Edmonton EMS blowing whistle on staff morale & wait times

[mobey]

EDMONTON - Alberta Health Services will create a joint committee with the union representing paramedics and emergency medical technicians in Edmonton to address worker reports of plummeting morale and a lack of resources so severe some patients wait hours for an ambulance.

The Health Sciences Association of Alberta conducted a survey which was completed by 146 out of 304 eligible members of the union.

It found that in the last four shifts completed by those workers:

— 86 per cent experienced a lack of resources, including no ambulances available for emergency calls, otherwise called a red alert.

— 72 per cent said they could not meet their response-time targets three or more times.

— 72 per cent had pending calls of more than one hour, sometimes up to four times.

“According to our survey respondents, the emergency ambulance service in the Edmonton metro zone is completely inadequate as it is and the vast majority of our respondents have raised their concerns to the attention of Alberta Health Services’ management but to no avail,” reads the executive summary of the online survey, done between last Nov. 4 and 11. “We shouldn’t be surprised then that two-thirds of our respondents are seriously considering seeking employment elsewhere.”

Only Edmonton workers were surveyed following individual reports the situation was worse locally than elsewhere in Alberta. Since 2009, the province’s ambulance services have slowly shifted from the control of municipalities to Alberta Health Services.

Sue Conroy, senior vice-president for emergency medical services for the health authority, said she takes staff concerns seriously.

“It shows we’ve got some challenges,” said Conroy, adding the median waiting time in Edmonton for an ambulance is about eight minutes. That’s up slightly from the 2009-2010 fiscal year when the wait was seven minutes. Conroy said the number of red alerts has declined since ambulances can now cross city boundaries to respond to calls. She had no figures available.

But anonymous comments made by those surveyed paint a picture of forced overtime, high stress and employees who go from call to call non-stop, eating their lunches in the back of ambulances where patients have been.

“This continuous lack of enough trucks on the street, no back up, no transport units so you can get off on time, multiple late calls, all take an extended toll on one’s body,” reads one comment.

“Incapable, incompetent, inefficient, unsupportive, predatory managers and management full of excuses and short on answers/solutions,” writes another.

“Our response times are a complete joke and it’s affecting the care I want to give people,” one person wrote. “Why should anyone wait for up to two hours for an ambulance? I don’t care if it’s low priority. Edmontonians are waiting.”

Elisabeth Ballermann, president of the Health Sciences Association of Alberta, said she gave the survey results to Alberta Health Services in November, looking for a response before taking the issue public. A meeting took place Thursday during which the health authority acknowledged the legitimacy of the morale and resource problems, and agreed to set up a joint committee to address them. That committee is expected to meet for the first time in February.

Ballermann said she knew of no deaths or severe health consequences for patients due to ambulance waits.

Conroy said there is always room for improvement.

“Staff morale is important to us,” Conroy said. “We’re open to having feedback; that’s what helps us get better.”

Ballermann is also meeting with Health Minister Fred Horne Jan. 10 to discuss the issues, including having too few ambulance stations in Edmonton. Two stations have closed, including one in Callingwood and another at 118th Avenue and 50th Street. Ballermann said the downtown station on 105th Street has been downgraded because of LRT expansion.

Ballermann said the union is currently in negotiations for paramedics and emergency technicians, whose contract expired March 31, 2010. But she said the negotiations are about wages and working conditions, not resources, such as the need for more stations.

“As someone who has family and friends in this city, if we can’t get an ambulance to someone’s home because there aren’t any ambulances on the roads, then we clearly need to put resources in place,” she said.

© Copyright © The Edmonton Journal

Read it on Global News: Global Edmonton | EMTs sound alarm over long waits for ambulance patients

http://www.globaltvedmonton.com/emts+sound+alarm+over+long+waits+for+ambulance+patients/6442554243/story.html

[DFIB]

Unfortunately this situation is one unique of Edmonton. Recently a thread was opened that addressed similar problems in Detroit.

http://www.emtcity.c...post__p__273012

I think that in these situations, in the absence of criminal activity, the reason for the deficiencies are more important than the individuals that are in the positions of leadership. Most systems that reach a breaking point in maintaining a proper standard f service have been lacking in one important area for years. They have not formed and implemented a structure for Continuous Quality Improvement (CQI).

Most systems have some semblance of Quality Assurance (QA). By definition Quality Assurance is process that identifies problems and (sometimes) finds solutions. The deficiency of this system is that it frequently tends to be reactionary in nature and often removes removes useful resourses instead of investing in training for the future. Quality Assurance covers the well after the child has drowned.

Continuous Quality Improvement in contrast establishes a process for ongoing evaluation and assessment that reviews trends and implements ongoing improvements without waiting for a problem to arise first and tends to be preemptive in nature. This system notices that the well is uncovered and provides a boundary to impede a child from falling into the well as well as educating as to the dangers of wells, swimming for kids, CPR, etc.

In the Edmonton case (in my opinion) worker morale is not the primary problem and it’s increase by other means will not offer a long term solution. The underlying problem lies in the administration of the resources of the EMS system.

I hope that the “New board” will be more focused on overall service from a patient advocate view than simply “fixing” morale. If they solve the causal problem they will resolve the effectual result.

I wish all involved well as they make the hard choices of Quality Assurance.

Edited for context and clarificaiton.

Edited January 7, 2012 by DFIB

[HellsBells]

Its interesting that Edmonton has these type of problems, where a city of comparable size, i.e. Calgary, is much more effecientally run.