There are longer EMS wait times in Alberta, but the centralized call-taking and dispatch model doesn’t affect that time, a provincially sanctioned, independent dispatch review showed.
Instead, two reports delivered to the province show an increased call volume, a lack of resources and the need for mental health and wellness support to bolster EMS response.
“Albertans deserve an EMS system that responds quickly to every emergency when and
where they need it,” said Alberta Health Minister Jason Copping.
The Alberta EMS Provincial Advisory Committee (AEPAC) final report and the independent Price Waterhouse Coopers report on EMS dispatch were both provided to media early Monday.
Call volumes have risen as much as 30 per cent in some areas since the summer of 2021.
“I know all EMS workers across the province have been feeling the impact of the significant increase of 911 calls,” said Copping.
“On top of the increase in calls, of course, the paramedics and other staff in EMS are tired after two and a half years of the pandemic. The reality is, EMS is under tremendous pressure, response times are too long, and we have to get them back down.”
The province said it will add 20 more ambulances during peak hours in Calgary and Edmonton starting this spring. Even with the added ambulances, thousands of shifts in both Calgary and Edmonton have gone unfilled each month, something the Alberta NDP raised last week.
Minister Copping said there would be a focus on recruitment, but they also want to address retention. That was brought up in the AEPAC report.
“It’s not only about attracting more people, to hire more people to expand EMS, but it’s actually keeping the ones that we have,” Copping said.
They also said they’re going to contract out interfacility transfers, plus the previously announced non-ambulance transfer system for non-urgent patients. They’ll also empower paramedics to assess the condition of patients to determine if they need to be taken to the ER.
Centralized dispatch has no impact on EMS wait times: Report
Calgary Fire Department Chief Steve Dongworth said, in a 2022 year-end interview, there continues to be challenges with the centralized dispatch model. Firefighters are dispatched as a medical first response (MFR).
“There’s no question,” he said.
“The notion that it works better when you separate it from the model we had before where it was integrated into the tri-services center, where the dispatchers, the call takers were all in the same room and could easily communicate with someone else was a better model.”
One year ago, Calgary EMS dispatch services were officially transferred to Alberta Health Services. MFR dispatch remained within the tri-services centre and they’re often the first on the scene in life-saving situations. Tens of thousands of these first-response calls are fielded annually by the Calgary Fire Department. Dongworth said in many cases Calgary firefighters have extended waits with patients due to delays in EMS response.
The PwC report (in full below) said overall, the centralized dispatch model was in line with leading practices worldwide. While it may not impact EMS response, the report substantiated that MFR notification times have increased since centralization. Their report shows an extra step in the dispatch of MFR. That MFR dispatch step requires an additional evaluation.
It also showed that municipalities that aren’t integrated with the AHS computer-assisted dispatch have a higher MFR response time.
The PwC report acknowledges but doesn’t quantify the time between EMS dispatch and MFR dispatch. It indicates that an extra step in the process is “resulting in an inherent but minor process delay for MFR dispatch.”
One of their graphics does show a five-second improvement up to the point of EMS dispatch but doesn’t go further to the MFR dispatch.
Minister Copping was asked about the substantiated aspects of the dispatch report – not directly about the MFR aspect.
“The response times did go up, but it wasn’t because of the dispatch system,” he said.
The report does suggest improvements to the computer-assisted dispatch system, including having a provincial system.
Next steps in improving EMS response
When asked about the timelines for more help for Alberta’s EMS system, Minister Copping said that a number of factors would influence that. He said that budget discussions would likely address short- and medium-term challenges in EMS.
He said MLA RJ Sigurdson would be working on blending the information from both of the reports to come up with a longer-term plan.
Sigurdson said more than 460 EMS staff have been hired, including more than 340 paramedics, since the start of 2022. He said they’re going to prioritize mental health supports for EMS, with regular, sustained mental health checks.
“Were committed to make we are committed to making improvements and continuing to listen to how we can make things better,” he said.
“Our priority is to fix EMS and the healthcare system so Albertans can get the emergency care they need, where and when they need it.”
Alberta NDP Health Critic David Shepherd said he’s disappointed that solutions called for by paramedics weren’t included in the report.
“This long-delayed report by the UCP on the profound crisis they created in our ambulance and emergency healthcare systems is too little, too late,” he said.
“Once again, the UCP is ignoring requests from paramedics themselves to get crews off-shift on time, offer all paramedics a permanent full-time contract, and expand harm reduction services to cut down the huge number of drug poisoning calls.”
The province said the recommendations are a direct result of consultation with a variety of stakeholders, including front-line paramedics.