reduce the pressures these put on emergency and hospital services, we are focusing on patients more proactively – with prevention, health management and better primary care in a patient’s community. A strong and responsive ambulance system is still critical,” Health Minister Terry Lake said.
“We must continue to modernize our pre-hospital emergency services and integrate them better with other parts of the health system, to create a more patient-centred, sustainable ambulance service for the province. This review gives us valuable information to help achieve that goal.”
The information below highlights some of the current service use and response times in BCEHS’ Metro Operations areas, which includes Metro Vancouver, Greater Victoria and the Fraser Valley.
- 6%: estimated growth in demand per year over the next five years
- 243: average number of patient events per day that 15 different fire services across Metro Vancouver respond to
- 827: average number of patient events per day responded to by ambulances in the Metro areas in 2014
- 21%: portion of patient events that are of the highest acuity
- 37%: portion of patient events that are of a serious but not critical nature
- 28%: portion of patient events that fall into the least acute category
- 14%: portion of patient events that are for transfers
- 10:24 minutes: The average amount of time it takes for BCEHS to respond in the Metro areas for the most critical patient events
- 9 minutes: the average amount of time BCEHS would establish as the target for response in the Metro areas to the most critical patient events 75 per cent of the time, as per best practices established in other jurisdictions
- 51%: the portion of times that BCEHS can currently respond in an average of nine minutes to the most critical patient events
- 15:07 minutes: the average amount of time it could take for BCEHS to respond to the most critical patient events in 2020 if nothing is done to improve existing services
The Action Plan, which will be developed in more detail over the coming months, identified five overarching strategies to help drive system-wide improvements.
They include:
- improving performance efficiencies to reduce dispatch and mobilization response times;
- reviewing the approach to responding to calls of a minor nature and low-acuity transfers;
- working with health authorities to improve turn-around times from hospitals and patient-transfer times;
- developing a multi-year strategy for implementation of new resources; and
- enabling innovation in the way the province delivers emergency health services.
The Action Plan will build on the work BCEHS has already started, as well as renew and revitalize emergency services to make the more effective for patients, said executive vice-president of the Provincial Health Services Authority (PHSA) and BCEHS Linda Lupini.
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In 2014, there were approximately 54 emergency incidents for every 1,000 people and by 2020, it is forecasted to rise to 70 incidents per 1,000 people.
GRAPHIC: Demand and Deployment Review breakdown
Drilling deeper into the data by ORH, they look at the 2014 demands for each community’s Local Health Area (LHA) and project the increase in demand for 2020.
CHART: Population-based demand for 2014 and projections from 2020 broken down by Local Health Area (LHA)
According to the PHSA, many of the action plan priorities will be applied in other areas of the province, outside the Lower Mainland and Greater Victoria areas, and a community paramedicine program has been implemented to help strengthen emergency care in rural and remote areas of B.C.
A copy of the BCEHS plan can be found here.
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