AHS - EMS Wait Times

[DoubleF]

Originally Posted by btimbit

My understanding from her is she feels if they just had the proper amount of medics, the ER waiting thing wouldn't be that big of a deal. But even ignoring the hospital intake problem, even still, EMS is just so understaffed, and the amount of OT is insane. Most medics are working at least 6 day weeks, and I barely see her because it's at the point where if she doesn't pick up an OT shift, then it just gets left unfilled and that's another truck that doesn't even go out. And that's how they all feel, obligated to pick up these extra shifts because they just don't have the people to fill a schedule. As you can imagine it's leading to a lot of burnout. A lot of her co-workers have quit and moved away. The medic she was partnered with when she started and really learned from when she was new, killed himself last year. The system is at a breaking point, and the Government is doing just enough to say they're trying.

Pretty frustrating overall

Not said enough, and probably not really much coming from an internet stranger, but what she does is very much appreciated.

[chedder]

Originally Posted by btimbit

My understanding from her is she feels if they just had the proper amount of medics, the ER waiting thing wouldn't be that big of a deal. But even ignoring the hospital intake problem, even still, EMS is just so understaffed, and the amount of OT is insane. Most medics are working at least 6 day weeks, and I barely see her because it's at the point where if she doesn't pick up an OT shift, then it just gets left unfilled and that's another truck that doesn't even go out. And that's how they all feel, obligated to pick up these extra shifts because they just don't have the people to fill a schedule. As you can imagine it's leading to a lot of burnout. A lot of her co-workers have quit and moved away. The medic she was partnered with when she started and really learned from when she was new, killed himself last year. The system is at a breaking point, and the Government is doing just enough to say they're trying.

Pretty frustrating overall

Home care is in the exact same situation. Understaffed and overworked. AHS banks on the fact that enough of these workers have too much pride to let shifts go unfilled which leads to overtime, burnout and eventual leaving the job. Then all you're left with are the lazy ones that take every advantage, strategically calling in sick, skimping on patient care. The whole system is broken.

[GirlySports]

Originally Posted by chedder

Home care is in the exact same situation. Understaffed and overworked. AHS banks on the fact that enough of these workers have too much pride to let shifts go unfilled which leads to overtime, burnout and eventual leaving the job. Then all you're left with are the lazy ones that take every advantage, strategically calling in sick, skimping on patient care. The whole system is broken.

You get this with nurses too. Either really good or really bad. There doesn't seem to be an in between. And the great caring nurses of course burnout.

[CorsiHockeyLeague]

Originally Posted by btimbit

Direct quote from my fiancee, a ACP and Supervisor in Calgary

"More doctors, more nurses, more medics. Some people have suggested stuff like EMT's watching waiting areas. That's dumb. Don't spend money fixing symptoms, spend it fixing the problem. Stop treating healthcare workers like garbage so they stop leaving, give the budget increase to reach proper staffing levels. The waiting area problem isn't great but still is the wrong focus, we can't fill a schedule anyway"

The problem is that this is the solution that everyone gives for everything - whether it's in education or health care or the court system (which if you want to talk about backed up, good God are the courts backed up) - it's always "just give us more money and hire more people, that's the solution". I mean, okay, I agree, a sudden injection of cash probably would help, but when literally every public service seems to be in the same boat and everyone has their hand out waiting for more funding... what do you actually expect is going to happen?

[GGG]

Originally Posted by CorsiHockeyLeague

The problem is that this is the solution that everyone gives for everything - whether it's in education or health care or the court system (which if you want to talk about backed up, good God are the courts backed up) - it's always "just give us more money and hire more people, that's the solution". I mean, okay, I agree, a sudden injection of cash probably would help, but when literally every public service seems to be in the same boat and everyone has their hand out waiting for more funding... what do you actually expect is going to happen?

You have a few options

1) add staff
2) cut service
3) Find efficiency by eliminating non essential activities.

