Parkland Institute report outlines EMS crisis in Alberta
Twenty-nine people were interviewed for the study, including 27 paramedics, one person with knowledge of dispatch operations and another who worked with paramedics in the province and had knowledge of union issues
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Lowered emergency medical services standards, erosion of key work processes, COVID-19 coupled with drug poisonings, and decreased morale and well-being have all contributed to the crisis of Alberta’s EMS system, a new report says.
Michael Corman, a medical sociologist with the Parkland Institute, has been studying EMS for about 15 years. His latest study “Lights and Sirens: The Critical Condition of EMS in Alberta” examines the current crisis facing paramedics in the province through a systematic and peer-reviewed analysis.
Twenty-nine people were interviewed for the study, including 27 paramedics, one person with knowledge of dispatch operations and another who worked with paramedics in the province and has knowledge of union issues.
Of the paramedics interviewed, on average they had more than 16 years of experience.
Corman said the current crisis can be characterized by four intersecting elements, the first being the lowering of EMS standards.
“Paramedics, for example, describe the system as failed and broken, a dumpster fire, a return to the dark ages due to staff shortages and burnout,” said Corman. “Others describe how it’s never been so busy, too busy to even do safety checks on ambulances. This not only impacts patient care and quality of care, but also the safety of practitioners.”
Also contributing to the crisis is an erosion of key work processes due to increased call volume and fewer available resources. For example, paramedics are increasingly having to work with someone they are unfamiliar with in order to ensure adequate coverage, yet that has added an additional layer of stress and uncertainty.
Downtime for paramedics has also been eroded in the name of gaining efficiencies, affecting their breaks, being able to decompress after challenging calls or even eating or going to the bathroom.
But the COVID-19 and overdose crisis is the “straw that broke the camel’s back.”
“COVID-19 and the overdose crisis did not cause this situation, but really is the result of a system that was already so lean and toxic that paramedics could not respond and didn’t have the resources in place to be able to respond to the pandemic and the overdose crisis,” Corman said.
“COVID-19 and the overdose crisis can be thought of as a triggering event due to the system being so ‘lean’ and ‘toxic.’ This made a problematic work environment simply unbearable.”
All of these issues have contributed to decreased morale and well-being for paramedics, Corman said. They describe being “almost dead inside,” and that they are being “held hostage” by the system.
Budget 2023 offers relief, says health minister
In a statement, Health Minister Jason Copping said the province has been working on addressing the EMS system by acting on the 98 recommendations from the Alberta EMS Provincial Advisory Committee. He added if passed, Budget 2023 will provide $196 million over three years to strengthen services by hiring staff and implementing the committee’s recommendations.
“This brings the total investment to $740 million this year alone for EMS. This is an increase of 23 per cent over last year’s budget,” he said. “In addition, $15 million over three years will be invested in a new program to purchase ambulances and related equipment, which supplements AHS’ self-financing program for EMS equipment.”
He added response times have improved across the province, with a reduction of 22 per cent in urban areas and 10 per cent in remote rural areas.
However, Corman said there is no silver bullet solution to this issue and any actions and reactions to the crisis have been implemented with that mindset rather than addressing the root of the issue.
“The report draws attention very clearly to the complexity of this issue and we know that complex problems require complex solutions,” he said. “We need to think about how can we reform and transform the current system, but we also have to think about why there is such a high need for doctors, nurses and paramedics and that requires us to look upstream, to look outside of health care to better improve health care services and supports.”
Mike Parker, president of the Health Sciences Association of Alberta, which represents 30,000 health professionals in the province, said there has been a “cultural devastation” of paramedics who were once proud of their jobs.
“This report highlights that it is a very dynamic issue,” he said. “But we aren’t even looking at the people on the front lines that are impacted the most and how we help them make it through. We can talk about recruiting all you want, we need to keep the folks that we have today.”
Copping said 39 frontline staff are being added and 80 full-time paramedics are being recruited in order to address burnout and fatigue.
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