The head of the union representing Nova Scotia paramedics says a new pilot program intended to reduce ambulance wait times at the Halifax Infirmary’s emergency department is a promising first step, but more needs to be done.
“We’re grateful that our members’ voices are starting to be heard. This is a step in the right direction, but more needs to be done for sure,” Michael Nickerson, business manager of the International Union of Operating Engineers Local 727 said in an interview Wednesday.
On Wednesday, the province announced the launch of a new pilot program at the Halifax Infirmary site of the QEII Health Sciences Centre. In a media release, the Department of Health and Wellness said the program is intended to improve patient flow, help reduce emergency department overcrowding, decrease patient wait times, and get paramedics back on the road sooner.
This will be accomplished through what the province is calling an emergency department transition team.
“We all agree there are pressures on the system, and we are working towards improving ambulance offload times by addressing patient-flow challenges in our emergency departments,” Department of Health and Wellness Minister Zach Churchill said in the release. “That’s why we are investing over $3 million to pilot a dedicated emergency department transition team at the QEII, where the need is the greatest.”
An ambulance offload time is the time that passes between a patient’s arrival at the emergency department until their transfer from a paramedic’s care into the care of emergency department staff.
The province said a similar transition team created at the Dartmouth General Hospital in 2017 was effective in reducing offload delays.
“It did see some success. Absolutely. To what extent I’m not sure, but I do know that wait times are significantly less at Dartmouth General,” Nickerson said.
“They do get backed up as well and we do have offload delays even with that team. That’s why we’re cautiously optimistic that this is a step in the right direction, but we’re not 100% convinced that it will work. We’re hopeful that it will.”
In February of 2018, IUOE Local 727 launched its #CodeCritical public campaign to alert Nova Scotians when ambulance availability is “critically low” in any of the province’s health zones and corresponding counties. Each report is followed by “We encourage everyone to call 911 in an emergency.”
On Tuesday, the union reported a Code Critical nine times throughout the province, with a tenth from Tuesday evening tweeted out on Wednesday morning.
“What I hope happens with this offload transition team … is (it’s going to) allow paramedics to get out of the hospital quicker, back to the streets where they’re needed and where they do their best work,” Nickerson said.
“We are hoping that it will have a trickle down effect of helping our members by not bringing in additional paramedic crews from the western part of the province and the northern part of the province to cover off in HRM.”
Nickerson said they’re hopeful that will translate into fewer shift overruns, as current call volumes have many paramedics regularly clocking many hours beyond their 12-hour shifts.
“I can tell you morale is absolutely the worst I’ve ever seen it. We have paramedics leaving the profession altogether. We have them leaving the province,” he said.
“This (pilot program) is a step in the right direction. But more needs to be done.”
While the union knows anecdotally that call volumes have gone up, they don’t know by how much because they no longer receive annual reports. He said they and the public have a right to know details like if and where calls are increasing and by how much, the number of kilometres driven by the fleet each year, and the kinds of calls they’re responding to.
Nickerson also repeated his frequent plea to members of the public to have patience with the province’s paramedics.
“Our paramedics are stretched thin. There is a major staffing issue, and they’re responding long, long distances and sometimes it’s not the outcome that any of us want,” Nickerson said.
“But sometimes our paramedics are getting verbally abused by family members or patients for extended response times. And I understand the frustration, especially when somebody is an emergency. Our paramedics are doing the very best that they can in the system that they’re working in and they need help. They need help from government and from the employer.”
In its media release, the Department of Health and Wellness noted the Charles V. Keating Emergency and Trauma Centre at the QEII’s Halifax Infirmary site sees about 200 patients per day. About 50 of those patients arrive by ambulance. In addition, 13% of patients, or about 26 per day, are admitted to inpatient care at the hospital
The province expects the emergency department offload team to be in place by September.
I’m left wondering: “Our paramedics are stretched thin. There is a major staffing issue, and they’re responding long, long distances…” – so… why isn’t there appropriate (or even excess) staffing and equipment in place to ensure rural Nova Scotia has sufficient ambulances and paramedics available?
What is the staffing model in use now? A risk-assessment-based numbers game tracking past calls, average wait times, distance travelled…. or a contract to EHS (a government agency?) that has a “bottom line” to abide? They EHS section of the Health & Wellness website has annual reports published, but only up to 2012.