British Columbia Ambulance Service. Helping Save Lives. Annual Report 09/10

Transcription

1 British Columbia Ambulance Service Helping Save Lives Annual Report 09/10

2 Table of Contents Table of Contents Table of Contents Message from the Chief Operating Officer...3 About Us...4 Top Stories from the Year...6 BCAS Key to Success of 2010 Vancouver Winter Olympic and Paralympic Games... 6 Responding to H1N Driving Innovation... 8 Labour Dispute... 8 NETCAD... 9 Services BCAS Emergency Event Response Process...10 Dispatch...11 Basic Life Support...12 Advanced Life Support...13 Air Ambulance...14 Critical Care Transport...15 Infant Transport Team...15 Special Operations...16 Inter-facility Transfers...17 Medical Programs...17 Emergency Planning...18 Public Education Vital Link and Good Samaritan Programs...19 P.A.R.T.Y. Program...20 ACT High School Program...20 Statistics /10 Total Event Volume by Region...21 Historical Provincial Event Volumes...22 Delta / Echo Event Volumes 2009/10 by Region...22 Air Ambulance Program...23 Dispatch/Communications Centres...23 BCAS Fleet...24 BCAS Stations...24 Fees...25 BCAS Gross Expenditures

3 Message from The Chief operating officer I am proud to be able to present the 2009/10 Annual Report for BC Ambulance Service (BCAS). Without question, the past year held many challenges for BCAS, yet we are now positioned to move into the future. BCAS endured a seven month long labour dispute with CUPE Local 873. The lengthy strike and its inherent difficulties had a profound impact on BCAS; however, I am pleased to say that our patients remained our top priority. Following the conclusion of the labour dispute, BCAS has gone through a period of recovery and is now focused on moving forward and capitalizing on the opportunities ahead. The H1N1 flu pandemic had a mild impact on the population of British Columbia in the Fall of 2009 and early Spring of The BCAS reaction to the pandemic demonstrated our organizations ability to quickly adapt to challenges and the importance of our emergency preparedness work. In February and March, British Columbia was host to the 2010 Winter Olympic and Paralympic Games. As the sole provider of ambulance services to the Games, this event truly was a highlight in our services history and for all staff involved. In 2009/10, BCAS also moved forward with improvements to the technologies in our Dispatch centres and in our ambulances. BCAS also made improvements in our ambulance vehicle design to help improve the care paramedics can deliver from the ambulance. I am proud to be able say that, despite the many challenges faced by BCAS in 2009/10, through the dedication and commitment of staff, we continued to deliver high quality ambulance services and can be proud of our performance supporting the 2010 Winter Olympic and Paralympic Games. As we go forward in 2010/11, we continue to focus on the opportunities ahead and the areas of our Service that we can positively impact. Les Fisher Chief Operating Officer 3

4 About Us BCAS strives to provide timely and high quality emergency medical services by caring for our patients and staff, providing creative solutions for changing health care needs and collaborating with our partners in the health care system and community. Created in 1974, the BC Ambulance Service (BCAS) operates under the authority of the Emergency and Health Services Commission (EHSC) and is tasked with the provision of public ambulance service across the Province. Today, BCAS is the largest provider of emergency medical services in Canada and one of the largest in North America. BCAS serves over 4.4 million British Columbians and responds to calls for service across six health authorities covering 944,700 square kilometres. In 2009/10 BCAS paramedics responded by ground to 478,958 events 372,106 pre-hospital (911) events, and 106,852 inter-facility transfers. BCAS also transported an additional 8,209 patients by air ambulance. BCAS employs 3,982 individuals 3,639 paramedic and dispatch staff, 205 support staff and 138 excluded management staff. BCAS operates from 186 ambulance stations, five administration offices, and three Dispatch centres. BCAS has a fleet of 535 vehicles, including 483 ambulances and 52 support vehicles. BCAS also has a fleet of nine dedicated ambulance aircraft. 4

