Actions including easing ambulance staffing requirements, reducing patient offload delays in emergency departments and launching innovative response pilots are all part of the EMS advisory committee’s initial recommendations that are moving forward after engaging with paramedics, EMS providers and municipal partners.
“We moved quickly to approve the recommendations of the EMS advisory committee, to improve EMS service delivery given the current strains on the system. AEPAC is doing vital work to provide workable solutions in response to the ever-changing needs of our emergency medical system. In the coming weeks, I am looking forward to seeing their interim report containing short-term and long-term recommendations to further improve our current system and the workplace environment for the vital front-line EMS workers.”
The recommendations focus on four main areas:
Providing a one-year exemption from current staffing requirements will allow emergency medical responders – a level of EMS practitioner – to staff more ambulances to transfer stable patients, in addition to working alongside other paramedics to respond to more types of calls. A ministerial order has been approved for this change.
Improving coverage and efficiency
Leveraging capabilities in integrated fire-EMS agencies through operational redesign:
- Launch a pilot to deploy community response units as part of the contracted EMS services provided by Strathcona County Emergency Services. These units will stay within the county and can improve service capacity and response times to urgent calls that require advanced care.
- Launch two pilots in Spruce Grove, including one to allow cross-trained firefighters-paramedics functioning as medical first responders to cancel inbound ambulances when not required.
- Review types of automatic requests for EMS standby for fire calls to free ambulances when not needed.
Addressing offload delays
Forming an Emergency Department Offload Delay Task Force to bring together key health-care partners involved in all levels of the health system to reduce not only EMS offload delay but to improve patient access to emergency departments and other health services.
This task force would also develop guidelines for the timely and safe transfer of EMS patients to emergency department waiting rooms.
Review alternative service delivery options for patients who do not need an ambulance and explore models used in other jurisdictions. This is to assess less urgent calls and respond with other safe alternative options like non-medical transport, primary care appointment access or other specialized services such as a community paramedic.
“I’m pleased EMS partners and front-line workers have come forward with innovative staffing solutions and proposals to ease system pressures such as the pilots in Spruce Grove and Strathcona County. We look forward to learning from their experiences and potentially expanding these pilots to make a difference in other communities. We will continue our work to find more ways to strengthen the system so Albertans can continue to receive high-quality EMS care.”
“We heard from front-line workers that there is a need to create a task force and bring together more health-care partners to tackle the delays in transferring patients from ambulances to emergency departments and other health-care facilities. The committee recognizes this is a complex issue and we are looking forward to working with this task force once formed to develop provincial guidelines for timely acceptance of patients in emergency departments and explore more solutions.”
“AHS EMS is excited about these innovative solutions and new initiatives. This work, combined with the ongoing work on the provincial EMS service plan, will help us strategically shift the model of EMS to do things differently and create additional capacity within Alberta’s Emergency Medical Services system. These recommendations also align well with the EMS 10-point plan, which is progressing in tandem with the advisory work.”
“Municipalities and the province share a collective responsibility for the safety and well-being of its people. This announcement demonstrates the power of using front-line expertise to help find innovative ways to respond to local EMS needs. This is the first step of many to resolve the ongoing ambulance availability challenges. We are grateful the Provincial EMS Advisory Committee has approved the Community Response Unit pilot for Strathcona County. Our responders need to be available in our community when there’s a call for fire or medical emergency support.”
“We are pleased to have the Community Response Unit pilot approved, as we believe it has the potential to help with the current system pressures, improve working conditions for our firefighter-paramedics and benefit Strathcona County residents. Strathcona County has a unique integrated service where, through this innovative pilot, we will have the ability to be flexible with our three-person ambulance service to help keep our emergency responders in our community. I am proud this pilot was a staff-driven solution.”
“First responders have deep roots in their communities. We?don’t just work in them. We live in them. We?volunteer in them. We raise our families in them. Strathcona County firefighter-paramedics are heavily invested in this community and consider serving it a?privilege.?We have been losing this ability since 2009 but today is a step towards refocusing on the needs of our community and the paramedics within it. I thank Minister Copping, and the work of the Alberta EMS Provincial Advisory Committee, for listening to the needs of front-line pre-hospital care providers so we may better serve our communities.”
“The two pilot projects approved for implementation in Spruce Grove are an example of how Albertans help Albertans. There is unprecedented stress on the ambulance system in Alberta and we are proud to do our part to not only ensure the residents and visitors of the City of Spruce Grove receive the highest level of emergency medical response possible but that we also take some of the pressure off the region by freeing up other ambulances for other responses. These pilot projects are the beginning of a journey that will see the growth of municipal and provincial partnerships.”
The EMS committee will submit their initial report, which includes short-term and long-term recommendations, to the Health minister in the coming weeks, and a final, more detailed report at the end of July. The committee co-chairs and members engaged with a wide range of partners and invited EMS staff to submit their ideas by taking a survey and participating in two telephone town halls in March and April. More than 1,400 front-line practitioners provided input.
- Budget 2022 provides EMS with a total operating budget of $587 million, a 12.2 per cent or about $64-million increase from Budget 2021.
- About the Community Response Unit pilot in Strathcona County:
- Strathcona County Emergency Services (SCES) will work with AHS to launch a pilot that would leverage the flexibility within the county’s integrated fire-EMS model.
- Two Community Response Units will be staying within the county to provide advanced life support care to support responding ground transport ambulances.
- When a call comes in that requires advanced life support within the county, the goal is to have the Community Response Units respond and begin treatment. This would lead to faster response times to treat patients at the scene or until an ambulance arrives to transport the patient if needed.
- The Community Response Units will be in addition to the four ground transport ambulances that SCES currently staffs. However, the four ambulances will transition from all advanced life support to a combination of advanced and basic life support units. This model will offer greater flexibility when dispatching resources to triaged patients, matching appropriate treatment and transport services to meet individual patient care needs.
- About the two pilots in Spruce Grove:
- The City of Spruce Grove operates integrated fire ambulance service that provides emergency medical services for patients in addition to traditional fire department services.
- The city’s fire service has asked for a temporary policy change to trial a pilot allowing firefighter-paramedics to attend calls in a Spruce Grove ambulance to transport patients if required by logging the ambulance in as an AHS resource.
- This can cut delays in getting critical patients to hospital while waiting for an ambulance to arrive.
- The second pilot would permit paramedics who are part of the city’s medical first response team to cancel ambulance dispatch if they are able to treat patients on site and refer them to other services. This will reduce duplication and free up other EMS resources faster.
- About the temporary exemption to allow EMRs to staff more ambulances:
- EMRs are one of three classes of EMS practitioners registered with the Alberta College of Paramedics.
- The temporary exemption means that, when necessary, two EMRs can transfer non-emergency patients without the need for a paramedic on board.
- Also, in situations when no other option is available, EMRs can join an advanced or primary care paramedic to respond to emergency urgent calls.
- The change is in line with other provinces, including British Columbia, Saskatchewan and Manitoba, which allow EMRs to function in a variety of similar roles.