Tuesday, September 29, 2020

'It's not broken': Calgary City council votes to oppose consolidation of ambulance dispatch

Madeline Smith CALGARY HERALD/POSTMEDIA
© Provided by Calgary Herald Calgary Mayor Naheed Nenshi (L) and Minister of Health Tyler Shandro (R). Alberta Health Services is planning to consolidate EMS Dispatch. Calgary is one of four municipalities that has yet to be consolidated. Calgary city council is opposing the plan.

City council took an official stand Monday against a bid to centralize Calgary’s ambulance dispatch under Alberta Health Services.


The latest move in the dispute between the provincial government and the municipalities that still control local EMS dispatch comes after Mayor Naheed Nenshi joined three other mayors in Edmonton last week to make the case directly to Health Minister Tyler Shandro against consolidation.

Calgary council held a special meeting Monday to hear from a series of officials and experts about how the city’s 911 and emergency dispatch system works. Calgary Community Standards director Richard Hinse and Calgary fire Chief Steve Dongworth both said the current model, where dispatchers for police, fire and EMS work in the same room, shouldn’t be changed.

Council voted nearly unanimously to oppose moving Calgary’s EMS dispatch and to ask Shandro to overturn the decision. Coun. Sean Chu and Joe Magliocca voted against the statement because they said AHS and the province hadn’t been given a chance to explain the “other side” of the issue.


According to city data, Calgary 911 deals with 15,000 calls per year that require all three types of first responders at the scene.

“Calgarians have already had the gold standard for 15 years of this model based on 911,” Hinse said. “It’s not broken. Why would you fix it?”

Red Deer, Lethbridge and the Regional Municipality of Wood Buffalo are the other places in Alberta where ambulance dispatch is still done locally. Starting in 2009, across the rest of the province, AHS dispatches EMS from three centres in Edmonton, Calgary and Peace River.

Mayor Naheed Nenshi said if he believed that the change would improve patient outcomes or save a significant amount of money, that could convince him to hand over EMS dispatch.

“I don’t believe either of those things,” he said, adding he questions why the city is having this conversation again.

'He has to stand down': Calgary council vows to fight Shandro on EMS dispatch consolidation

AHS has tried several times over the last decade to consolidate the remaining municipally run EMS dispatch work, but health ministers across several governments have rejected it.

“I have yet to see any evidence that patient outcomes will improve or money will be saved,” Nenshi said.

In an interview with Postmedia last week, Alberta’s chief paramedic Darren Sandbeck said the move is about finishing the work AHS started in 2009 and creating a “truly integrated” EMS dispatch system.

“When we started this journey there was 37 EMS dispatch centres in Alberta. Those 37 dispatch centres were not connected in any way, shape or form and had no understanding of what resources were available,” he said.

“Emergency services, first response groups always want to have direct co-ordination over their resources. … We want to have the same thing. We want to have direct co-ordination with our staff, within our system of all of our EMS resources across the province.”
© Gavin Young/Postmedia Network Alberta Health Service’s chief paramedic Darren Sandbeck was photographed in Calgary on Tuesday May 30, 2017.

If consolidation goes ahead, EMS dispatch would move over to AHS in January. There are currently 45 ambulance dispatchers that work for the city, and they’d be replaced with 25 positions at AHS.

After meeting with Nenshi and the mayors of the other affected communities last week, Shandro said he would review their information.

And on Monday, he said if there’s evidence that shows emergency response times would “somehow be adversely affected” then he’d be against the change.

“But that’s quite frankly not the evidence I’ve seen right now from AHS.”
How Calgary 911 works

When a Calgarian dials 911, a municipal employee answers the call — and that would still be the case even if consolidation goes ahead.

But the process of sending out emergency services would look different. Currently, depending on whether the caller says they need police, fire or ambulance, they’re transferred to a municipal dispatcher who’s responsible for sending that service to the scene.

But if AHS takes over EMS dispatch, a call for an ambulance would be transferred to the AHS dispatch centre, while police and fire dispatch are in a different building.

Hinse said splitting emergency dispatchers into different workplaces means they won’t be able to communicate directly, and that opens them up to errors.

“For a purely medical emergency — a broken leg, a slip, a fall — an AHS dispatch centre may work well,” he said. “The problem is that emergencies are messy.”


In Calgary’s 911 call centre, police, fire and EMS dispatchers are intentionally seated adjacent to each other, and Hinse said there are times when dispatchers simply “twist and shout” to their colleagues that they need additional first responders on their call.

Alerting Calgary fire to calls is one of the city’s main concerns. Firefighters are currently first on the scene of a medical emergency slightly more than half the time, and they can offer medical help before the ambulance arrives. But that requires co-ordination between ambulance and fire dispatchers to make sure resources are sent out as soon as possible.

Chief paramedic Sandbeck maintains that emergency response times won’t be affected, and firefighters will continue to be first on the scene for the same percentage of calls.

Calgary ambulance dispatchers started using an AHS computer-aided dispatch (CAD) system to handle calls in 2017, and Sandbeck said that means the only thing that changes under consolidation is the dispatcher’s employer and location.

“There’s CAD to CAD interface, which means our dispatch software immediately talks to fire dispatch software and alerts them that we need them for a response,” he said.

“If the call triggers up as unconscious and not breathing, that will automatically send a notification to the fire dispatcher that we need a medical first response.”
© Gavin Young Calgary Fire Chief Steve Dongworth speaks at a media press conference on Wednesday, June 3, 2020.

But Calgary fire Chief Dongworth told council Monday the AHS CAD system added extra steps that actually set firefighter response times back by 49 seconds, on average, since 2017.

And Hinse said waiting for call takers in another building to let fire dispatch know whether they’re needed is a waste of precious seconds when firefighters could be pre-alerted that they’re needed. And in the meantime, the caller has to wait to be transferred to the AHS centre.


Replying to @meksmith
Nenshi says he doesn't like the implication that city staff telling #yyccc their professional opinion "is just one side of the story."
Nenshi: "This is not a matter of council mediating between both sides," says calling city staff "just one side" is "troubling" to him. #yyccc



Replying to @meksmith
Hinse: "If AHS consolidates EMS dispatch, they will do a great job at dispatching ambulances. The problem is emergencies are messy," and they often require multiple first responders. #yyccc
This is an example about how emergency dispatchers are sitting together in Calgary's call centre. Hinse says the CAD system that AHS uses to transfer calls with the push of a button sometimes doesn't work, and communication is crucial. #yyccc
Image

Foothills County opposition

Foothills County Reeve Suzanne Oel also told council about her community’s experience with consolidated dispatch.

AHS took over EMS dispatch across most of southern Alberta in 2009, and Foothills has been advocating to take it back for years, citing particular problems with dispatching firefighters for medical first response.

“Because of the logistics of transferring the call back and forth, the total time to dispatch a medical fire response averages about five minutes now, or three times longer than before,” Oel said.

Sandbeck said a CAD to CAD interface was put in place between EMS and fire dispatch over the summer to address concerns from Foothills.

Coun. Jyoti Gondek said she was dismayed to see the province consider changing Calgary’s emergency dispatch system without adequate data.

“I’m really at a loss of understanding how we’re going to build a relationship or collaborate with a government that continually degrades, defunds and dismisses anything that municipalities have to say. This is a perfect example.”

Council also voted to ask for representatives from AHS to meet with them as soon as possible.

“This is the beginning,” Coun. Diane Colley-Urquhart said. “And we’ve got several months ahead of us where we’re going to stay the course and fight a good fight on behalf of Calgarians.”

masmith@postmedia.com

Twitter: @meksmith

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