5 About Us BCAS Operations are organized into four regional service delivery areas as well as Provincial Programs (air ambulance, fleet, emergency management, scheduling) and dispatch/communications. Dispatch / Communications Within Dispatch / Communications there are three regional centres, the Interior and Northern Region Dispatch / Communications Centre located in Kamloops, the Lower Mainland Region Dispatch/Communications Centre located in Vancouver and the Vancouver Island Region and Provincial Air Ambulance Dispatch / Communication Centres in Victoria. Together the three locations receive, assess and dispatch all ambulance and air ambulance requests. Provincial Programs Within Provincial Programs are four speciality program areas: Provincial Scheduling, Emergency Management Office, Fleet Operations, and Air Ambulance and Critical Care Transport. 1 Vancouver Island Region BCAS Vancouver Island Region serves the residents of Vancouver Island as well as the Gulf and Discovery Islands. The Vancouver Island Region includes 44 ambulance stations, the BCAS Vancouver Island Region Administrative Office and BCAS Provincial Headquarters, both located in Victoria. 3 Interior Region BCAS Interior Region also serves a large geographic area, which ranges from densely populated to scarcely populated areas. The Interior Region stretches from Williams Lake to the U.S.A. border and from Anahim Lake in the Chilcotin to the Alberta border. The Interior Region includes 62 ambulance stations and the BCAS Interior Region Administrative Office, located in Kamloops. 2 Lower Mainland Region BCAS Lower Mainland Region is characterized by communities with high population densities. The region serves the 604 and 778 area codes and stretches from the USA border, east to Manning Park and north to Boston Bar. The region also serves the Howe Sound corridor to Pemberton and the Sunshine Coast. The Lower Mainland Region includes 46 ambulance stations and the BCAS Lower Mainland Region Administrative Office located in Vancouver. 4 Northern Region BCAS Northern Region covers almost two-thirds of B.C., and is bordered by the Northwest and Yukon Territories to the north, the B.C. Interior to the south, Alberta to the east, and Alaska and the Pacific Ocean to the west. The Northern Region includes 34 ambulance stations and is home to the BCAS Northern Region Administrative Office located in Prince George. 5

6 Top Stories From the Year BCAS Key to Success of 2010 Vancouver Winter Olympic and Paralympic Games As the dust settles on Vancouver and Canadians reflect on what has been described as a redefining moment in our collective history, BCAS can only be proud of the role it played in the tremendously successful 2010 Vancouver Winter Olympic and Paralympic Games. When the Olympics were first awarded to Vancouver in 2003, BCAS was quickly identified as an integral part of the medical services plan. That being said, providing ambulance service at dozens of venues and coordinating with local and international partners, all in the midst of unprecedented crowds was uncharted territory for BCAS. Further complicating the role was the challenge of finding solutions that would span the large geographic area of the Games and last through 17 days of Olympic competition and 10 days of Paralympic competition. Reflecting on the service provided, it is clear that BCAS met these challenges head on. Throughout February, the overall regional event volume increased 10% over the same period last year, an increase of 1,530 events. The greatest increase in events occurred within the City of Vancouver. In Vancouver the event volume was up 1,040 events, representing approximately 68% of the total increase in events throughout the region. Inside the security perimeters of the Olympic venues, there were a total of 183 events requiring ambulance response, and a total of 136 patients transported to either a hospital or to one of the Games-time polyclinics. By anticipating an increase in demand and dedicating additional ambulance resources to the competition venues as well as public areas, BCAS was able to maintain its response time performance for the most urgent or life threatening calls. BCAS also prepared for the Games with the early arrival of 65 new ambulances, the temporary addition of two air ambulances, the purchase and lease of ambulance Gators to navigate the heavy crowds, and increased Chemical, Biological, Radiological and Nuclear (CBRNE) capabilities. In addition, BCAS implemented a pilot program where BCAS physicians assisted with triage in dispatch to help deal with the increased demand. BCAS also integrated more closely with local, provincial, federal and international security and health partners. These partnerships provided direct communication channels and needed situational awareness. The hard work and dedication of the paramedics, dispatchers, managers and support staff who worked tirelessly planning for and during the Games ensured that athletes, visitors, spectators and British Columbians received high quality ambulance services during the Games. 6

7 Top Stories From the Year Responding to H1N1 The H1N1 pandemic in the Spring and Fall of 2009 had a moderate impact on the population of B.C. Within BCAS, every reasonable measure was taken to keep frontline paramedics and all BCAS employees safe, healthy and ensure that staff did not contribute to the spread of disease. Key elements of BCAS H1N1 readiness included; achieving a high degree of paramedic compliance regarding the use of personal protective equipment (PPE); effective cleaning, decontamination and hand-washing procedures; and uptake on vaccinations. This was accomplished by providing: information on the status of the H1N1 outbreak; appropriate PPE for paramedics; a comprehensive training package; opportunities for all paramedics to get vaccinated protocols on vehicle cleaning and station cleaning; and information for all staff regarding infection control measures at work and at home. In addition, a dedicated training course, Occupational Safety and Health (OSH) 5: Response to H1N1 Human Swine Flu was created by BCAS paramedics, Medical Programs, and OSH staff and provided to paramedics. This training included: identifying and recognizing risk; protecting self and others from infectious disease; and applying new procedures and treatment guidelines to respiratory infection and risk. 7

