Cold Lake council and the Cold Lake Ambulance Society (CLAS) are concerned ambulance service levels in the city are being compromised.
Debra Pelechosky, President of Cold Lake Ambulance Society said, “With the increase in call volume, it has put a lot of stress on our service. And at times we just don't have enough cars to deal with the call volumes. There have been times when there was not an ambulance available in Cold Lake.”
The two sides met at the Feb. 11 regular council meeting, with MLA for Bonnyville-Cold Lake Genia Leskiw in attendance, to discuss their concerns with ambulance service in the city and the response from Alberta Health Services (AHS).
The concerns arose following AHS's decision to transition to a central dispatch system for the majority of the province's ambulance services, including Cold Lake and Bonnyville.
Pelechosky explained the flaws in the current system, saying one of the most time consuming and concerning issues is the number of times Cold Lake ambulances are “tagged” when returning from an inter-hospital transfer to Edmonton.
Essentially, an ambulance will transfer a patient from the Cold Lake hospital to a centre in Edmonton, however, rather than simply returning to Cold Lake, if an emergency call comes in central dispatch will “tag” the nearest ambulance to respond to that call, even if the call is coming from Edmonton.
This leaves Cold Lake ambulances clearing up their transfers and then having to respond to calls on their way out of Edmonton, which delays their ability to return and provide service in Cold Lake.
“The system still works,” said Chris Palmer, manager of the Cold Lake Ambulance Society. “Our crews are still able to provide quality service. But with increased call volume and increased number of transfers and cars being tagged before returning to Cold Lake, it's adding a lot of stress to that system and putting a strain on our crews.”
He added, “Because we're at the end of the road and our transfer time can be about three hours, unless the transfer call you get is right at the start of your shift, you're probably going to be working a 12-16 hour day or more. Depending on whether your car is tagged on the way back to Cold Lake and you are required to respond to another call, you could be looking at a 20-hour day.”
Pelechosky said she was not only concerned with staff fatigue and burnout, but also the service level the system could potentially leave Cold Lake with.
“Prior to AHS taking over ambulance service, there was a criteria in the contract that stipulated an ambulance would remain in Cold Lake and available at all times. So it was the standard previously, but now with central dispatch our crews can be tagged outside of Cold Lake which means that is one less ambulance available for residents.”
Coun. Vicky Lefebvre was concerned Cold Lake ambulances were helping out others but getting nothing in return. “So we're improving Edmonton's service, without them having to add ambulances. Do we have any right of refusal?”
Pelechosky was concerned with the consequences of not responding, “What is the fallout if we don't take that call, don't respond?”
“They've traded the city problems at the expense of the rural areas,” said Coun. Bob Buckle.
“It is Alberta Health Services' duty to provide safe, high quality and efficient EMS care to all Albertans. Any time one of the communities we partner with to provide services is concerned about the quality and standard of patient care we take action,” said Rick Trimp, AHS interim president and CEO for Province-Wide services, in an email to the Nouvelle.
“Alberta Health Services is looking forward to meeting with the Cold Lake Ambulance Service and the City of Cold Lake next week to discuss their concerns.”
Mayor Craig Copeland appeared frustrated with the fact the problems persist.
“We've met with AHS but nothing seems to be getting better in this situation. It only seems to be getting worse,” he said.
Pelechosky said some of the solutions put forth by AHS have left Cold Lake in precarious situations.
“We've operated for years on the premise that ‘Code Red' means there is no ambulance in Cold Lake and now AHS is saying there can never be a ‘Code Red' because with the central dispatch system they can dispatch an ambulance from another community to cover Cold Lake. But all that means is they stage an ambulance nearby, maybe in Ardmore or Bonnyville. Does that really mean there is an ambulance in Cold Lake?”
Palmer suggested putting the society's fourth ambulance into use more often, but said AHS appears reluctant to do so.
“We used to man our extra car when we needed it and only when we needed it. Now it seems like because of the contract AHS would have to pay for the extra car on an hourly rate. So they would just as soon send a car from Bonnyville to cover Cold Lake, which takes almost 30 minutes, than call in and pay for the extra car in Cold Lake, which we could have ready in less than five minutes. Yes, they've agreed it can be done, but it's not happening and that's a concern.”
According to AHS, “Under the current contract, if CLAS activates the fourth ambulance they are required to receive approval from AHS so that they can be compensated for the additional resource.”
“AHS has not received a request for usage of a fourth ambulance or been invoiced for additional resources under the current agreement with CLAS.”
Pelechosky suggested, “I think we should look at re-introducing the policy of ensuring an ambulance is always in Cold Lake and it should be included in the contract but that would mean re-opening contract negotiations with AHS. But maybe that makes sense.”
Copeland explained, “The city's contract with the society said that an ambulance would always be in Cold Lake. When AHS took over, they said service would not deteriorate. We've always said that an ambulance in Ardmore does not mean an ambulance in Cold Lake.”
Pelechosky also suggested developing a provincial inter-hospital transfer system to alleviate some of these issues.
“I think the province needs to look at how they are going to deal with inter-hospital transfers. I think if the province provided a facility transfer unit and that was the only task of the unit, that would be another way to alleviate some of the stress on our crews.”
According to AHS, there is an inter-hospital transfer system being developed.
The society, council and administration and AHS have agreed to meet again on Feb. 20.
