EMS transition kick-off

Sharon McLeay

Times Contributor

 

On April 29, at the Strathmore Civic Centre, six representatives stood face to face with stakeholders, hoping to score a touchdown for the EMS dispatch transition process. They were associated with Alberta Health Services (AHS) in various capacities and several were veteran street paramedics. The team wants to include stakeholders in the game plan, to address concerns about the move to a centralized dispatch. 

Jim Garland, executive director of communications and deployment for EMS Dispatch, said that AHS had learned many things from early transition experiences, and changes were made to increase communication and develop methods to address unique characteristics of service areas. 

“What you are participating in tonight is the first piece of that transition process. It is what we call the kick-off meeting for the project,” said Garland. “Then we go on to develop a Project Charter. In that charter, we determine what it is we need to do to capture your interests and make sure we capture our interests. Things like…if interagency inter-operability is important to the community and other public safety agencies in the community, we need to address that. That forms part of the tasks for the charter.” 

He clarified that the South Communication Centre (SCC) would not take the initial 911 calls, or dispatch fire crews, but notifications and interactive protocols would be identified within the charter, as to how those services interact with Wheatland ambulances. Provisions for staff scheduling—according to contract provisions—can also be built into the business rules of the charter. Garland said that response to aboriginal communities can be incorporated into the plan as well. It was stressed that stakeholder input was critical for this part of the process.

“My role is to make sure this is friendly, safe, successful and seamless; it is to help put the groups together and make sure we capture the needs and goals. It is not about poor quality in the dispatch system. We have no major concerns about the system,” said SSC Manager Stephanie Nicoll. She will work with Rob Witty, WADEMSA’s Operations Director, to develop details of Wheatland’s Charter. She emphasized that there was experience and expertise on both sides that would contribute to the process.

Accurate area mapping was discussed. 

“Rural addressing across the province is not standardized or legislated, so there are a number of formats and regimes,” said Garland. 

Municipal mapping information is accessed, reformatted and integrated into dispatch system maps. Cross references are built in to address descriptions, like colloquial place names. The system is continually updating data, and municipalities submit new data for integration as it becomes available. Communication and geographic anomalies would be tested, to ensure coverage was in place. 

“We have built in a number of redundancies for the technology in case of failures,” Garland said. Currently, commercial cellular networks, Iintegrated digital enhanced network, and enhanced data voice optimization networks are used. The system has proven success even in remote areas in Northern Alberta, where traditional coverage was not available. He said if ambulance tech failed, dispatchers verbally direct cars. In no service areas, alternate radio signals can be used, such as Global Satellite services, or ONSTAR. The technology used by the SCC is one of the most sophisticated in North America. Garland also said that Wheatland staff will have an increased pool of medical expertise to draw on by becoming part of the provincial system.

“What that allows us to do, is take best practices and state of the art technology and get that out to communities that never had it before. For a small community it is expensive,” said Garland.

Once operational, SSC would receive call notification from 911 services. Dispatch paramedics answer the call, ascertain the patient location, gather scene details, monitor patient safety, and initiate call response to the designated ambulance. They stay on the line with the patient and the responding crew to coordinate information. 

All ambulance locations are tracked, by computerized System Status Management software. It identifies the first available, most appropriate, closest ambulance to the call, governed by data-assisted call projections. If WADEMSA submits a year of call input data, the system could help with area call volume and response projections. In the future, being part of the provincial system may provide back-up ambulances when Wheatland ambulances are delayed.

“Fifteen or 20 times a month, we call ‘Code RED’ and have no ambulances available. I have had to call Calgary and arrange an ambulance to standby. One of the benefits I see in this is that I won’t have to babysit the dispatch 24 hours a day waiting for RED calls, the system will handle that for us,” said Kevin Link, WADEMSA paramedic.

Assurances were given that every attempt is made to keep ambulances in their area and return them to home base as soon as possible.

“We rely on crews to communicate with us to improve,” said Garland. “All of the variables contribute to us trying to make good patient care decisions and provide full patient experiences. We are all in this for the same reason.” 

Members in the audience wanted more information on accountability processes. It was voiced that concerns may be lost between WADEMSA and the large organizational structure. Garland replied that communication channels exist and data is available, to monitor quality and accountability. Garland said it was the first time budget costs and financial information was requested. As for WADEMSA staff overtime required to implement the transition and train on equipment, there was no information on who would pay.

“Is it going to be efficient? I will prove it is efficient,” said Garland, who challenged those present to hold him to the promise.

Garland indicated that stakeholders can leave their contact information with WADEMSA, and they will be put on a transition communication fan-out that delivers updates as the process develops. WADEMSA’s transition will be pushed quickly, simultaneous with 13 other Alberta regions. A projected finish date is December 2013.