8 Top Stories From the Year Driving Innovation One hundred new ambulances were purchased from Demers Ambulance in 2009/10, as part of BCAS fleet replacement program. These ambulances are unique in that they were designed with input from frontline BCAS paramedics and include new features and improvements to better support paramedics and patient care. The most notable enhancements include extra room in the ambulance, additional stretcher positions and a quieter engine. BCAS previous design included large fender skirts over the wheels. By trimming these down BCAS was able to widen the actual body of the ambulance by six inches. Each ambulance is now fitted with three stretcher position options, improving paramedic ergonomics and patient care. Other innovative design components include: the console being integrated in the control panel, a new lateral style double door including a unique slider, and a LED type emergency light system. BCAS also invested in an upgrade to in-vehicle technology, supplying GPS units for every ambulance in the BCAS fleet. In the past, paramedics unsure of a call location worked with Dispatch to get more information and/or referenced a map book provided in each ambulance. GPS technology helps paramedics find the call location, and determine the best driving route, reducing the chance of delay. Labour Dispute 8 In 2009/10 CUPE Local 873, the union representing paramedics went on strike beginning April 1, The strike was settled November 7, 2009 by back to work legislation. As an essential service, BCAS and paramedics continued to provide essential ambulance services to the public throughout the dispute. Although frontline ambulance services were essential and continued to be provided a number of projects, initiatives and back office processes such as ambulance billing, paramedic training, and technology changes were negatively impacted by the strike. As part of the conclusion to the strike, government appointed an Industrial Inquiry Commission to review the service and labour relations structure. That report provided a number of options on future service delivery models. Government undertook a consultation in February 2010 on the three main options identified, and announced in March 2010 that a provincial health model would be retained and that BCAS would transition to the Provincial Health Services Authority (PHSA).

9 Top Stories From the Year NetCAD Supporting the work of BCAS is a network of telecommunication and technology platforms. This year, BCAS continued to work to consolidate and optimize information technology and information management systems to provide frontline paramedics, managers and administrative employees with improved tools and information, while laying the foundation for future enhancements. By the Summer 2010, BCAS will have made the final installment in its Dispatch/ Communications Centres and all three centres will run on NetCAD, a consolidated, full function platform designed to improve the communication of event and resource information among all Dispatch centres, field paramedics and first responders. Having all Dispatch centres on a common computer platform allows each Dispatch centre to act as a back-up for another in the event of a technical failure, facility issue, or other incident. Created to meet current day-to-day business needs, while improving communications between centres, the system enables the use of new technologies such as Automated Vehicle Location (AVL) monitoring and mobile data terminals. The increased use of technology through NetCAD also helps reduce unnecessary manual processes and contributes to enhancements in real-time operational analysis and reporting. 9

10 Services BCAS handled over a million incoming calls, dispatched 624,384 ambulance resources and responded to 372,106 pre-hospital and 106,852 transfer events across the province in 2009/10. When a patient requires ambulance services, BCAS receives the call(s), responds with the necessary ambulance resource(s) and ultimately manages the emergency or transfer event. Events represent the unique demand for ambulance services so BCAS uses this metric most often when discussing demand volume. BCAS Emergency Event Response Process The diagram below illustrates the roles and actions involved in responding to a typical emergency event. 10

