Improving EMS Response Times
EMS response times have fallen significantly, and more ambulances are staying in their home communities.
- EMS response times are improving, despite call volume fluctuations of up to 30 per cent at times. Minutes matter when responding to calls seeking help for life-threatening situations. Since November 2022, EMS response times for the most urgent calls are shorter:
- 12 minutes in metro and urban areas, down from 21.8 minutes in November (a 44 per cent improvement).
- 14.5 minutes in communities with over 3,000 residents, down from 21.5 minutes in November (a 33 per cent improvement).
- 33.2 minutes in rural communities with under 3,000 residents, down from 36 minutes in November (an eight per cent improvement).
- 39.6 minutes in remote communities, down from 63.9 minutes in November (a 38 per cent improvement).
- Note: AHS is focusing its measures on the 90th percentile, meaning the response time is at or better than the numbers above 90 per cent of the time. This means that most calls are being responded to in less than the times mentioned above.
- In March, AHS launched the EMS Return to Service initiative, and it is now in place in five large areas of the province. The initiative supports paramedics to safely hand over patient care to ED staff within a 45-minute target.
- The amount of time paramedics spend in an ED has decreased from 3.6 hours in November, to 1.2 hours in April - a 66 per cent improvement. This means more paramedics are on the streets and available to respond to urgent 911 calls.
- The initiative is keeping ambulance crews in their home community. Ambulances from outside Calgary were required for a response within Calgary 58 times between April 10-16, down from the rolling 52-week average of 246. In Edmonton, that number dropped to an average of 24 outside responses, compared to a rolling 52-week average of 154.
- Since mid-January, 2,500 people who called 911 for EMS were transferred to Health Link and directed to appropriate care that did not require an ambulance and had their health needs met in a different way. This, in turn, frees up ambulances to respond to emergency calls, and reduces pressure on ED.
- AHS has filled 51 per cent of the 127 FTE allied health, pharmacy, and geriatric positions required to support patients who visit the ED in getting safely back home or connected to the right health service.
- AHS has also filled 46 per cent of the new positions required to support the EMS Return to Service initiative.
- AHS continues to work to fill the remaining postings.
- The frequency of red alerts is also coming down. So far in April, Edmonton has spent about 10 minutes in red alert, compared to 295 minutes in November 2022. Calgary has spent about four minutes in red alert in April, compared to 254 minutes last November.
- Red alerts measure the brief instances when all available ambulances are busy helping patients at a point in time but are prioritized to respond to the most urgent calls.
- In Central Zone, a new inter-facility transfer program is putting 10 new ambulances on the road to support the transfer of stable, low-acuity patients between facilities.
- The first of these ambulances was put into service April 18 with the remaining nine to be on the road by July 3. This program is the first of several that will be built up across the province.
- This new program is helping to address capacity pressures at Red Deer Regional Hospital Centre by providing more patient transport options and help keep other EMS resources available for emergencies.
- In addition, AHS is working with approximately 180 contractors to provide non-critical transfers for Albertans requiring transportation home after discharge from both ED and hospital stays.
- A new pilot project at the two EMS Mega Stations located in Calgary and Edmonton will hire a total of 32 net new Ambulance Readiness Attendants to clean, restock and perform vehicle and equipment checks on ambulances between shifts, removing that duty from paramedics who start and end their shifts at these stations.
- This pilot project is expected to reduce the amount of time paramedics remain unavailable for service at the beginning of shifts, help improve ambulance availability for calls and contribute to the reduction of EMS response times.
- Between November 2022 and January 2023, EMS added 39 front-line staff, including paramedics, emergency communications officers, and front-line supervisors. Overall, EMS hired 457 new staff members in 2022, including 341 paramedics.
Decreasing Emergency Department (ED) Wait Times
ED wait times are coming down. From November 2022 to March 2023:
- ED wait time to see a doctor has been reduced by 17 per cent, from 7.1 hours to 5.9 hours. This measure includes time required for diagnostic investigation.
- Total time spent in the ED for admitted patients has been reduced by 26 per cent, from 42 hours to 31 hours.
- Total time in the ED for discharged patients has been reduced by seven per cent, from 11.9 hours to 11.1 hours. AHS is focusing its measures on the 90th percentile, meaning 90 per cent of the patients experience these times or shorter times.
Reducing Wait Times for Surgeries
There are now less people waiting for surgeries than before the pandemic, and less people waiting longer than clinically recommended. AHS has made significant improvements to the wait list in the 2022/23 fiscal year, and more Albertans are getting their surgeries within clinically recommended timelines.
In addition, more cancer patients are getting their surgery faster and within clinically recommended timelines.
- Compared to the beginning of the 2022/23 fiscal year, there are approximately 7,000 fewer patients waiting on the adult surgical waitlist, and 11,190 fewer patients waiting longer than clinically recommended (a more than 25 per cent improvement). This is the net change in numbers waiting.
- Approximately 292,500 surgeries were completed in the 2022/23 fiscal year. Our total surgical wait list as of April 17 is 66,900 with 53 per cent waiting within clinically recommended wait times.
- In the 2022/23 fiscal year, AHS completed approximately 22,100 cancer surgeries, compared to approximately 20,040 pre-pandemic, a 10 per cent increase. Nearly 65 per cent of these were completed within clinically recommended wait times.
- More children and more cardiac patients are also receiving their surgeries faster.
- Almost 75 per cent of pediatric patients are now waiting within the clinically recommended surgical target, a 23.3 per cent improvement since mid-2020.
- 86 per cent of cardiac patients are waiting within target, compared to 66 per cent three years ago.
Improving Patient Flow Throughout the Healthcare Continuum
More Albertans waiting to be placed into continuing care or more appropriate settings in emergency departments are being transferred faster.
- The number of people waiting at the 14 largest hospitals for continuing care placement dropped 20 per cent from a peak of 299 in September 2022, to 240 at the end of March.
- AHS placed more patients no longer requiring hospital care, but awaiting continuing care, into an appropriate living option within 30 days. The percentage placed from hospital in to continuing care within 30 days increased from 70 per cent in April 2022 to 78 per cent in March 2023.
- AHS has opened about 1,250 new continuing care spaces in the last fiscal year, and another 250 are anticipated to open before June 30, 2023.
- Between November 2022 and January 2023, AHS:
- Opened 292 net-new designated supportive living beds.
- Opened 55 net-new long-term care beds.
- Opened 30 net-new mental health beds and 26 net new addiction beds (for a total of 56 beds).
- Opened 362 net-new community spaces with wrap-around health supports.
- The Bridge Healing Transitional Accommodation Program in Edmonton began accepting patients on March 16 to help provide transitional care for people experiencing homelessness or other housing insecurity who have been discharged from EDs.
- The site now has 12 spaces available for patients, and helps clients get connected to appropriate community supports and services as they work towards achieving stable housing. The program is helping with patient flow in our hospitals, by providing Albertans with supports necessary to address their housing needs and to continue treatment and recovery in a supported environment. A further 24 additional spaces will open in the coming weeks.
- That, in turns, frees up ED spaces as well as hospital beds, and most importantly, provides care in appropriate settings for complex clients.