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Report on N.S. ambulance service says delays caused by offloading wait times

HALIFAX — A report into Nova Scotia's privately operated ambulance service says a significant amount of ambulance time is exhausted by unproductive non-emergency activities.
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HALIFAX — A report into Nova Scotia's privately operated ambulance service says a significant amount of ambulance time is exhausted by unproductive non-emergency activities.

The report by Fitch and Associates released Monday says ambulances spend a considerable amount of time waiting in hospitals to offload patients into busy emergency departments. The U.S.-based consulting firm also notes ambulances are often tied up responding to requests to transfer patients between facilities, a task it says could be handled by other transport options.

“Resources that could be dedicated to emergency responses are unnecessarily deployed to the (inter-facility transport) system to meet the contract demands,” the report said. “This is inefficient and ineffective.”

Nova Scotia mandated Fitch and Associates in 2018 to look for ways to provide an “efficient, effective and sustainable" emergency medical system for the next 10-to-15 years. The consulting firm says its report was completed in 2019 but the public release was delayed because the province had entered into negotiations with private ambulance operator Emergency Medical Care Inc.

Fitch said in the report that Nova Scotia's current model doesn't take advantage of the “medical sophistication” paramedics can provide because all patients that accept assistance must be transported to hospital.

The consulting firm offered 68 recommendations, 64 of which the company said have already been implemented, are outside the scope of emergency services, are still being considered, or will be included in the new contact between the government and its sole ambulance operator.

Nova Scotia Health Minister Zach Churchill told reporters Monday the government has renewed its contract with Emergency Medical Care, adding that many of the recommendations in Fitch's report have been included in the agreement, which enters into effect April 1.

The five-year deal is worth $165 million a year and comes with the option of two two-year extensions.

Churchill said the province wants to turn its ambulance service from a “transport-based system to a health-delivery model.” Medical services, he said, will be provided on site, potentially relieving patients in their homes and giving paramedics more opportunities to use their skills.

He said the province has purchased three non-ambulatory transport vehicles to help charter patients between and from hospitals, allowing ambulances and paramedics to be reserved for serious medical cases.

Along with non-clinical transport, the new contract will also expand community paramedic programs, station a nurse in the medical communications centre for less-serious 911 calls, and add a second team for air-transport services.

Nova Scotia Paramedic Union spokesman Michael Nickerson says he is happy to see the province has already put some of the recommendations in place to improve conditions for paramedics.

“They are tired, they are worn out, they feel underappreciated and undervalued by not only their employer, but their government,” Nickerson said during an interview Monday. “We're cautiously optimistic (and) we'll take a wait-and-see approach.”

This report by The Canadian Press was first published March 8, 2021.

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This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship.

Danielle Edwards, The Canadian Press

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