What I expect to happen is the portion of GDP spent on public services to rise and taxation to reflect that increased level of service.

[iggy_oi]

Originally Posted by GGG

You have a few options

1) add staff
2) cut service
3) Find efficiency by eliminating non essential activities.
4) Not have an inexplicably and otherwise unjustifiably low corporate tax rate so that you can afford to do option 1 when the other two options fail.

What I expect to happen is the portion of GDP spent on public services to rise and taxation to reflect that increased level of service.

I’m just trying to think outside of the box here

[foshizzle11]

I don’t get this bottleneck of having to wait as a paramedic to handoff to a doctor or nurse. There has got to be a better way than holding these EMTs hostage doing almost nothing for hours while people are dying waiting for an ambulance.

Seems so insane to me. I’ve been in the ER as a patient, I wasn’t watched for hours on end just in case something happened to me. Like why does a stable patient need that?

I get critical cases but this seems bizarre that it is going on when there is a critical problem in the system.

We have discussed this, call an Uber if you’re alone and need to get to the hospital or drive yourself or your neighbor instead of waiting, I know basic first aid, I think I can handle a few issues that need to be handled in an emergency.

[Mean Mr. Mustard]

I guess I can sort of answer that. Even if you aren't critically sick, you can still deteriorate if left unmonitored. Some people just aren't safe to be downloaded from a EMS stretcher to a waiting room. That being said if there aren't beds available in the emergency department then they have to be still monitored by an EMS crew.

There are many different areas of bottlenecks in the system, getting people into a hospital bed needs one available but for that bed to become available someone else needs to be discharged from the hospital... Which requires community supports and assistance. There isn't really one magic cure or easy solutions.

[CliffFletcher]

Originally Posted by GGG

You have a few options

1) add staff
2) cut service
3) Find efficiency by eliminating non essential activities.

What I expect to happen is the portion of GDP spent on public services to rise and taxation to reflect that increased level of service.

The problem is we can’t seem to acknowledge the increasing demands we’re placing on public services. It’s getting ever costlier to deliver health care to an aging population. The massive expansion of post-secondary education has not yielded economies of scale. The cost of skilled labour has increased, but the nature of most public-sector work means that labour isn’t more productive (better trained nurses and teachers can’t support more patients and students). Building standards and the cost of construction labour and materials have gone way up (it costs far more in inflation-adjusted dollars to build a public school today than it did in the 60s).

This reality is unwelcome. So instead of recognizing increased demands and costs, we frame the gap between what we expect and what we get as cuts to funding. I suppose that’s a more attractive outlook because it means we just have to restore previous levels of funding and the ship will right itself. But previous levels of funding won’t cut it. To meet our expectations, we need to substantially increase the resources we devote to public health care, education, policing, etc, and that means higher taxes across the board.

That’s a hard sell when our leaders can’t even openly express the problem. The dependency ratio is the single most important factor in the economics of public policy. Can’t talk about it. Because seniors lose their #### if anyone points out the twin empirical truths that A) statistically, most retired Canadians are net costs to the public balance sheet, and B) few paid sufficient taxes in their working years to make up this shortfall. And on the public service side, teachers, nurses, police, etc lose their #### if you explain that they’re paid considerably more in inflation-adjusted dollars than their counterparts 40 years ago. And the anti-tax crowd loses their #### if you point out that Canadians are undertaxed relative to our expectations of public services, and this shortfall cannot be wholly made up by cutting administrative waste.

Any politician presenting the real problem will infuriate about two-thirds of Canadians. Hardly a smart move for someone trying to win elections.

[jayswin]

Originally Posted by PsYcNeT

FIL had a cardiac event on Sunday night; Fire got there about 20m after my MIL called 911, EMS arrived about 15m later.

He's okay, but yeah I was surprised that I had time to stop cooking dinner, put everything away, pack a bunch of "gonna sit at the hospital for a few hours/overnight" items, get my toddler sorted and into the car, drive to their house (~10m away) and still beat EMS by 10m or so.

