Alberta adopts 'shared response' to triage emergency calls

The Alberta government says its new strategy of looping in Health Link nurses into each 911 call will help streamline emergencies and ensure ambulances are sent to the calls they must respond to.

Details of the program, called the EMS-811 shared response team, were unveiled during a media conference with Health Minister Jason Copping and Alberta Health Services administrator Dr. John Cowell on Thursday.

"Empowering dispatchers to divert non-urgent calls to a dedicated team of experienced nurses within 811 when clinically appropriate is a win for Albertans," Copping said in a statement. "Everyone will have access to the appropriate level of care they need when they need it. The new approach makes our EMS system more responsive to the needs of Albertans."

In the shared response model, emergency communications officers make the determination when "a patient’s situation is best handled with alternate levels of care" and forward the call to a team of 811 nurses, who will then proceed with caring for the patient.

If at any time an ambulance is required, one will be dispatched, officials said.

Nicola Opsal, who has called 911 for a medical emergency recently, said she had hoped the announcement would include more staffing.

Opsal called 911 in June 2022 after her neighbour, 86-year-old Betty Ann Williams, was gravely injured in what would eventually become a fatal dog attack - and the subject of a report released by the Health Quality Council of Alberta.

"As they've stated, there isn't enough (staff). There's not enough ambulances to go around, there's wait times in the hospitals waiting for EMS to release people," said Opsal.

She added, without people and resources, it's not possible to "have faith in a system where you don't have enough people to run it." 

'WE NEED REAL ACTION': NOTLEY

The change comes a day after more criticism over the state of Alberta's health-care system.

On Wednesday, opposition leader Rachel Notley said the UCP government still hasn't done enough to address the problem, when Calgary has seen an increasing number of red alerts over the past several months.

"We need real action. There are specific steps that paramedics themselves have been calling for and the UCP have ignored for years," she said in a statement.

Late Thursday afternoon, Mike Parker, the president of the Health Sciences Association of Alberta (HSAA) issued the following statement:

"Making sure people receive the appropriate level of care they need is important but these changes won’t solve the long-term issue facing dispatch, which is not enough emergency communications officers (ECOs).

"This government seems like it will do anything but add permanent staff to solve staff shortage issues in Emergency Medical Services (EMS).

"Albertans want an ECO waiting to take their call and to quickly dispatch help when they are in an emergency – process change may help a bit but it doesn’t address the full scale of the problem.

"HSAA knows a credible response to the crisis requires two things – improve working conditions for the dedicated professionals responding to calls for help, and get more paramedics on our streets and ECOs to answer the call.

"Until we see more permanent paramedics and ECOs, Albertans will still be waiting to see that any help is on the way."

GROWING CALL VOLUME

Meanwhile, AHS says it's been dealing with an increased call volume that hasn't let up since summer 2021.

"They’re still up to 30 per cent higher than they were before, and staff are strained by nearly three years of the pandemic," AHS wrote in a statement. "We are responding by adding staff as fast as we can and implementing new strategies to increase capacity."

AHS says it has added 300 paramedics since 2019 and pledges that more will be hired as needed.

While red alerts are a major concern for health officials, AHS insists that it doesn't mean anyone is being left without care.

"When additional resources are required, we reposition units from other communities, defer non-urgent transfers, deploy supervisors, and use single paramedic response units to provide care. Red alerts are normally very short in duration," AHS continued in its statement.

AHS adds it already has a number of strategies in place to help with the strain on EMS, including non-ambulance transfers and the Metro Response Plan – a system it says will keep ambulances in their home communities.

"We must ensure 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," AHS said.

Officials are also continuing work on identifying alternative mode of transportation when ambulances are not required for patients, including non-emergency transfers between hospitals.

AHS says is it also working on speeding up the process of transferring patients from the care of paramedics over to hospitals.

"On Jan. 5, an AHS provincial policy was put in place 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."