During a regular meeting on Nov. 7, Airdrie city council members heard an update on Alberta Health Services’ (AHS) Emergency Medical Services (EMS) operations in Airdrie, including statistics on resources, response times and the number of ambulances serving the community.
The information was presented to council by AHS’ EMS operational leadership team, Randy Bryksa, associate executive director of EMS Operations in the Calgary Zone, and Chris Baker, operating manager for EMS in the Calgary Zone.
The presentation brought with it some concerns for both Mayor Peter Brown and councillors regarding ambulance response times in the city. For many, the statistics underscored local advocacy efforts regarding ambulatory response times in recent years.
Bryksa's presentation provided insight on EMS resources, call volume, and availability in Airdrie, while also looking at the communities and areas served by Airdrie's ambulances and their transport destinations.
The presentation also highlighted current EMS response times for life-threatening 9-1-1 calls, as well as challenges for and mitigation strategies faced and mitigation strategies employed by the public health authority.
Bryksa said he also hopes to address some of the concerns voiced by Airdrie's mayor and council and to look and lobby for areas and opportunities to improve following the presentation.
“Just recently, we’ve added three basic life support ambulances,” Bryksa said. “This is to support the transfers out of the Airdrie Urgent Care Centre (AUCC) and along the Highway 2 north corridor. This will allow us to keep our emergency resources in community.”
In addition to the recent ambulances, Airdrie is home to three 24-hour Advanced Life Support ambulances, and one 12-hour Peak Advanced Life Support ambulance, according to Bryksa.
He added other health services available to residents include the 24-hour AUCC, as well as emergency medical aid provided by Airdrie Fire Department (AFD), and STARS air ambulance support/response units.
Furthermore, he said there are more than 16 registered automated external defibrillators (AEDs) in the community through AHS’ Alberta Public Access to Defibrillation (PAD) program to increase survival from sudden cardiac arrest.
Since making changes to EMS’ response plan, Bryksa said from April 1 to Sept. 30 of this year, many of these resources are now staying within the community.
“Airdrie is now doing about 10 per cent greater of their own call volume,” Bryksa said. “The City of Calgary is only responding in to the community 20 per cent of the time, so eight per cent less.
“Which we see as a very positive sign that the resources are remaining in community.”
Comparing this year to last year’s fiscal year, Bryska said the overall call volume has remained “relatively static.”
"Our call volume in total is 5,044 for the previous fiscal year,” he said. “Data from the [last] two quarters remains relatively the same.”
However, he noted the health authority has seen a “slight uptick” in call volume, which is consistent with what AHS is seeing across the province and in other health zones.
He said the Calgary zone has decreased the number on average per week an Airdrie resource was responding to a call in Calgary from 131 times to 83 times per week. According to the associate executive director, from April 1, 2021 to March 31, 2022, Airdrie units were attending Calgary emergency calls 62 per cent of the time, which he added was a “very alarming and concerning” statistic.
“[This year], we’ve reduced that down to 45 per cent. We’ve seen almost a 30 per cent decrease in frequency of ambulances coming in that start and stop out of Airdrie coming in to service Calgary,” he said. “That was a major concern for this mayor and council [previously] and we acknowledge that and the subsequent change.”
He said though instances of Airdrie ambulances reporting to Calgary calls still occur regularly, the overall frequency has been reduced compared to 2021.
Bryksa added EMS has aldo done “fairly aggressive” work with the AUCC to increase the number of transports to Airdrie where appropriate for the patient population.
“Two years ago, we were transporting to AUCC up to 967 calls,” he said. “For this year (2021-22), we’ve increased that by over 300 calls and we’re seeing a very positive response.”
On the flip side, Bryksa said though EMS is transporting more patients to the urgent care centre, they are not transporting as many out of AUCC.
“That tells us what we’re seeing is the appropriate patients are being transported to the AUCC,” he said, adding the aim is to keep the resources that start and stop in Airdrie, in the community.
Though he remarked on some areas of improvement, Bryksa said EMS continues to experience problems meeting their target response times in the city, with eight minutes median, and 12 minutes at the 90th percentile.
For life-threatening events, Bryksa said response times have increased and are “creeping up slowly in all areas.”
“At the 90th percentile, we continue to struggle and see that primarily because of resources being out of community based on our system model at this point,” he said.
He added EMS continues to work on this area specific to the AUCC and to the Metro Response Plan to determine areas where the health authority can add resources.
“We continue to have problems in areas I presented to you over a year ago,” Bryksa said of the lagging response times.
He claimed the numbers are a result of increased event volumes in Calgary and throughout the province.
“The standard increase in event volume for EMS over the last 10 years has been six to eight per cent,” he said. “Since March 2021, we’ve seen a 30 to 25 per cent increase that has been sustained and continues to be our new norm going forward.”
To address this, he said he and his team have done work to encourage the access of alternative transport options where appropriate and where care is not required, employing secondary triaging at 9-1-1 call centres, and adding 10 new ambulances to AHS' Calgary Zone to decrease the burden on the large city's neighbours.
“We continue to experience prolonged hospital waits. This continues to be the number one problem EMS is facing. Despite our best efforts, we continue to see challenges in this area,” he said. “We continue to lobby our colleagues, and quite honestly, we’re having difficulty in this area doing that.”
In response to the presentation, Coun. Ron Chapman said he didn’t have any other words except to say that he was “disgusted” by the numbers presented.
“Your response times back in 2009 when we were guaranteed response times were going to improve hasn’t been the case in over 13 years,” he said.
“You’re not even getting close to meeting the 50th percentile. You’re a minute off. I don’t know what AHS or the organization is [doing] there to fix that.”
Coun. Al Jones said he echoed Chapman’s frustrations at the current response times.
“I’m expecting an elevated service, not a subpar service,” he said during the meeting. “I get frustrated when we get lumped into the Calgary zone despite being a city of our own.
“I’m seeing a shortfall still from when we handed over the reins to AHS in 2009 – I am frustrated.”
He added City of Airdrie councillors have received many phone calls and emails from residents expressing frustrations with the current state of ambulatory care in the city.
“Although your stats may be showing an improvement, we’re not feeling it,” Jones said. “I personally would appreciate if those frustrations were shared up the chain.”
