Alberta Health EMS addressing pressures on the system

The COVID-19 pandemic has put a strain on the provincial healthcare system, and the first responders at AHS Emergency Medical Services have witnessed it firsthand.

EMS has seen a 30 per cent increase in call volumes in many areas, and all call types are increasing. With these high call volumes have come longer response times since last summer, and rising concerns about ambulance availability among many Albertans.

We are taking action to ensure that ambulances will always be there when needed – both now and in the future.

We are putting more ambulances and paramedics on the street, changing practices to free up ambulances for critical calls, and increasing capacity in our hospitals to reduce transfer times.

AHS EMS recently announced a 10-point plan to address continued system pressures and create capacity within the EMS system.

At the core of this plan – and every decision we make – is patient safety.

EMS has made several operational changes to help create capacity by freeing ambulances up for urgent patient care needs and allowing EMS to better manage continued high call volume.

The first elements of the Metro Response Plan (MRP) are underway, which sees changes to how some ambulances are assigned in order to help keep suburban ambulances in their home communities.

It’s early days, but EMS is seeing signs of community coverage increasing and response times decreasing over the last several weeks in several communities.

Another element of the plan sees calls being diverted to the Poison and Drug Information Service (PADIS) as part of the initiative to transfer low-priority calls. A project in conjunction with Health Link is also being established to further refer calls for secondary triage.

EMS has also stopped the automatic dispatch of ambulances to non-injury motor vehicle collisions, and since this began, EMS Emergency Communications Officers have already noted instances where an ambulance that would have previously automatically been sent as a precaution, instead remains in service to respond to urgent calls.

EMS also recently received budget approval to add new ambulances: five ambulances each in Calgary and Edmonton, each year for the next two years, for a total of 20 new ambulances.

Adding resources in the province’s two largest cities – the areas of highest demand – will have a positive ripple effect on neighbouring communities. We are also adding coverage hours and additional shifts in other municipalities, including Lethbridge and Red Deer.

EMS has also documented improved responses to high-priority events in just a short time. This stems from allowing ambulances to be pre-empted from lower priority assignments and diverted to higher priority assignments when needed.

Similarly, we have two innovative pilot projects that help keep ambulances available to patients in urgent need: EMS has concluded phase one of a project which helps manage non-emergency inter-facility transfers (IFT) by transporting patients who do not need acute care using means other than ambulances (i.e., family, shuttles, taxi, etc.).

While data is currently being evaluated, anecdotal evidence has been positive and the project is being extended to all hospitals in Calgary Zone. In North Zone, the IFT pilot began Jan. 9 at four rural sites and continues for six months.

Similarly, the Red Deer Inter-Facility Transfer Pilot Project manages low-acuity patient transfers between facilities with dedicated transfer units, freeing up ambulances to handle emergency calls.

EMS is committed not only to the wellbeing of our patients but also of our staff.

We are deeply grateful for the dedication of our staff through the pandemic and several elements of the plan help improve patient care by boosting supports for those who work for EMS.

This includes the Hours of Work/Fatigue Management project to mitigate fatigue risk among staff, who have been going all-out for the last two years.

The Calgary Integrated Operations

Centre is set to open in May. This initiative brings paramedic leads together with zone and hospital staff to improve integration, movement of resources and flow of patients.

Since January, EMS has hired a total of 66 staff: nine temporary full time, and 57 casual.

We’ve also been meeting with learning institutions about hiring new graduates and potentially expanding training capacity.

We also know the importance of a longterm vision for EMS. That’s why we’re also developing a provincial service plan for the next five years.

As a first step, EMS staff, our partners and the public have weighed in on the current state of EMS and we’re analyzing the feedback collected.

The 10-point plan is a work in progress, but we believe it is already helping improve healthcare for all Albertans.

Darren Sandbeck is the Senior Provincial Director and Chief Paramedic of AHS EMS.