11 Services Dispatch BCAS response to pre-hospital medical emergencies and interfacility patient transfers begins with BCAS Emergency Medical Call Takers (EMCTs) and Emergency Medical Dispatchers (EMDs) in BCAS Dispatch/ Communication Centres. These dedicated professionals gather critical information from the caller and using internationally-recognized protocols, assess and triage the incoming calls. BCAS categorises events as: work with First Responders, Search and Rescue Teams, and Police to ensure the right people and resources are on scene. Based on the call categorization and the resources available in the community, BCAS then dispatches the most appropriate ambulance and paramedic resources. BCAS EMCTs and EMDs also Not only will the call categorization determine the type of crews that are dispatched but also the urgency in which crews needs to arrive. In Urban and Metropolitan communities, BCAS aims to arrive within 9 minutes for calls categorized as Delta/Echo. Chris Iregui EMCT Station Lower Mainland Regional Communications Centre (LMRCC) 2 ½ years with BCAS Can you tell us a bit about your role? As an Emergency Medical Call Taker (EMCT), I have a role that empowers me to help more people in a single day than I could ever have imagined. I am the first voice of help when people are in need; sending the paramedics and providing life saving instructions to my callers. What is the best part of being part of BCAS LMRCC? The best part of being a member of the LMRCC aside from my role as an EMCT is the teamwork and support we give each other. If you weren t working for BCAS where would you be? If I wasn t working for BCAS I would have continued in my previous career in Information Technology, as well as teaching technologies at the college level. What s the worst thing about the job? When asked what the worst thing about my job is, I struggled to find an answer. It s a great job. The downside is at times struggling with the emotions when tragedy strikes the young and innocent and it is my voice maintaining calm and providing reassurance during the early stage of their crisis. 11

12 Services Basic Life Support The most common ambulance service provided by BCAS is Basic Life Support (BLS). BLS paramedic crews provide care for medical emergencies and traumatic injuries. Emergency Medical Responders (EMRs) and Primary Care Paramedics (PCPs) provide this service. Patricia Thompson PCP IV endorsed Station Quesnel 23 years with BCAS Can you tell us a bit about your role? I am a Primary Care Paramedic (PCP) and provide Basic Life Support (BLS) ambulance services throughout the community and neighbouring areas. My role at the station includes Paramedic, Safety Officer, and Acting Unit Chief. Working as an EMR is an entry-level community focused position that is ideal for people who live and work in a rural or remote area and have a desire to make a difference. BCAS employs EMRs on an on-call, part-time basis. The majority of paramedics working across B.C. work as PCPs and have chosen paramedic practice as their profession. They work in both full-time and part-time positions in rural and larger communities. What is the best part of being stationed in Quesnel? I grew up in Quesnel on a third generation cattle ranch. Not only did I go to school here, but my mom also did and now my kids do to. I enjoy having a connection to the people I serve. I love our town and its history. Tell us about a memorable call. I can recall many memorable calls! Some very funny, some very satisfying, some incredibly sad, some terrifying. I remember events with partners I have worked with that have bonded us. I think I will write a book one day. 12

13 Services Advanced Life Support When more advanced care is required, BLS paramedic crews can be supported by Advanced Life Support (ALS) paramedic crews. ALS ambulances are staffed by Advanced Care Paramedics (ACPs) who receive additional training which enables them to perform more advanced emergency care procedures. BCAS staffs ALS ambulances in Victoria, Nanaimo, Vancouver, Abbotsford, Chilliwack, New Westminster, Surrey, North Vancouver, Richmond, Kelowna, Kamloops and Prince George. Darren Waller ACP Station Kamloops 18 years with BCAS Can you tell us a bit about your role? I am an Advanced Care Paramedic (ACP), and work to provide Advanced Life Support (ALS) ambulance services in Kamloops. My role involves responding to calls designated Highest Level Available by our dispatch centre. These types of patients are in serious condition. As an ACP, I am able to provide more advanced interventions involving medications, advanced therapies and patient monitoring. What is the best part of being stationed in Kamloops? The best part of being stationed in Kamloops is the unusual variety of work. Often our calls take us into rural or remote locations, interacting with BLS crews which allows us to mentor more than we would be able to in metropolitan areas. Another benefit to being stationed in Kamloops is the lifestyle opportunities which exist here. Tell us about a memorable call. I think my most memorable call would be shortly after I started as a part-time paramedic and our station was issued its first defibrillator (AED). We responded to a local bank in our small town for a patient who was in cardio/respiratory arrest. After numerous defibrillations, we successfully resuscitated the man. A few months later the patient thanked us during an awards ceremony. This call reinforced for me that I had picked a rewarding career. As an ACP, I am able to provide more advanced interventions involving medications, advanced therapies and patient monitoring. 13

