BARRHEAD - The Alberta government realizes there is a problem with ambulance wait times across the province, and it is taking steps it believes will help alleviate the situation.
On Monday, Jan. 24, Alberta Health Minister Jason Copping announced the province would be creating a provincial emergency medical services advisory (EMS) committee to look for recommendations, in the medium to long term, that will inform a new EMS service plan.
"Emergency medical services are facing unprecedented pressures," Copping said, adding that since February 2020, call volumes have increased by about 30 per cent.
“All types of calls have increased, and staff are quite frankly exhausted, and some Albertans are frustrated,” he said.
Copping added the previously unseen call volumes are due to several factors, including the opioid crisis, increased patient transfers, staffing shortages across the healthcare system, global supply issues delaying the arrival of new ambulance units on the road and the pandemic.
Copping said the government has heard from EMS and other healthcare providers, municipalities and the public that their efforts to ease the pressure on EMS and ambulance wait times haven't been enough, saying many of these issues have been around for several years.
He noted that in the last two years, the government bolstered the provincial budget by $20 million and increased the number of paramedics by more than 200, a nine per cent increase.
The new committee will include contracted ambulance operators, paramedic unions, municipal representatives, and Indigenous community representatives, among others. It will be co-chaired by United Conservative Party (UCP) Grande Prairie MLA Tracy Allard and UCP Highwood MLA R.J. Sigurdson.
Copping noted that both MLAs represent smaller communities in northern and southern Alberta and will help bring rural concerns to the discussion.
"Having all these voices at the table is important," he said.
The committee’s task is to identify concerns, provide advice and provide input for future EMS planning. Its first report is expected in May. In the meantime, they may suggest shorter-term solutions.
Copping also announced the government will contract an independent third party to conduct a review of the EMS dispatch system.
"We believe that an outside group of experienced health system experts will be able to identify opportunities to address ongoing pressures and improve efficiencies in how the dispatch system works," he said.
For more immediate solutions, Alberta Health Services (AHS) chief paramedic and senior provincial director Darren Sandbeck said AHS will immediately start on a 10-point plan to help lessen the strain on the EMS system.
The more immediate actions include transferring more non-emergency, low-priority calls to other aid agencies and transferring non-emergency interfacility patients by means other than ambulances. The latter is part of a pilot program in the Calgary and North health zones.
Sandbeck said AHS has also changed its dispatch procedures so that ambulances no longer automatically respond to motor vehicle accidents where no injuries are reported.
"We continue to hire paramedics to fill openings as quickly as possible," he said, adding AHS is also working with post-secondary institutions to increase the number of qualified paramedics to fill those vacancies.
Sandbeck said AHS is also in the process of changing other ambulance dispatch procedures.
One of the most notable changes is the evaluation of dispatch calls by an emergency communications officer to determine if an ambulance from outside its normal response area should be dispatched to a 911 call.
He used the example of an ambulance from Okotoks who just dropped off a patient at a Calgary hospital.
"They may be the closest ambulance to a Calgary call, but it might be more appropriate to route that unit back to Okotoks where it can provide coverage and send the next closest ambulance," Sanbeck said.
This process, he said, would allow EMS, where appropriate, to divert ambulances to higher priority calls.
Although this would mostly be done in Edmonton and Calgary, Sandbeck said this will help keep ambulances in suburban and rural communities.
Town of Barrhead’s first impression
In recent months, Town of Barrhead council has been increasingly vocal about the lack of available ambulance service to the community, noting that on several occasions, the town and surrounding community has been without ambulance service in whole or in part for extended periods. They have also voiced their concern about the number of times Barrhead Regional Fire Services (BRFS) firefighters responds to medical or ambulance assist calls.
As part of that frustration, council has written to Health Minister Copping and AHS directly.
Town of Barrhead mayor Dave McKenzie said he hopes the province's creation of a committee to investigate ways to improve the EMS system and AHS' 10-point action plan will help alleviate pressures on the ambulance system.
However, he remains skeptical.
"I went through (AHS) immediate action items, and my first thought is, this is stuff that should already be in place. So when I see things like this, I am a bit concerned," he said, adding he understands it isn't an easy problem to solve.
