Three years after it went public with issues due to uncoordinated dispatch, Foothills Regional Emergency Services Commission is still facing service delays with potentially deadly results.
Suzanne Oel, chair of FRESC, gave a presentation to members of the Alberta Party on March 1 highlighting ongoing issues with dispatch being split between Foothills 911 and Alberta Health Services.
In October 2009, EMS ambulance dispatch was removed from Foothills 911 in what Oel, the Foothills County reeve, called an experiment, which led to the service being consolidated to the AHS EMS south communication centre in 2017. The move was part of a plan to transfer all ambulance dispatch in Alberta to AHS EMS centres in Calgary, Edmonton and Peace River.
“When EMS dispatch is moved to any other call centre, this adds time delays in getting responders to the patient,” said Oel.
She said additional problems arise due to lack of response co-ordination, poor area familiarization in terms of geography and addressing, ambulance response delays, gaps in coverage, and inappropriate deployment of ambulance.
Removing ambulance dispatch from local call centres across the province “erodes service levels for more Albertans,” said Oel.
The result is a fragmented call, she said.
When Foothills 911 received a call from one of its 25 southern Alberta municipalities and an ambulance is required, the call is transferred to the AHS EMS dispatch centre, which takes about 30 seconds. An ambulance is dispatched by AHS, but Foothills 911 does not have an estimated time of arrival.
Should medical fire response be necessary, the call is then sent back to Foothills 911, which Oel said is when delays occur. Information must be re-entered at Foothills 911 before a fire response can be dispatched, which takes another 60 seconds.
“Because of the logistics of transferring the call back and forth, and the total time to dispatch a medical fire response, this can take up to three times longer than a single-point dispatch,” she said.
Timeframes have been improved slightly since July 2020, when FRESC purchased a CAD-to-CAD connection that allows some information to be shared between Foothills 911 and AHS. However, she said the time it takes to transfer calls and re-enter data still come into play.
“These time delays are further compounded by callers who may be in distress, who have to repeat information twice,” said Oel.
Splitting dispatch between two centres leads to poor co-ordination of emergency response for larger incidents that require multiple agencies, she said, with delays in fire and police arriving at scenes.
When a call is managed by one centre, resources can be dispatched simultaneously without delay, she said.
“Unfortunately, Foothills 911 still sees the impact of the fragmented call daily,” said Oel.
In one incident regarding a suicide attempt, fire medical first response was dispatched as per protocol but Foothills 911 had not been advised there was a safety holdback initiated by AHS EMS, so responders could have been unknowingly entering into a dangerous situation.
Another involved a cardiac arrest, in which an incorrect address was process by AHS EMS dispatch and FRESC dispatched fire medical first response. Fire arrived on-scene three minutes before the ambulance, which was coming from the same hall location but had been rerouted due to the wrong address information.
One particular unfortunate incident occurred when a witness saw someone in cardiac arrest and bystanders began performing CPR. The volunteer fire department in the area was dispatched at the same time as AHS EMS, which had a 50-minute response time despite other units being 10 and 20 minutes away but not being called in. The fire department performed CPR for nearly 40 minutes, while the ambulance drivers, unfamiliar with the area, took an additional 10 minutes to arrive. The patient died prior to EMS arriving.
“The AHS EMS ambulance designated to cover this large rural area was on another call and had not been back-filled,” said Oel.
She said it’s not uncommon for fire medical response to arrive on-scene ahead of ambulance.
An Alberta Party member, who wished to remain anonymous, shared her experience as a former employee of FRESC working out of Black Diamond as a dispatcher. After returning to school to become a paramedic, she took a position with the City of Calgary EMS before working in a rural setting in the Nanton area.
She recalled the days of taking a call and jumping up to read legal land map to dispatch services like ambulance from Claresholm alongside fire from Granum.
It’s much more difficult now that the calls are divided, she said.
“Frequently, from my position, we put a request in for fire support if they’re not dispatched automatically and that request can be sent down the line up from FRESC, but we’ll never know if it is reaching them, there’s never the follow-up,” she said. “It’s like the two centres don’t talk to each other after the request has been sent.”
She said the AHS EMS dispatch does a fine job of deploying ambulances, but the service level will always be sub-par if it remains fragmented, particularly for rural Alberta.
“I am 100 per cent in support of seeing FRESC return to dispatching in my community, myself as a front-line responder,” she said. “I fully believe that AHS and the Government of Alberta don’t see the big picture. They only can ever get their head wrapped around an urban picture, they cannot see a rural picture at all.”
Oel said FRESC has been documenting examples and providing evidence to different provincial governments for years in an effort to highlight the issues for rural areas.
Letter-writing campaigns with support from area municipalities in 2012, 2015 and 2017 did not show results, and in 2020 FRESC went to the plate again with a letter of support from the Mayors and Reeves of Southwest Alberta group, and showed its support for the four centres in northern Alberta that stood on the precipice of losing their EMS dispatch.
She said the solution is to use the existing 911 centres to co-ordinate proper, efficient emergency response. There are nine qualified 911 dispatch centres in Calgary, Lethbridge, Foothills, Medicine Hat, Red Deer, Parkland, Grande Prairie, Wood Buffalo and Strathcona, she said.
“There would be significant cost savings recognized by the Province should our EMS dispatch be restored, as these centres already have the infrastructure and expertise required to provide the EMS dispatch services alongside the 911 and fire dispatch service,” said Oel.