14 Services In addition to BLS and ALS emergency ambulance services, BCAS provides a number of specialty services including the following: Robert Wand Airevac Unit Chief Station YVR 23 years with BCAS Can you tell us a bit about your role? I am the Unit Chief responsible for the air ambulance teams. I am responsible for making sure the flight paramedics are trained in the latest in critical care and trauma medicine and am also involved in moving BCAS forward with new initiatives. Air Ambulance BCAS Air Ambulance Program provides the critical transportation linkages between accident scenes, hospitals and referral centres across the province for patients requiring more specialized care than what is available in their local community. Operating from three flight centers located in Vancouver, Kelowna and Prince George, the Air Ambulance Program employs a total of six dedicated fixed wing airplanes (three based in Vancouver, two based in Kelowna and one based in Prince George), and three dedicated helicopters (two based in Vancouver and one based in Prince Rupert). BCAS also employs approximately 40 charter carriers throughout B.C. BCAS Air Ambulance program employs highly skilled, advanced care, critical care and infant transport paramedics who have received aviation training. I am thankful to be part of a team that can help patients and their families. What is the best part of being part of BCAS Air Ambulance Team? I work with a highly trained and specialized team that makes a difference in people s lives during their most stressful time. I am thankful to be part of a team that can help patients and their families. Tell us about a memorable call. The most memorable time for me was my involvement in the 2010 Vancouver Winter Olympics. I actually got to help Petra Madjic, the Slovanian bronze medalist in cross country skiing up onto the Olympic podium to receive her medal after she had been injured earlier in the day. 14

15 Services Critical Care Transport In 2009/10 BCAS operated two ground based Critical Care Transport (CCT) Teams: one in Kamloops that operates throughout the Thompson, Cariboo and Shuswap areas, and another in Trail, that operates throughout the east Kootenay Boundary area. These ground based CCT teams provide highly-specialized care and long-distance transport between health facilities for critically ill or injured patients. They enable community physicians and nurses to stay in the community while paramedics still provide specialized patient care. We truly all work together as a specialized team to provide the best care for our patients. Infant Transport Team BCAS has specialized teams that work with paediatric, neo-natal and high-risk obstetrics patients. All paramedics serving on the Infant Transport Team (ITT) complete a specific training program focused on providing care to children, and the advanced skills specific to those patients. In addition, ITT paramedics liaise with specialist physicians who provide support and guidance. Formed in 1976, BCAS ITT is one of only two paramedic units of its kind in the world. Trish Fryer ITT Paramedic Station Vancouver 20 years with BCAS Can you tell us a bit about your role? As a member and recent graduate of the specialized Infant Transport Team Program, my role is to provide emergency medical care to neonates, paediatrics, youth and high-risk obstetrics patients throughout the province. My job requires me to fly around the province but I also respond to street calls when available in Vancouver. What is the best part of being a member of the Infant Transport Team? The best part of being a member of the Infant Transport Team is the team work and collaboration that exists between my colleagues, doctors, nurses, respiratory therapists, and the staff at BC Women s and Children s Hospital. We truly all work together as a specialized team to provide the best care for our patients. If you weren t working for BCAS where would you be? Most likely I would be working in some capacity in the same line of work. What s the worst thing about the job? The shift work. It wasn t so bad when I was younger but after 20 years, the nights seem to get more and more difficult to recover from. 15

16 Services Special Operations In addition to providing emergency medical and non-emergency transport services, BCAS also offers contracted paramedic services at major public, international and professional sporting events, movie sets and community fairs. As part of this service, BCAS deploys paramedics on bicycles and small all terrain vehicles, known as Gators, when large crowds can limit access and speed of response for normal ambulance vehicles. BCAS was one of the first North American Emergency Medical Services agencies to organize and deploy paramedics on bicycles. The Special Operations Unit which oversees the bike squads was first implemented in Victoria in BCAS bike squads currently operate in Vancouver, Victoria, and Kamloops, as well as their neighbouring communities when required. Jana Hargreaves PCP Paramedic Station 264, Vancouver Special Operations 13 years with BCAS Can you tell us a bit about your role? I currently work in the Planning Section of Special Operations. This job entails meeting with special event groups and city hall representatives, completing risk assessments, estimates, contracts, crew schedules and developing operational plans. If you weren t working for BCAS where would you be? During my part-time years, I worked in Parks and Recreation. I loved being outdoors and working with the youth in my hometown community of Port Alberni. I think I would continue on in that field if I wasn t working for BCAS. Can you tell us about a memorable event? In June 2007, the International Triathlon Union World Cup was held in the West End of Vancouver. The weather conditions for this event were not favourable with water temperatures for the swimming leg being extremely low. Numerous participants had to be pulled from the water and out of the race due to complications resulting from hypothermia. The impact of this sort of event on downtown operations and the 911 system is tremendous. It was incredible to see how successfully the BCAS Special Operations crews were able to adapt to the conditions and help make the event a success. What s the worst part about the job? I can t really think of anything that I don t like about being in this position. I feel fortunate to have had the opportunity to be involved with this department. 16