McKenzie said the Jan. 24 press conference did little to address the issue the town and other rural municipalities have voiced in that AHS is using rural fire departments to supplement the ambulance service.
"I know our fire crew doesn't have an issue with it, but for the municipality, there is no compensation for them using our equipment and personnel," he said, adding he doesn't believe that to be fair. "It has been something that we've been trying to address for years, but they continue to choose to ignore that they are using municipal funds for something that is a provincial responsibility."
Coun. Don Smith agreed with McKenzie but said he is willing to take the government's announcement as a good sign that they recognize there is a problem and that there is an urgent need to address it.
"I'm glad they are taking it seriously and that they know changes are needed," he said. "I'm hopeful going forward, but there is no question that ambulances and dispatches are in a whole lot of trouble right now."
Smith has been one of the most vocal councillors about how the municipality was bearing the brunt of the costs. At the Jan. 11 council meeting, he suggested that Barrhead and other rural municipalities might have to decide to draw a line in the sand and have their fire departments stop providing medical first responder service.
In September, chief administrative officer Edward LeBlanc stated that to that point in 2021, BRFS firefighters had responded to 126 medical assist calls (of which they were first on the scene 63 times), at an estimated cost of $36,000.
The amount is based on the new system BRFS chief Gary Hove instituted at the beginning of the year for sending four firefighters to medical assist calls. Previously, a complete crew of up to eight firefighters could have responded to a medical assist call. The number of BRFS medical responses would have potentially been more as well. In 2018, Hove revamped the department's medical first responder dispatch plan eliminating responses to less urgent calls.
Although the issue of AHS downloading medical responses due to long ambulance wait times has existed for several years, Smith said for the last three or four years it has been steadily getting worse.
Nor does he remember having these types of issues when the municipality owned and operated the ambulance service itself.
In about the mid-2000s, Smith said the municipality bought the privately run ambulance service from Buzz and Louise Gottschalk, and for the better part of 10 years, the town operated the service.
McKenzie agreed, noting the ambulance service used to be a line item in the town's budget, with AHS paying the municipality for the service.
Both Smith and McKenzie also noted it was the province who decided not to renew the ambulance service contract when they selected Associated Ambulance after deciding to move to a more provincewide system.
Alberta municipality advocacy groups weigh in
Both the Rural Municipalities of Alberta (RMA) and Alberta Municipalities (formerly Alberta Urban Municipalities Association) were pleased to hear about the creation of the provincial emergency medical services advisory committee and both are cautiously optimistic that it will come up with potential solutions to improve the ambulance service. Both organizations will have seats at the committee table.
RMA president Paul McLauchlin, who is also reeve of Ponoka County, believes the large and diverse makeup of the committee will, in itself, help them come up with potential solutions.
"I'm really excited about it. It is an issue that has been building for several years and now, in the last year or so, it has become a crisis," he said.
McLauchlin also believes the 10-point plan AHS announced is an important piece of the puzzle.
"The discussion is always about how to utilize the resources you have. The most important piece is how to look after the boots on the ground," he said.
McLauchlin noted the average paramedic leaves the profession much earlier than ever before.
He added that there was a time when the longevity of a paramedic was at least nine years.
"Then it went to seven. Now it is more like three to five years. That is alarming that so many EMS professionals are choosing to leave the profession because of the burnout, mental health and fatigue," McLauchlin said. "Ensuring the job of supporting those folks is the most important thing, and I see components of that in the 10-point plan."
He added an important discussion that needs to take place is about educating the public.
McLauchlin said that often EMS is misused by people with minor aliments or as transportation to appointments.
"People need to understand what our EMS units are for, and that is for life support and crises," he said.
AM president and St. Albert mayor Cathy Heron said she is also pleased about the committee's creation as it is a sign the province was listening to their member's concerns.
In November, she said, AM passed three resolutions regarding EMS, one to examine dispatch services, having an independent third-party review of the EMS system and one to help solve the fatigue and mental health stress paramedics are experiencing.
As to whether the committee will make a difference, she said that "the proof would be in the pudding."
She added the committee met for the first time on Jan. 27.
"We have some very tight timelines, but we have a good group and (AHS) are already trying to address some of the issues through their 10-point plan," Heron said. "So let's say I'm cautiously optimistic."
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