OSOYOOS TIMES-March 24, 2010

By Laurena Weninger - Osoyoos Times

It’s been roughly four months since the BC Ambulance Service (BCAS) made changes to its method of dispatching ambulances in Osoyoos.
So far, there have been no catastrophic results, as initially predicted by ambulance paramedics represented by CUPE 873 – but it’s still risky, said Ian McCoan, an Osoyoos paramedic and the union’s local shop steward.
“Right now the only thing I’m prepared to say on this issue is nobody has died yet because of it. Not yet. Is there a potential? Could be.”
In January, McCoan appeared as a delegation at an Osoyoos town council meeting to express the union’s concerns about the changes and urge council to write letters of protest.
In late November, the BCAS officially changed the ambulance deployment model in the South Okanagan to have in-station standby crews take care of the first call that comes in, whether that call is responding to an emergency situation or a patient transfer.
The Osoyoos ambulance station is manned on day shifts from Monday through Thursday. In addition, there is a second car on back-up duty and paramedics manning that car are on a standby pager system.
Previously, patient transfers were assigned to the back-up car, leaving the in-station crew available to handle the “lights-and-sirens” emergency calls, said McCoan.
He told council that depending on the on-call crew to reply to emergencies is risky, because their response time can be anywhere from 10 to 30 minutes – which could make all the difference to the person needing the ambulance.
But the numbers from BCAS don’t reflect those predictions, explained Larry Jackson, the ambulance service’s executive director for the Interior Region, in a letter to town council.
“In Osoyoos, crews do less than one transfer a day (during the dayshift) on average. The average number of pre-hospital (emergency and non-emergency) calls in Osoyoos is 1.4 per day (during the dayshift),” his letter explained.
He also said the average time it took an on-call crew to leave the station in an ambulance after a call came in was six minutes, 59 seconds in 2009.
The average response time for high-acuity or urgent calls in 2008/2009 was 11 minutes, 29 seconds.
“So far in 2010, the on-call crew in Osoyoos has responded to two high-acuity calls that came in when the in-station standby crews were already undertaking patient transfers,” said Jackson.
During the first high-acuity call, the on-call crew had just completed another call and responded immediately.
The second was cancelled before the crew left the station.
“Additionally, so far in 2010, the on-call crews have completed 22 patient transfers and the in-station crews have responded to 17 patient transfers… if pre-hospital call volume increases from the current rate of one call every seven hours, BCAS may switch to having the on-call crews undertake all patient transfers,” Jackson stated in the letter.
“BCAS continually monitors call volume data and will adjust deployment models when there is a business case to support the change,” he said.
McCoan has difficulty with Jackson’s explanation that the method of deployment is based on a “business case” and said patient safety shouldn’t come down to a roll of the dice, based on budgetary matters.
But he also admits part of their concern as paramedics is money as well.
Fewer calls to the on-call paramedics, who are paid by the call, makes it harder for them to make a living.
That means some area paramedics are starting to look for other jobs in bigger centres and that could translate to a shortage of people willing to take on work as paramedics in rural communities.
At its March 15 committee of the whole meeting, council agreed to receive and file Jackson’s letter and decided not to send any letters of support for either side of the issue.
“Obviously we’re concerned about the quality of the ambulance system and response times,” Osoyoos Mayor Stu Wells later said.
But the matter is too complicated for council’s liking, with a level of detail that makes it hard for councillors to properly assess the situation.
“It’s really beyond our skill set as a council,” Wells said.
According to a March 10 media release from CUPE 873, the union and the province agreed to roll over the union’s current collective agreement, which expires April 1, until April 1, 2012.
CUPE 873 president John Strohmaier said the move to extend the current collective agreement would at least give paramedics and emergency dispatchers some much needed stability while allowing the union and the employer to use existing mechanisms to resolve the day-to-day operational needs of paramedics.
The province’s 3,500 ambulance paramedics and the Crown-owned ambulance service have been at the bargaining table on and off for more than a year and a half, the release stated.
On March 11, Kevin Falcon, B.C.’s minister of health, said in another media release that oversight for the Emergency Health Services Commission and BCAS will be transferred from the ministry to the Provincial Health Services Authority.
The decision is based in part on a month-long consultation, states the release.
Falcon said integration with the health sector is the most logical and appropriate way to enhance patient care.
Falcon said fixing the model of service delivery is the important first step to resolving key issues raised consistently by front-line paramedics throughout the recent labour dispute.
These included heavy reliance on overtime in the Lower Mainland and the need to improve service delivery and employment conditions, particularly for part-time paramedics and those in rural and remote communities.
reporter@osoyoostimes.com