17 Services Inter-facility Transfers BCAS also coordinates and completes inter-facility patient transfers. Patient transfers are managed through BCAS Communications/Dispatch Centres, who assign both ground and air ambulances to patient transfer requests from health care facilities. A number of private patient transfer operators also provide non-medical patient transfers under contract with Health Authorities. These non-medical transfers are restricted to stable patients who do not require the skills of a paramedic during transport. Medical Programs BCAS employs its own Medical Programs Division which is responsible for: paramedic medical oversight including policy, patient care and real-time advice; performance management; ongoing education; and research. Working within the team are physicians, educators, researchers and paramedics. BCAS is undertaking a fundamental change in the approach to patient care through the transition to new Treatment Guidelines, a combination of best practice and evidencebased medicine designed to better equip paramedics to make informed decisions in the field. BCAS is steadily increasing the ability to provide paramedics with timely and accurate performance information and feedback to ensure continuous improvement and patient safety. Continuing medical and workplace education is part of BCAS effort to improve paramedic safety and enhance the quality of service delivered. BCAS delivers courses in both face-toface and online formats. Courses are focused in the following general categories: Patient Care, Paramedic Safety, Leadership, Dispatch, Regional Initiatives, Orientation, Work Tools and Emergency Management. BCAS participates in and uses research to ensure patient needs are being met in the most effective and efficient manner possible. Of note is BCAS participation in the Resuscitation Outcomes Consortium, which is focused on research in the area of pre-hospital treatment of cardiac arrest and severe traumatic injury. Paul Leslie Projects Director, Medical Programs Provincial Headquarters - Victoria 28 years with BCAS Can you tell us a bit about your role? I facilitate initiatives that relate to paramedic practice. When our medical experts determine that a new skill or new piece of medical equipment should be deployed into the field it falls to me to make sure all of the elements of implementing the initiative are included, from education, communications, quality improvement and operations. I also maintain the Treatment Guidelines which govern, support and guide what paramedics do. What is the best part of being part of the medial programs team? I work with a brilliant group of physicians who are experts in emergency medicine and totally committed to supporting paramedic practice as an essential component of health care. What s the worst thing about the job? Being stuck in the office. I had my fair share of excitement, 20 years worth, and I m okay with leaving the running around to those younger than me but I do miss the street. 17

18 Services It s a 24/7 hands on type of job and there is always something to do training, coordinating, monitoring, advising BCAS crews on the ground to maintain safety. Emergency Planning BCAS Emergency Management Office (EMO) is responsible for emergency planning, mock disaster exercises, and other joint training initiatives to ensure disaster preparedness and response capabilities. This includes BCAS Chemical, Biological, Radiological, and Nuclear (CBRNE) response team and Technical Advisors (TA) who, in conjunction with the Regional Dispatch Centers, provide direction and advice regarding hazardous substances. During major events, the EMO supports the organization by ensuring that a solid emergency management framework is in place. Rene Bernklau BCAS Provincial Coordinator Hazardous Substance Response & CBRNE Technical Advisor Provincial Emergency Management Office 28 years with BCAS Can you tell us a bit about your role? I lead the BCAS Technical Advisor (TA) program, a one of a kind safety program. I work with BCAS managers, dispatchers and responding crews to ensure overall scene and paramedic safety. What makes working in the Emergency Management Office unique? My job is unique because I assist Health Authorities, Hospitals, Fire Departments, Police Departments, Haz Mat Technologists, and many scientific specialists in responding to events with unique hazards. Can you describe a typical shift? It s a 24/7 hands on type of job and there is always something to do training, coordinating, monitoring, advising BCAS crews on the ground to maintain safety and also responding to emergency events. What part of your job to you enjoy the most? Being the on-duty TA and working through responses with our front line paramedics, dispatchers, and supervisors to provide a safe and intelligent response, as well as assisting the patients and receiving hospitals to prevent further injuries or contamination. 18

