Province says it will implement EMS recommendations

Mayor Cathy Heron says the province’s announcement last week that it is implementing over 50 recommendations to improve Alberta’s emergency medical service network is a step in the right direction.

Mayor Cathy Heron says the province’s vow to implement over 50 recommendations to improve the emergency services network is a step in the right direction.

Alberta Minister of Health Jason Copping announced Jan. 16 that the final report of the provincial EMS Advisory Committee, which included Mayor Heron, would be released, as well as a report on the EMS shipping system from PricewaterhouseCoopers (PwC) consultants. He said a plan is being developed to implement all of the recommendations in both reports.

“I’ve said from the beginning that Minister Copping is very committed to finding a solution for EMS in Alberta, so this is just further evidence that I see as evidence of his commitment,” Heron said.

“An enormous amount of time has been expended – by myself and the other representatives of the committee – [developing those] 53 recommendations, and if some of them just got rejected, it would have wasted all the time and effort we put in,” she said.

The province set up the advisory committee in January last year. It included representatives from the Alberta College of Paramedics, Alberta Fire Chiefs Association, Alberta Municipalities, Alberta Health Services (AHS), Health Sciences Association of Alberta and more, as well as three MLAs. A full list of committee representatives is included in the final report on the province’s website.

Last May, the province announced that 10 initial recommendations should be implemented immediately, including developing guidelines for paramedics transferring patients to hospital emergency departments. Those policies were announced at Copping’s January 16 press conference.

“Response times are too long and we need to bring them back down, and that means adding resources and applying new strategies to ensure our paramedics can be there when they’re needed,” Copping said.

The committee’s remaining 43 recommendations include strategies to improve EMS capacity, system performance, and working conditions for first responders.

St. Albert operates an integrated emergency fire and medical service system, meaning first responders are trained as advanced care firefighters and paramedics.

St Albert’s Firefighter Union President Greg Harvey told The Gazette he wanted to see the recommendations implemented soon.

“Reports are good on paper, but the action will be where it really counts,” said Harvey.

A recommendation to “improve the ability of rescue workers to take scheduled breaks and voluntary time off” highlights the pressures first responders are under, Harvey said.

“You shouldn’t have to write a report that breaks, and being able to get some rest while you work is something that needs to be mandated,” Harvey said.

“We know what our job is, we love doing our job, but the reality is when you don’t get breaks – you don’t even get a chance for a bio break or just your lunch – that’s really starting to happen to wear on people mentally and it leads to even more problems later.”

shipping verification

PwC EMS shipping verification comes after the Calgary, Lethbridge, Red Deer and Wood Buffalo shipping centers were consolidated into one centralized system in 2021.

The report states that Alberta’s centralized shipping system broadly follows leading practices in other jurisdictions in Canada and around the world, but has room for improvement.

A key recommendation is to give ambulance workers and paramedics access to electronic health records.

“To move away from episodic care, patient health information needs to be made available to assessors and paramedics,” the report said.

“AHS EMS Dispatch should seek to integrate this information into their systems and processes to provide call dispatchers with insight into past treatments, current medications and chronic illnesses so that the most appropriate care can be provided.”

Harvey said that access to a patient’s medical history might be helpful in certain situations, but there’s usually not time to learn a patient’s medical history before a 911 call arrives.

“It would help, but I don’t think looking at these on a daily basis would help us unless we treat and refer on the spot, which is another of the recommendations,” Harvey said.

The committee recommends that the province pilot a project that would legally allow paramedics to treat patients at the point of an emergency call, when appropriate.

“It’s nice to have the ability to make those decisions, but the problem is liability. If something goes wrong, it falls squarely on the practitioner who made the decision,” said Harvey.

“The mindset in the industry right now is you make the call on site and transport for personal liability protection, which isn’t always the best case for patient care, and just transport everyone to a hospital.”

Alberta’s EMS capacity expanded 2.2 percent between 2017 and 2022, according to the Dispatch Review Report, despite a 39 percent increase in call volume and emergencies over the same period.

“Alberta had expanded total capacity by 2.2 percent, but due to staffing issues, actual system growth was only 0.8 percent,” it said.

“When we consider the significant increase in workload on the EMS system due to an increased number of events and the time to complete each event, as opposed to stagnant system capacity, the entire EMS system is under significant stress.”

The Gazette contacted the Department of Health to see if and when the plan to implement the recommendations would be released, but received no response.