EDMONTON – A year after paramedics sounded the alarm to Global News about
what they described as a crisis in ambulance service in the province, a review
by the Health Quality Council is validating their concerns.
Last year, after hearing the paramedics’ concerns, the Health Minister asked the Health Quality Council of Alberta (HCQA) to completely review the system.
Monday afternoon, the report on that review was released publicly. The report shows data was lacking when it comes to response times, and that a patchwork dispatch system made for a system that doesn’t work properly.
“We interviewed literally hundreds of individuals,” explained Dr. John Cowell, Chief Executive Officer of the Health Quality Council of Alberta.
“Sadly, we found that the provincial EMS data system is lacking in availability, adequacy, usefulness and so on.”
Cowell said Alberta Health Services (AHS) employees, 911 answering service workers, unions, associations, municipalities, employees at dispatch centres, EMS providers and first responders were all consulted.
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“One of the things that can happen sometimes in a large system is that people who are in decision making roles can unintentionally lose touch,” added Health Minister Fred Horne.
Horne says he is directing Alberta Health Services to implement all of the Health Quality Council of Alberta’s five recommendations, which are:
1. legislation, operational standards and an accountability framework for Alberta’s 911 system;
2. expedited completion of province-wide, consolidated EMS dispatch;
3. a provincial vision and plan to standardize care while respecting local requirements;
4. a single, comprehensive source of EMS data to support decisions, quality and safety; and,
5. integrating quality and safety into planning and performance documents.
The president of the union representing frontline workers, Elisabeth Ballermann, says this is a good first step, but she still wants to see how the recommendations are implemented before drawing any final conclusions.
“If people are having life-threatening… incidents and it’s taking more than ten minutes to get an ambulance to those folks… We should ask some questions about how to improve on that,” she says.
Ballerman adds long response times are a particular concern for those in rural Alberta.
“We saw some marginal improvement in Edmonton and beyond that, in the rest of the province, we’ve seen a creeping up of some response times that are published on the website, especially in the rural communities.”
The recommendation that all dispatch be consolidated is being well-received, but it’s a decision opposition members say should have happened years ago.
“It’s hard not to go back three years and ask ‘where was the planning three years ago? Where was the consultation?’” asks Liberal MLA David Swann.
“Why have we gone through three years of chaos, suffering, risks to lives, and demoralization in our workforce because the government failed to do a proper approach to this? Now, we’re playing catch-up. It’s going to be six months before we actually get a system in place that melds the dispatch centres with the 911 centres.”
“It’s really appalling what has happened,” Swann adds. “These are recommendations that should have been there before we made these kinds of decisions.”
Opposition members are also critical of the fact that only 50 frontline workers were consulted for the report.
“I can tell you that the paramedics that I’ve spoken to, both in the major cities and the ambulance people that we’ve talked to in rural Alberta, were never consulted,” said Wildrose health critic Heather Forsyth.
She stressed many first responders still don’t feel comfortable talking about their concerns with the system.
“You just have to watch your program- in regards to the paramedics going undercover – completely undercover in this day and age, 2013, voices changed. The ones I talk to are completely looking over their shoulder all the time. It just shows that they’re afraid to come out and speak, and then the fear of intimidation continues.”
Horne said the priority of health care is always on patient safety, but that listening to staff is an important element.
“First and foremost of course in all of this are patients who are in need,” he said, “but the system also has a responsibility to support as best it can and to be responsive of EMS workers.”
“I certainly hope based on the Health Quality Council report that our front line staff will feel that they’ve been heard, and that their concerns have been activated on,” he added.
The HQCA’s recommendations were reached after a year-long review that examined the transition of ground ambulance services from municipalities to AHS, which began in 2009. It also looked at the province-wide consolidation of dispatch services, specific challenges for integrated fire service and EMS providers, the availability of adequate data on EMS performance, and challenges specific to urban, rural and remote areas.
Over the next six months, Associate Minister of Municipal Affairs Greg Weadick will lead the development of a detailed plan that addresses challenges faced by 911 call centers, volunteer fire departments, and municipalities.
MLA Rick Fraser, meanwhile, has been appointed by Horne to be the provincial liaison on EMS issues. Fraser will be responsible for investigating and reporting on local EMS issues identified by MLAs.
You can see the full HQCA report below:
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