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EMS Review by HQCA

EMS Review by HQCA

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Published by pkGlobal
Health Quality Council of Alberta’s report on ground ambulance services; released March 4, 2013
Health Quality Council of Alberta’s report on ground ambulance services; released March 4, 2013

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Published by: pkGlobal on Mar 04, 2013
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03/04/2013

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Promoting and improving patient safety and health service quality across Alberta.
Review of Operations of Ground Emergency Medical Services in Alberta
In Accordance with Section 15 (1) of the
Health Quality Council of Alberta Act 
January 2013
 
 
 
TABLE OF CONTENTS
i
 TABLE OF CONTENTS
 
EXECUTIVE SUMMARY .............................................................................................................. 1
PROJECT OVERVIEW ............................................................................................................... 11
Background and Purpose .................................................................................................... 11
Objective .............................................................................................................................. 11
Scope ................................................................................................................................... 11
PROJECT GOVERNANCE ........................................................................................................ 12
INTRODUCTION TO EMS ......................................................................................................... 13
 A brief history of EMS in Canada ......................................................................................... 14
EMS in Alberta ..................................................................................................................... 14
The process of EMS delivery in Alberta ............................................................................... 16
The structure and operations of EMS in Alberta .................................................................. 18
EMS health professionals .................................................................................................... 24
 APPROACH AND METHODOLOGY .......................................................................................... 26
FINDINGS ................................................................................................................................... 35
Semi-structured interviews with key stakeholders ............................................................... 39
Questionnaire to municipalities, PSAP centres, dispatch centres, and contracted EMSservice providers .................................................................................................................. 41
Semi-structured phone interviews with EMS practitioners and medical first responders .... 47
On-site observations of PSAP and dispatch centres ........................................................... 49
Review of EMS data ............................................................................................................ 52
Documentation review ......................................................................................................... 58
Interviews with other EMS organizations ............................................................................. 62
Systematic literature review about EMS .............................................................................. 63
Summary of findings ............................................................................................................ 65
ISSUES, ANALYSES, RECOMMENDATIONS AND REQUIRED ACTIONS ............................. 73
 APPENDICES ............................................................................................................................. 85
 Appendix I: Glossary ............................................................................................................ 86
 Appendix II: Ministerial Request and Extension Letter ........................................................ 90
 Appendix III: Terms of Reference ........................................................................................ 93
 Appendix IV: Definitions and Descriptions of First Response Terms used in Alberta ......... 95
 Appendix V: Systematic Literature Review .......................................................................... 97
 Appendix VI: Questionnaires ............................................................................................. 208
 Appendix VII: Stakeholder Interview and Questionnaire Thematic Analyses .................... 230
 Appendix VIII: EMS Review Frontline Worker Interviews Report ...................................... 279
 Appendix IX: Data Elements that are Collected within AAIMS .......................................... 320
 Appendix X: Saskatchewan EMS Review 2009 – Summary of Recommendations .......... 326
LIST OF FIGURES ................................................................................................................... 330
LIST OF TABLES ..................................................................................................................... 331
 ACRONYMS ............................................................................................................................. 332
REFERENCES ......................................................................................................................... 334
Review of the Operations of Ground EMS in Alberta – January 2013
 
 
Foreword
When a medical emergency occurs and a 911 call is placed, Albertans expect and deserve a response thatis appropriate, effective, efficient and reliable. None of us expect or anticipate a medical emergency, butknowing urgent medical care is available when and where we need it provides great comfort. Emergencymedical services (EMS) are an essential element of our province’s healthcare system.This review examined the implications for quality and patient safety with respect to ground emergencymedical services in Alberta. Our research and analysis identified important issues leading us to fiverecommendations and sixteen required actions that we believe are essential to improving the quality andsafety of this critical service for Albertans. Establishing a province-wide EMS system is a very complexundertaking, however, the continued integration of EMS with the provincial healthcare system will provide substantial benefits to patients requiring urgent medical care.The HQCA will collaborate with Alberta Health and other stakeholders in their review of this report, andis committed to following the progress of the accepted recommendations.Many people contributed their time and expertise to this review. Thank you to the members of the reviewteam who dedicated many months to ensure the quality and integrity of the review. On behalf of the team,I would also like to thank the individuals who participated in interviews, responded to questionnaires, andwere readily available to answer questions and provide background information. Every individualinvolved in the review demonstrated a great passion for improving the EMS system in Alberta, and acommitment to do what is best for all Albertans.Dr. John Cowell, Chief Executive Officer, HQCACalgary, AlbertaJanuary 31, 2013
Review of the Operations of Ground EMS in Alberta – January 2013

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