Alberta Health Services (AHS) is working to improve Emergency Medical Services (EMS) response times and ensure Albertans needing emergency care, get that care. Improvement will be driven by innovative new approaches to delivering care, the addition of new resources, better use of existing resources, as well as support for existing EMS staff while seeking new workers to augment our team.
EMS/811|Inter-Facility Transport Contracts|More Ambulances & Paramedics|Safe Transfer of Care|ATR Guidelines| Non-Ambulance Transfer|Red Deer / Central Zone IFT|AEPAC|MFR Program Enhancement
EMS/811 Shared Response is already helping patients get the care they need and reducing unnecessary ambulance responses. Launched mid-January, this new collaboration between EMS and Health Link 811 allows for the transfer of EMS callers who EMS assesses as low-acuity – or not experiencing a medical emergency that requires an ambulance - to Health Link 811 registered nurses for further triage, assessment and care. This collaboration provides better support for patients while allowing ambulances to remain in the community to respond to life-threatening emergencies, meaning faster emergency response times and better flow through the health system: two of AHS’ four key priorities. Since the launch in January 2023, more than 9000 EMS 911 callers were assessed as low acuity, transferred to 811, and helped by 811, keeping more ambulances available for higher acuity calls.
To improve the capacity of metropolitan area ambulances, AHS is working with two partners to provide dedicated low acuity transfer services for non-urgent for patients requiring transport between hospitals and care centres and to home in Calgary, Edmonton and surrounding areas.
By contracting for these non-urgent transfers, new, additional resources are being added to the EMS system that will help AHS free up ambulances and paramedics to focus on emergency medical responses in Alberta’s two largest cities.
Patient transfers that are urgent, emergent, beyond 50 km from metro areas, or require higher levels of clinical care will continue to be provided by existing EMS resources.
The competitive process was done through a Request for Expression of Interest & Qualification (RFEOIQ)
AHS will continue to examine demands of inter-facility transfers on rural communities and will explore opportunities to improve EMS response times where IFTs can be managed more effectively.
To support understanding of the various types of transports that are completed by AHS EMS, and by these and other contractors, please see the list of transport type and provider, below.
| Type of Transport | Details | Provider |
|---|---|---|
| Interfacility Patient Transfers: Critical | A critical-clinical condition requiring an unscheduled emergent response and transport, typically to a higher level of care. | AHS EMS and existing contracted EMS providers outside of Calgary and Edmonton |
| Interfacility Patient Transfers: Potentially life-threatening | A potentially life-threatening clinical condition requiring an unscheduled urgent response for higher or specialized care at another facility. | AHS EMS and existing contracted EMS providers outside of Calgary and Edmonton |
| Interfacility Patient Transfers: Scheduled, low acuity | Scheduled, low acuity interfacility transfer services (IFT) for non-urgent patients requiring transport between hospitals, between hospitals and care centres and from hospital or care centres to home in Calgary, Edmonton and surrounding areas. | New dedicated IFT contract services providers: Associated Ambulance Services Guardian Ambulance Ltd. Advanced Life Support (ALS) |
| Advanced Life Support (ALS) Units | ALS Units are ambulances staffed with at least one Advanced Care Paramedic (ACP). | AHS EMS and existing contracted EMS providers outside of Calgary and Edmonton |
| Basic Life Support (BLS) Units | BLS Units are staffed with at least one Primary Care Paramedic, and may include Emergency Medical Responders (EMR), with a standard level of equipment to provide essential medical care for patients | AHS EMS and existing contracted EMS providers outside of Calgary and Edmonton |
| Paramedic Response Unit (PRU) | A single member practitioner, typically in an SUV, who provides rapid response capabilities. | AHS EMS and existing contracted EMS providers outside of Calgary and Edmonton |
| Mobile Integrated Health (Community Paramedics) | ACPs with additional training and equipment who provide complex care to patients in order to keep patients out of the hospital. | AHS EMS |
| Non-Clinical Transport (NCT) Services | Arranged by the facility and is not part of EMS. Health care professionals in consultation with the patient (adult or pediatric), and/or alternate decision-maker, and/or designated family/support person, and health care team, must determine if the patient meets the non-clinical transportation criteria | All Healthcare facility teams (AHS, Covenant, Long-term Care) |
| Air Ambulance | Providing fixed-wing air transport services for emergencies and Scheduled Inter-Facility Transfers | AHS EMS Air Ambulance STARS / HALO / HERO (contracted) |
EMS has added new ambulances; 10 in Calgary and 10 in Edmonton. AHS is deploying these new ambulances to Calgary and Edmonton because these are the two areas of largest use and need. Adding ambulances here means less need to move ambulances from suburbs and rural areas, into the cities.
AHS is rapidly recruiting new paramedics while also ensuring every effort is made to retain our dedicated staff. This includes the launch of a multifaceted marketing campaign that targeted local, national and international audiences, in an effort to recruit new EMS staff to Alberta. Our efforts are seeing results.
EMS also continues to have ongoing meetings with learning institutions regarding hiring of new graduates and potentially expanding future training capacity
On March 15, 2023, AHS launched the EMS Return to Service initiative, which supports paramedics to hand the care of patients over to emergency department nurses within a 45-minute target, is now fully operational in all major hospitals across Alberta.
This new provincial policy allows paramedics to return to service in the community faster, by moving patients who do not need observation to appropriate hospital waiting areas instead of automatically waiting with paramedics to be seen. While waiting, patients will be cared for by the ED/Urgent Care Centre (UCC) team, and a decision to assign a patient to the external waiting room will be based on patient stability and care needs. While still in its infancy, the EMS Return to Service initiative has resulted in a significant reduction in response times, has freed up more ambulances to complete scheduled inter-facility transfers, and helped to improve patient flow across the continuum of the healthcare system.
EMS has enacted new guidelines which allow paramedics to assess and treat a patient, without necessarily transporting to hospital. Patients are provided options for alternative care as well as referrals, if they do not need transport to a hospital or Urgent Care Centre.
This supports our emergency and acute care teams in suggesting non-ambulance alternative transport options to move patients who are medically stable, and ready to return home or to another care environments. This was announced in December 2022 and has been implemented.
A new inter-facility transfer program has put 10 additional IFT ambulances on the road to support the transfer of stable patients between facilities.
These new ambulances have improved IFT on-time performance, helping to ease capacity pressures at Red Deer Regional Hospital Centre. By providing more transportation options to move IFT patients, this has kept other EMS resources freed up to respond to emergency calls. This has increased ambulance availability by 28% and reduced emergency response times in some communities by over four minutes.
EMS has accepted the recommendations of the Minister's Advisory Council on Emergency Medical Services in Alberta (AEPAC).
To strengthen the quality and delivery of MFR in communities across the province, EMS is working to enhance collaboration with stakeholders to seek input and contribute to process improvements. In partnership, we are designing MFR response plans that are right for local communities. We are hiring dedicated staff to support increased engagement with EMS, increased funding for Direct Financial Support and Equipment and Training of $3.85 million distributed directly to enrolled MFR agencies to help strengthen emergency medical services across the province.
By collaborating with partners to tailor local response plans where MFR is appropriate, and skills are maximized, we are increasing opportunities for inter-professional training and ensuring residents have access to high quality services when and where they need it.
