The province and an independent committee have released their recommendations to improve Alberta Emergency Medical Services (EMS) response times — more than fifty — and the province announced more details Monday on how they’ll start on them.
The Alberta EMS Provincial Advisory Committee and third party review of the province-wide dispatch system was announced a year ago. Health Minister Jason Copping said the province has accepted each recommendation from the two reports, some of which are already underway, like two pilot projects in Spruce Grove.
The first project adds “surge capacity” to the ambulance system in the region, the report says, by using the city’s integrated fire ambulance services. Firefighters who are also trained as paramedics are able to assess and transport patients.
The second allows firefighters to respond to non-urgent calls and see if they can address the issue at the scene. If they can, they will, and they’ll let the ambulance know it doesn’t need to come.
Spruce Grove fire chief Robert Kosterman gave the example of a cancer patient in their sixties who needed urgent pain medication. The firefighters were able to attend the call, administer the meds, and let the paramedics know the ambulance wasn’t needed.
“It’s good for the patient, it’s good for the fire crew and it’s good for the ambulance system because that frees up a resource,” said Kosterman.
Copping said the two pilot projects were seen as a success and they’re looking at how to implement the practices across Alberta.
Other actions include transferring patients between facilities using a taxi or homecare shuttle instead of an ambulance, allowing paramedics to assess if a patient needs to be taken to hospital or can be treated on scene, and speeding up hospital drop-offs by putting less-urgent patients in the waiting room instead of into a hospital bed.
“We’ve heard from paramedics they don’t want to spend their time sitting around in a hospital,” said Copping.
The province said AHS has put a new policy in place that will see emergency room staff assess patients arriving in ambulances to see if they can wait in the waiting room with other medically-stable people or if they need to be seen right away.
Ambulances will still be used for transfers if a patient needs high levels of clinical care. The province said non-emergency patient transfers will be overseen by Alberta Health Services (AHS) and meet appropriate staff and equipment standards.
The province said Edmonton and Calgary will each get 10 more ambulances this spring, but as for the paramedics that will actually staff those ambulances, Copping said the province is working on increasing postsecondary seats across the province for paramedics.
“We’re also actually looking at going afield. We understand in Australia, for example, that they have a surplus of paramedics,” he said.
Copping said EMS hired 341 paramedics in 2022 and said EMS is working on retention, which was mentioned in the report a number of times.
To address work-life balance, Copping said the EMS scheduling will change: instead of being on-call for long shifts with fewer calls, paramedics will have a more regular schedule. Mental health supports and a more inclusive, welcoming work environment were also recommendations in the reports.
Copping said success will be measured by looking at response times (how long between the ambulance being dispatched and arriving at the hospital) and handoff times (how long after arriving at the hospital can the paramedics hand off the patient and get back on the street).
Mike Parker, head of the union representing Alberta paramedics said adding more ambulances is not the same as adding more staff.
“Calgary had more than 9,000 unfilled shifts last year. Edmonton had almost 19,000 unfilled shifts. The issue is a lack of paramedics, not a lack of ambulances,” said Parker.
Parker pointed to working conditions, explaining that the paramedics rarely get meal breaks, they work long hours and often need to stay late to take care of patients.
“Nobody has said, ‘We’re going to get you off shift on time because we’re resourcing properly,’” said Parker.
“We have no discussion on safe staffing levels, we have no discussion on just getting a meal break. What we have right now is a system that functions in a code red system all day long and it’s burning out our folks,” he said.
Parker said he would also like to see more casual staff hired on full time.
Calgary Fire Department Chief Steve Dongworth said his crews see the impact of extended red alerts – periods of time where there are no ambulances available in the city.
“We’ve often been on scene at medical calls much longer than we would have been pre-COVID,” Dongworth told Global News. “In some instances over an hour and in some instances over two hours waiting for an ambulance.”
CFD crews co-respond with EMS to higher acuity calls, to help provide life-saving services, along with things like traffic control and extraction from vehicles or buildings.
Dongworth said Monday’s announcement was “encouraging” but would “wait and see” what kind of results the promised new ambulances would provide on the ground.
The CFD chief pointed to the staffing of the ambulances.
“Just as one of our units, to have a fire truck and a station with no staff does nothing for the community. So that’s a concern,” he said.
Neufeld CFD crews will continue to co-respond to 911 calls.
“If it’s longer than we would be used to, we’ll keep doing that because our commitment, our mission is to our customers, to the citizens, saving lives and doing what we can to mitigate harm.”
The Opposition’s health critic said that while there are certainly elements of the report that he’s in support of, it’s “thin”, especially considering how long it’s taken to come out.
“It’s simply too little, too late,” said David Shepherd.
Shepherd said inter-facility transfers aren’t “anywhere near” the biggest problem facing paramedics and that introducing non-AHS transfers is the government’s way of moving towards healthcare privatization.
“We know that this government often has a predilection for looking for opportunities to privatize the delivery of services,” said Shepherd, adding he hasn’t seen if that necessarily provides better results for Albertans.
“We have opportunities to invest in our public health care system and that is where we should be looking first.”
–with files from Adam Toy, Global News
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