HCAP: Direct action to lower EMS response times

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Alberta’s government is committed to ensuring an ambulance is available to everyone where and when they need it.

Alberta’s Heath Care Action Plan (HCAP) will lead to better EMS response times. To fulfill this commitment, Alberta’s government will be accepting all recommendations of both the Alberta Emergency Medical Services Provincial Advisory Committee (AEPAC) report and the independent dispatch review and is working on a plan of action to carry them out.

“We are acting on the most urgent issues facing frontline EMS workers in our Health Care Action Plan. Albertans deserve an EMS system that responds quickly to every emergency when and where they need it. We are making needed adjustments in policy to get paramedics out of hospital waiting rooms and back out into their communities so they can get Albertans the help they need sooner when they call 911 for an emergency.”

Jason Copping, Minister of Health

Actions identified by frontline workers, municipalities and other EMS partners are being put in place, including:

adding 20 additional ambulances during peak hours — expected to start rolling out in the spring in Calgary and Edmontonfast-tracking ambulance transfers at emergency departments by moving less urgent patients to hospital waiting areas, based on new provincial guidelines that are now in placefreeing up paramedics by contracting appropriately trained resources for non-emergency transfers between facilities in Edmonton and Calgaryempowering paramedics to assess a patient’s condition on scene and decide whether they need to be taken to an ER by ambulance.

“This work supports four priority areas that we’ve been focused on at AHS: improving EMS response times; decreasing emergency department wait times; reducing wait times for surgeries; and improving patient flow throughout the healthcare system. We are getting there, and making progress every day.”

Dr. John Cowell, official administrator, Alberta Health Services

“The work underway is key to ensuring that patients requiring care from emergency medical services get that care; while we improve the efficiency of EMS patient flow, both within EMS and across the emergency department/acute care environment. I want to thank our EMS teams for all that they are doing to care for Albertans during this busy time and recognize their efforts as nothing short of heroic.”

Mauro Chies, interim president and CEO, Alberta Health Services

“Our Health Care Action Plan goals come directly from our frontline workers and EMS partners who engaged with the Alberta EMS advisory committee, and I am pleased we have already began putting recommendations in place to improve response times and ease the pressure on EMS staff. I would like to thank all paramedics, EMS staff and providers, and municipal partners for their valuable input and I look forward to our continued work together as we roll out more actions and solutions.”

RJ Sigurdson, parliamentary secretary for EMS reforms and co-chair of the Alberta Emergency Medical Services Provincial Advisory Committee

Dispatch review

A PricewaterhouseCoopers review concluded that Alberta’s central dispatch model follows world-leading practices and design. The review analyzed significant volumes of data, engaged community and service delivery partners, and conducted pan-Canadian and global jurisdictional scans. According to the report, increased demands on EMS services are the leading driver behind longer wait times, which have at times put pressure on the availability of ambulances.

The independent review found the centralized model and the current call-taking process do not affect these wait times. However, in its 45 recommendations, the report outlines many opportunities for improvement. Alberta’s government has accepted these recommendations and is committed to implementing all recommended improvements while continuing with the central dispatch system and addressing municipalities concerns.

Speeding up EMS transfer of patient care to emergency departments

AHS has instituted a new provincial policy, now in effect at all hospitals, which provides direction and guidelines to streamline the transfer of stable and less urgent patients from the care of paramedics to emergency department and urgent care centre teams. This new policy allows for EMS crews to respond more quickly to more 911 calls and spend less time waiting in emergency rooms.

Emergency department staff will assess patients arriving in ambulances based on the new criteria to determine if they are eligible to remain in the waiting area with other stable patients. This change aims to provide an appropriate and similar response to all patients based on their condition, whether they arrive to the hospital by ambulances or on their own.

Non-emergency transfers between facilities

In the coming weeks, AHS will issue a request for proposals for non-emergency transfers between hospitals and care centres in the Calgary and Edmonton areas. This supports the priority goal of finding ways to use more appropriate modes of transportation when the use of ambulances and highly trained paramedics is not needed, as recommended by the advisory committee report.

This change frees ambulances and AHS paramedics from approximately 44,000 non-emergency transfers per year and will improve response times for urgent calls. This is in addition to introducing a new program for non-clinical transports for patients discharged from a facility or acute care.

"I am extremely proud of Spruce Grove Fire Services for partnering on innovative ideas to address challenges related to both capacity and speed of care. Thank you to the Government of Alberta and Alberta Health Services for the collaborative opportunity to successfully pilot them in our community."

Jeff Acker, mayor, Spruce Grove

“Our integrated department has seen great success throughout this pilot and it’s rewarding to see the results helping to inform future steps to reduce stress on the ambulance system, while still providing quality care to our community. We look forward to continuing to collaborate with Alberta Health Services and the Government of Alberta in the future.”

Robert Kosterman, fire chief, City of Spruce Grove