19 Public Education BCAS participates in community programs focused on improving the ability of the public to react in emergency situations. BCAS believes education about emergencies is an important part of patient care and the prevention of health emergencies. Vital Link and Good Samaritan Programs Support provided by quick thinking members of the public can often mean the difference between life and death for patients. Whether performing bystander CPR, providing critical information to dispatchers or assisting paramedics on scene, British Columbians are an important link in the health care system. To recognize the significant contributions made by citizens during medical emergencies, BCAS supports two community award programs: the Vital Link Award and the Good Samaritan Award. The Vital Link Award is presented to citizens who are involved in saving a life through successful cardio-pulmonary resuscitation (CPR) efforts. The Good Samaritan Award is presented to individuals who have provided unselfish and humanitarian assistance during a medical emergency. It is BCAS hope that by recognizing contributions and reinforcing the importance of bystander support, similar behaviour will be encouraged. 19

20 Public Education P.A.R.T.Y. Program Together with local partners, BCAS is helping educate B.C. youth about how to stay safe through the P.A.R.T.Y. Program (Prevent Alcohol and Risk-Related Trauma in Youth). P.A.R.T.Y. is a one-day, in-hospital, injury awareness and prevention program designed to reduce death and injury due to alcohol, drug and risk-related behaviours. Open to students ages 16 and older, participants follow the path of a trauma patient from the time of injury until discharged from hospital. During these sessions, paramedics hold a mock-crash demonstration and describe in detail the process they go through when they attend a serious motor vehicle collision. The program is structured to bring them face to face with the consequences of risky behaviour. ACT High School Program Cardiovascular disease is the second leading cause of death in B.C., accounting for more than one fifth of all deaths in the province. Research shows that a cardiac arrest victim is four times more likely to survive if CPR is administered by a bystander while paramedics are enroute to the scene. With most out-of-hospital cardiac arrests occurring at home, early recognition of a cardiac emergency by a family member, early access to medical help (calling 911) and early citizen CPR are critical to saving lives. Students in B.C. are becoming well-versed in this life saving skill, thanks to the High School CPR Program, an initiative aimed at establishing CPR training in every secondary school in B.C. by The program is made possible through a unique partnership between BCAS, the Advanced Coronary Treatment (ACT) Foundation (a national charitable organization dedicated to school-based CPR) and CUPE Local 873. By the end of the 2009/2010 school year, the High School CPR Program will have trained an estimated 40,000 students in CPR. 20

21 Statistics 2009/10 Total Event Volume by Region The 2009/10 figures reported include impacts resulting from the seven months of CUPE Local 873 paramedic job action and providing ambulance service to the 2010 Winter Olympic and Paralympic Games. Pre-Hospital Events by Region Patient Transfers by Region Event Types The most common emergency calls attended by BCAS paramedics include falls/back injuries, traffic accidents, sick person (no specific diagnosis), unknown problem (man down), breathing problems, chest pain and unconscious/fainting. 21

22 Statistics Historical Provincial Event Volumes From 2005/06 to 2009/10, demand for services has fluctuated with overall demand decreasing by 1.9 per cent. In the five year period from 2005/06 to 2009/10 pre-hospital events increased 5.5 per cent, from 352,595 to 372,106 and patient transfers decreased 21 percent from 135,694 to 106,852. The large decrease in patient transfers is a result of Health Authorities developing alternate transfer management strategies for low acuity patients who do not require paramedic care. Delta / Echo Event Volumes 2009/10 by Region BCAS is taking action to ensure life-threatening calls are prioritized by implementing call prioritization strategies, reducing emergency department delays, investing in dispatch technology, utilizing first responder resources, realigning patient transfer responsibilities and adding additional ambulances where needed. BCAS is dedicated to providing high quality and timely patient care. In Urban and Metropolitan communities, BCAS is striving to meet its target of less than 9 minutes for those calls that are the most serious (Delta/Echo). Call Location / Region: Events: Average Response Tme: % < 9 min: Call Location / Region: Events: Average Response Tme: % < 9 min: Northern 4,164 10min 28sec 58.5% Interior 11,457 10min 50sec 53.5% Call Location / Region: Events: Average Response Tme: % < 9 min: Lower Mainland 48,323 10min 33sec 47.4% Call Location / Region: Events: Average Response Tme: % < 9 min: Vancouver Island 13,478 9min 21sec 60.6% 22

