Changes to 911 dispatch called threat to rural lives

Members of the Foothills Regional Emergency Services Commission (FRESC) are demanding Alberta Health Minister Sarah Hoffman reinstate local EMS dispatch in their communities, fearing patients’ safety may be at risk.

The plea comes after the service was removed from their control earlier this year as part of a provincewide consolidation of emergency call handling.

“Separating fire and ambulance emergency response dispatch is plagued with problems,” commission chair Suzanne Oel said in a statement to be issued Monday, obtained by Postmedia.

“Albertans living in the southern, rural communities of our province are paying the price for a model that has fragmented the emergency response system.”

The commission further charges that the “very serious situation” has led to the kind of delays that put lives at risk, though public health officials have said that’s not the case. Alberta Health Services (AHS) has consolidated EMS dispatch for much of southern Alberta.

When the idea of creating a provincial dispatch system was first unveiled several years ago, the goal was to ensure the nearest ambulance responded to an emergency, regardless of municipal boundary.

AHS maintains that since the provincial model was implemented, its publicly reported performance measures show dispatch and response times have remained consistent.

“Our dispatch model does not put patient safety at risk, nor has it increased response times,” AHS chief paramedic Darren Sandbeck said of the system. “In fact, the provincial dispatch system has improved our ability to respond to patient needs regardless of where they live.”

But critics say the strategy has now split apart what was once a unified communications framework with local fire departments in many communities. It’s this separation that’s of concern to Foothills 911 — which was responsible for dispatching both fire and EMS in a wide swath of southern Alberta until Feb. 21, when ambulance dispatch moved to a consolidated Calgary call centre.

Urgent medical calls are normally dispatched with a “medical first response” (MFR) — fire department crews qualified in emergency medicine sent to stabilize patients prior to ambulance arrival. This is especially important in rural settings, where ambulances are spread farther and fewer between than in cities.

“The consolidation hasn’t worked. They’re allowing our urban neighbours to have a solution while they’re trying to keep this thing going for whatever reason,” Oel said, citing communities such as Red Deer, Lethbridge and Fort McMurray — all successful in holding on to their local EMS dispatch.

“The quality of patient care is degrading before our eyes. It shows up in a lack of co-ordinated response and a reduction in communication, and the results are lifethreatening delays,” Oel alleges.

She talks of an ambulance sent on a two-hour drive to attend to a nine-month old baby with severe breathing difficulties, while less than seven kilometres away sat an undispatched team of medically trained firefighters. In that case, Oel claims it was more than an hour before FRESC dispatchers were notified of the call.

“It’s important to understand that lives are being put at risk every day while this is going on — both of those who live in rural southern Alberta, plus anybody travelling on our highways and visiting our parks and tourist attractions,” she said.

“They’re at risk. They’re subject to the same thing we’re living with every day.”

According to NFPA (National Fire Protection Association) Standard 1221, processing times for emergency medical dispatch calls that include requests for medical first response should be “90 seconds, 90 per cent of the time” from when a call is first answered to

The quality of patient care is degrading before our eyes.

when it’s forwarded for dispatch.

According to information provided to Postmedia by FRESC, only four per cent of calls requiring medical first response are being transferred to Foothills 911 within industry standards.

Of those, 73 per cent of MFR requests are one minute over the 90-second NFPA 1221 standard, while more than 53 per cent are longer than three minutes. According to FRESC, the longest delay in forwarding a call was 64 minutes.

None of these times include the extra 30 seconds it takes to transfer medical calls north to Calgary from FRESC’s Black Diamond 911 call centre.

Jason Schneider, reeve of Vulcan County, said returning EMS dispatch to FRESC is the best solution for residents of the commission’s 26 member municipalities.

“In the city, everybody’s got numbers on their houses,” he said.

“Going to a centralized system, the lack of rural knowledge is quite frustrating — it really is unrealistic to think a central location could dispatch the whole of the province, there’s just no way to have that local knowledge.”

While Postmedia did not ask AHS officials to respond directly to the allegations made by the commission because they hadn’t yet received the letter, Sandbeck disputes claims the dispatch model puts patient safety at risk or increases response times.

“The creation of one provincial EMS dispatch system means AHS can see where all EMS resources are located in real time, which means that the nearest available ambulance can be sent to a patient regardless of any geographic boundaries,” he said.

“All AHS dispatch centres and ambulances are also equipped with the latest medical protocols and technology, including GPS, to ensure patients get the quickest and best medical care possible.”

AHS maintains that, since the provincial model was implemented, the health authority has managed millions of events.