Alberta's Minister of Health, Jason Copping confirmed that he has received the final report and recommendations from the EMS provincial advisory committee. The committee was launched in January as a response to the immense strain that is being experienced by Emergency Medical Services across the province. The committee was meant to provide immediate and long-term recommendations that will inform a new provincial EMS service plan.
According to Copping, the provincial government is taking the necessary time to study the final report’s recommendations and develop the next steps.
"That said, we are not waiting to make real improvements to the system. Work is underway on multiple fronts to improve EMS coverage across the province. That includes implementing the committee’s initial recommendations that I approved last May to introduce efficiencies and pilot new solutions," he stated a in press release.
In May 2022, the government announced a series of steps that they were taking following as a way to ease ambulance staffing requirements as well as reduce patient offload delays in emergency departments. Pilot projects were also launched in Strathcona County and Spruce Grove.
The pilot program in Strathcona County was meant to deploy community response units as part of the contracted EMS, which would stay within the county. This program would allow improved service capacity and response times to urgent calls that require advanced care, while the Spruce Grove pilot projects were to allow cross-trained firefighters-paramedics functioning as medical first responders to cancel inbound ambulances when not required. There was also to be a review of the types of automatic requests for EMS standby for fire calls to free ambulances when not needed.
Copping also underlined that Alberta Health Services is also making rapid progress on its 10-point plan to add EMS capacity and ensure the most critical patients receive immediate care.
"More than 200 new EMS employees were hired, including 167 paramedics, since the start of this year, and 19 additional ambulances are now on the roads in Edmonton and Calgary," Copping said.
According to an EMS 10 Point Plan Update on September 27 by Alberta Health Services, between January and September 26, AHS EMS added 19 new ambulances in Calgary and Edmonton, nine and 10 respectively. Additionally, AHS stated that extra hours of ambulance coverage were added in Okotoks and Chestermere in August. New staff have also been hired to support the new ambulances: AHS has hired 40 new Primary Care Paramedics – 20 each in Calgary and Edmonton.
"Relieving some of the pressure on the EMS system by adding resources in the two largest cities in the province, and the areas of highest demand is having a positive ripple effect on neighbouring communities, as this allows EMS to help retain ambulances in the community where they are based," the update stated.
However, Health Sciences Association of Alberta (HSAA) President, Mike Parker said that the move is only a drop in the bucket of what’s needed to meet the demand for emergency services.
“Ambulances are a good start, but they don’t care for the sick and injured, people do,” Parker said. “We started this week in Alberta with more than 500 paramedic shifts unstaffed. We need people."
AHS also enumerated on what they say are operational changes that are underway, which include diverting calls when appropriate, to the Poison and Drug Information Service (PADIS) as part of the initiative to transfer low-priority calls.
"From January to August 31, 2022, 464 calls met the criteria to be diverted to PADIS."
A project that will be commenced in the coming weeks with Health Link will also be meant to further refer calls for secondary triage.
"It is estimated this work will evolve throughout the remainder of 2022 and into early 2023. Numerous complexities have emerged that are being managed including IT considerations to ensure calls are not dropped or disconnected, nurses are being engaged for feedback, and protocols are being created to ensure appropriate transfers and follow-up mechanisms are in place."
EMS has also stopped automatically dispatching ambulances to non-injury motor vehicle collisions, and AHS cited that EMS Emergency Communications Officers have already noted instances where under previous guidelines an ambulance would have automatically been sent, although they predict that this initiative will become most apparent and effective during the coming winter, likely during major weather events.
"The Metro Response Plan (MRP) has been implemented as of March 2022, and since then there have been significant and noticeable improvements in keeping suburban ambulances in their home communities. EMS is continuing to see a significant decrease in suburban and rural ambulances coming into metro areas, which allows for local community coverage to be increased and suburban and rural response times to decrease since this was first implemented in March 2022."
According to AHS, this change the average number of weekly calls for suburban and rural ambulances called into the Calgary Zone was approximately 400, while currently, the weekly average is approximately 130.
Other pilot projects that AHS is working on include a project which helps manage non-emergency inter-facility transfers. This pilot has concluded successfully in Calgary and North Zones, and there are plans to expand it.
"This project transports patients that do not need acute care using means other than ambulances (i.e. family, shuttles, taxi, etc.). Both data and anecdotal evidence show a positive impact and a reduction in the number of ambulance trips needed for these types of transports however there are more transports that can make use of these resources. A working group has now been formed that will guide the creation of a formal policy to plan the expansion of the pilot project to all zones beginning in the fall-winter of 2022/23."
Other initiatives include mitigating fatigue risk for first responders. AHS stated that EMS has engaged with contract service partners and has provided the Hours of Work/Fatigue Management project recommendations for this purpose.
Minister Copping cited that Alberta’s government remains committed to making sure EMS is responsive to the needs of Alberta communities.
"We are making progress towards addressing the current system challenges, but we know more needs to be done. That’s why the work to ease EMS pressures will continue to be a priority for the province.”
Copping also reiterated that more suburban ambulances are staying in their home communities since launching the AHS Metro Response Plan in March. According to Copping, the average number of weekly calls for suburban and rural ambulances called into the Calgary Zone has dropped to about 130 from about 400 before the plan.
However, in previous reporting, through data obtained by Discover Airdrie via the Freedom of Information and Protection of Privacy Act (2022-G-219), while there was a month-to-month decrease in non-Inter-facility Airdrie ambulances travelling to Calgary between January and June 2022, based on total call volume between January and May 2022, Airdrie ambulances were still averaging 48 per cent of their total 9-1-1 call events in Calgary.
While Airdrie EMS didn't respond as frequently to Calgary in the first two months of 2022, there was a seven per cent increase of 9-1-1 calls in other areas between January and February. That trend steadily increased in the subsequent months, with 138 calls in May, the single largest amount of calls Airdrie ambulances responded to in other areas since the beginning of 2021. The 2022-G-219 FOIP request does not detail which service areas were included.
The decrease of Airdrie ambulances responding to Calgary slowed later in 2022. From February to March there was a 33 per cent decrease, while March to April saw an increase of Airdrie ambulances travelling to Calgary, approximately 34 per cent.
Data also showed that Calgary ambulances responding to Airdrie had also increased in 2022. In January 2022, Calgary ambulances responded 107 times. By February there was a drop to 60 responses. However, since February 2022, the numbers have steadily increased. Between March and April of 2022, there was a nearly 30 per cent increase of Calgary ambulances responding to emergencies in Airdrie, while April to May saw a 45 per cent increase.
On April 25, a new ambulance was added to Airdrie's fleet, which was meant to be a Basic Life Support (BLS) ambulance. According to AHS, the primary focus of this ambulance would be an Inter-Facility Transfers (IFT) ambulance, though AHS underlined it would play a dual response role for both inter-facility transfers and 911 emergency response. However, according to FOIP documents also obtained by Discover Airdrie, in its first few weeks in operation, the new ambulance responded to a singular emergency event and 30 IFT events. 15 of the IFT events had Calgary listed as the 'pickup municipality', while Airdrie was listed twice. The IFT ambulance also had pickups in Red Deer, Strathmore, Innisfail and Didsbury.
Minister Copping thanked all committee members and the co-chairs for their work over the past nine months.
"I would also like to thank all the paramedics and EMS staff, as well the EMS providers and municipal partners for sharing innovative ideas and solutions with the committee."
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