Insights from the front lines

Edmonton, Alberta – A new research report by Parkland Institute — "Lights and Sirens: The Critical Condition of EMS in Alberta" — examines the current crisis facing paramedics in the province. Authored by medical sociologist Michael K. Corman, the report focuses on understanding the current crisis from the perspective of paramedics, and offers potential avenues for change based on insights from those who live, experience, and breathe the crisis on a daily basis.

While the provincial government tries to blame the EMS failures on increased call volumes, the report argues that the problem—and its solutions—go beyond this simplistic view: “The current crisis was not simply the result of increased call volumes due to the pandemic,” says Corman. “The pandemic just exposed the weak foundation of a system that has been teetering on the edge for some time.”

Problems identified by paramedics include, for example, an erosion of key work processes that are central to being a competent paramedic. “This was in large part brought on by a system that focused exclusively on efficiency, on the idea of ‘doing more with less’.”  At the same time, some of the policies and practices adopted resulted in a lowering of standards and a toxic work environment that made providing good care nearly impossible.

“The ongoing crisis in health care is having a very real impact on our members,” says Mike Parker, president of the Health Sciences Association of Alberta, a union that represents 30,000 health professionals in the province. “The system is not only broken for those needing emergency care, it’s also breaking our paramedics and emergency communications officers.”

Paramedic burnout can be seen, for example, in the significantly higher numbers of sick time experienced by workers in the last few years: “Sick time in 2022 represents a loss of over 22,000 12-hour paramedic shifts,” says Corman. Recent Workers’ Compensation Board stats also point to an alarming increase in disabling injuries among paramedics in the province.

“The root of the current crisis dates back at least to the amalgamation of emergency medical services in the province in 2009,” explains Corman. The reform resulted in Alberta Health Services and the Government of Alberta assuming responsibility for most EMS in the province and adopting a “command and control” governing style with damaging effects for paramedics and the EMS system as a whole.

Throwing money at the problem – The EMS crisis has multiple facets and is rooted in long-standing problems. Adding more resources might be part of the solution, but much more is needed. “Throwing money at the problem will not solve it,” says Corman.

“Investing money in EMS for new equipment won’t solve this crisis,” says Mike Parker. “Government needs to consult with us to create working conditions that are both physically and psychologically safe for all health-care professionals. More staff helps, but without improved working conditions all we are doing is throwing more professionals into a broken system that will only break more people.”

To show how EMS in Alberta could be reimagined to better meet the current and future health and social care needs of Albertans, Corman drafted a set of 15 recommendations that address much-needed EMS-specific changes but also changes more geared toward “upstream medicine” and the social determinants of health.

“EMS doesn’t happen in a vacuum,” explains Corman. Elements of the health-care system such as home and community care, long-term care, and physician services all impact the need for EMS.  

But even “upstream” factors outside the realm of health care acutely affect the pressures placed upon emergency services. Enhancing social care spending based on the principles of equity and inclusion, for example, results in healthier populations. Better access to services and supports such as safe consumption sites would also contribute to reducing the workload of paramedics.

The EMS-specific changes proposed include, among others, developing an evidence-based plan to determine the resources needed; changing the data collection strategies that are used to inform the development of policies and system design; and making the non-traditional role of community paramedics a mainstay in Alberta.

Another key recommendation is to address the source of paramedic burnout through the adoption of the principles of a trauma-informed environment that centres on the mental and physical health of employees.

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For the full report, visit https://www.parklandinstitute.ca/lights_and_sirens  

For more information or to arrange an interview, please contact:

Rita Espeschit
Parkland Institute Communications Coordinator
[email protected]