So with these kind of response times it's likely safe to assume we're seeing daily deaths in Calgary due to lack of ability to respond in a timely matter to medical emergencies? You'd have to think so.

I mean a lot of cardiac and overdose calls likely require 3-10 minutes to save the life, if they're up in the 20's and 30's and even 45 minutes I'd imagine people are simply dying before they get there on a fairly regular basis?

[jayswin]

Originally Posted by Sliver

Yep, I'm going to look at it like that, too. Most of us in Calgary are pretty fataing close to a hospital at all times. Things would need to be pretty dire for me to roll the dice on an ambulance showing up quickly right now.

Yep, if you can drive yourself and/or you can drive an injured/medical event family member to a hospital I'd go that route right now. Yikes.

[jayswin]

Originally Posted by 81MC

Friends 1 year old had a seizure out of the blue while at a restaurant. Child went blue, parent thought kid was legit dead. Ambulance took 45 minutes. That’s a god dammed eternity.

A child turning blue at a restaurant ws a 45 minute response? I won't push Whitetiger for comment on that, but that seems.......wrong? Despite what we've read and commented on in this thread with regards to astonishing wait times, I really don't see how a 1 year old going lifeless in a restaurant is a 45 minute response time in a third world country let alone here.

[WhiteTiger]

Originally Posted by jayswin

A child turning blue at a restaurant ws a 45 minute response? I won't push Whitetiger for comment on that, but that seems.......wrong?

I can't answer for EMS/AHS (or CFD for that matter) anyhow, I only deal with CPS dispatching.

[powderjunkie]

Originally Posted by Mathgod

Quoted for truth. Solving this problem would alone reduce the high wait time problem to a huge extent. Hospitals really should have people whose job it is to stay with patients until they get seen by a doctor, so that paramedics could be on their way and attending to the next call instead of sitting in emergency rooms for hours on end. Why more isn't being done on this front is something I don't understand.

1 big issue is that transfer of care is where errors happen most. You're creating a game of telephone.

Originally Posted by WhiteTiger

This...actually is a significant problem that people are abusing, which adds to wait times.

I can't go into details, but there are people out there who call on EMS 15+ times a month. Things are being done to address those cases, but it's a challenging ethical grey area.

Originally Posted by Hemi-Cuda

At the very least give the EMS guys a dedicated intake person or a way to bypass the line. I watched 2 EMS guys stand in line at the Airdrie UC yesterday with a patient for almost an hour before they were triaged, seems like such a horrible use of their time

If EMS got greater priority, you'd probably exacerbate the problem by incentivizing EMS use...

I'm not sure what proportion of patients could be safely transferred to the general waiting room...maybe 10%? Probably not going to move the needle much.


I've done long rants on this before, but I think all emergency service need a serious re-think. Fire/EMS should integrated, and there is a lot of room to integrate police and social workers.

Actual fire-fighting is thankfully now a fairly rare need, and could be considered more like a SWAT team or bomb squad. CFD does a ton of other great work, but there is almost always a concurrent need for EMS (or at least medical attention) on most calls. I'm sure there are plenty of exceptions - like potential gas leak calls.

Combining these stations would just generally help with logistics. Instead of tying up two paramedics and the ambulance, one stays with the patient and the other returns to base. A firefighter can collect the EMT from the hospital once they are free. Maybe you don't even need 2 EMT's per ambulance; 1 EMT and 1 firefighter with advanced first aid and training to drive the bus.

Maybe not every EMT needs to be in an ambulance. If necessary you have a 1FF+1EMT team arrive in an SUV...maybe that ambulance that now only has a driver can get to the scene five minutes later. There is generally a bit of lag time between EMT arrival and actually loading the patient into an ambulance.

No doubt there would be some challenges with this approach, but it seems like a good trade to have faster/broader access to emergency personnel, even if it means a few extra minutes for a more specialized response.