23 Statistics Air Ambulance Program Through BCAS Air Ambulance Program, residents of B.C. are able to access needed care that is hundreds of kilometres away in just a few hours, or reach a trauma centre in only minutes. The BCAS Airevac and CCT Program is the second busiest provider of air transport in North America. Rotary (Helicopter) Hours Flown: 2,339 Fixed Wing (Plane) Miles Flown: 2,515,649 Air Ambulance Call Volume BCAS Dispatch/Communications Centres BCAS response to emergency events begins in one of three Dispatch/Communications centres. Lower Mainland Dispatch Communications Centre Dispatches ambulances to over 30 communities in some of the province s most densely populated areas On average, receives 1,700 calls and makes 1,100 calls on a daily basis Vancouver Island Dispatch Communications Centre Dispatches ground based ambulance resources to all of Vancouver Island, Powell River and the surrounding Gulf Islands On average, receives 600 calls and make 350 calls a day Also responsible for coordinating and providing provincial air and ground CCT transports. Interior / Northern Region Dispatch / Communications Centre One of the largest geographical Dispatch/Communications centres in North America, the centre is responsible for dispatching ambulances in 98 communities throughout Interior and Northern B.C. On an average receives 800 calls and makes 500 calls a day 23

24 Statistics BCAS Fleet Total Ambulances/Total Support Units BCAS ambulances travelled over 20 million kilometres in 2009/10. In addition to ground ambulances and supervisory support vehicles, BCAS also has a fleet of bicycles and Gators which are used at large public events and a fleet of Medical Support Units which are used during major incidents to support paramedics and other emergency responders. BCAS Stations BCAS has 186 ambulance stations plus additional facilities which house: Provincial Headquarters in Victoria 3 Regional Dispatch Centers (Victoria, Vancouver and Kamloops) 4 Regional Offices (Victoria, Vancouver, Kamloops, and Prince George) 10 local offices for Superintendents (Campbell River, Castlegar, Chilliwack, Cranbrook, Dawson Creek, Kelowna, Parksville, Smithers, Kelowna airport and Vancouver airport). Station Designation BCAS ambulance stations are classified as Metropolitan, Urban, Rural or Remote. Station classification is dependent on call volumes, geography, remoteness, proximity to other ambulance stations and health authority designation of facilities that are in the area. 36 Metropolitan stations are staffed 24 hours per day by full-time paramedic crews. 35 Urban stations are also staffed 24 hours a day, but use a combination of full-time and stand-by paramedics. 50 Rural stations are staffed using a stand-by model, where paramedics are paid a reduced rate to stand-by at the station ready to respond. When they respond to a call, they are paid their full hourly wage. 65 Remote stations are staffed similar to volunteer fire departments where paramedics are called to respond by pager. 24

25 Statistics Fees While BCAS fees are not an insured benefit under the BC Medical Services Plan (MSP) or the Canada Health Act, fees are heavily subsidized for persons with a valid BC Care Card who are covered by MSP (known as MSP Beneficiaries). The fee for ambulance service is $80. Fee Schedule MSP Beneficiaries 911 Ambulance Transport: when an ambulance is requested and a patient is transported. $80 flat fee - ground or air Net Revenue to Government Ambulance Fees $19.23 million MSP Beneficiaries - Inter-Hospital Transfers: when a BC Ambulance transports a patient between hospitals. $0 Non-MSP Beneficiaries All the above ambulance transport/transfer categories: persons with no valid BC Care card e.g. visitors to BC/non-residents, as well as work related injuries, claims under RCMP, and other federal agencies. $530 flat fee - ground service $2,746 per hour - helicopter $7 per statute mile - airplane Beneficiaries and Non-MSP Beneficiaries 911 Response Fee: when an ambulance is requested to a residence/workplace but transportation is not required/refused. $50 flat fee *Exemptions and Bills paid by other agencies - MSP Premium Assistance and Income Assistance Clients are exempt from ambulance fees. The Department of Veteran Affairs (DVA) and Indian and Northern Affairs Canada (INAC) also cover some ambulance fees for their clients. 25

26 BCAS Gross Expenditures * Total expenditures include onetime extraordinary costs of labour dispute and ambulance service to 2010 Winter Olympic and Paralympic Games. ** Corporate Services includes Finance, Human Resource, Communications, Legal & Policy, Occupational Safety and Health and Medical Program costs. 26

27 BC Ambulance Service Location PO Box 9600 Stn Prov Govt VICTORIA BC V8W 9P1 Mailing Address Block C 2261 Keating Cross Road SAANICHTON BC V8M 2A5 Website

28