The Paramedic Association of Canada (PAC) has over 14,000 members from coast to coast. Founded in 1988 as the Canadian Society for Ambulance Personnel (CSAP), PAC represents prehospital practitioners on a national level to promote quality care and development of our profession in the public interest.
Probably best known for authoring the National Occupational Competency Profile (NOCP) for paramedicine, PAC works diligently to represent paramedics on numerous federal initiatives and committees. PAC is currently undertaking a major review of the NOCP, working with regulators and the Federal Labor Mobility Coordinator Group on issues related to inter-provincial reciprocity, considering options for accreditation of EMR education programs, and has identified development of a national examination and registry as priorities within the organization's business plan. And today PAC takes a big step toward fulfilling their very ambitious agenda...they're hiring a Registrar.
The Executive, committee chairs and membership are to be commended for all that PAC has accomplished for our profession and our patients. But the "next steps" would never be realized if we continued to rely solely on volunteers to keep a national association alive.
The posting for this .5 to .75 EFT Registrar position is available on the PAC web site. I anticipate we should see this position filled before we meet in Winnipeg for the 2007 PAC AGM on June 2nd.
Friday, March 16, 2007
Thursday, March 08, 2007
Right Care - Right Practitioner - Right Place
Dr. Mark Taylor, deputy head for the Department of Surgery at the University of Manitoba, made some very interesting statements in his commentary (Huge amount can be done to fix health care) published March 6th in the Winnipeg Free Press. The entire article can be viewed by clicking here.
One comment made by Dr. Taylor that's sure to raise eyebrows in the medical community..."Our health care system has largely evolved for the best interest of the practitioners". It's hard to deny that many of the road blocks placed in the way of change within our health system are a result of "protectionist attitudes" that have existed in the health care community forever. Although there seems to be more acceptance within professional realms to share responsibilities and scopes of practice, it's still too often an uphill battle when looking at ways to better utilize various health practitioners in non-traditional roles.
And in part it's this reluctance to think outside of the traditional medical model that stands in the way of doing what Dr. Taylor rightly suggests needs to be done if we want to address many of our health care woes. He goes on in his commentary to say "We need to reorganize our systems of care provision to ensure the patient gets the right care by the right practitioner in the right place".
More emphasis needs to be placed on ensuring patients entering our health care system, especially many of those currently seen in over-crowded hospital emergency rooms, are directed to more appropriate health facilities and treatment options whenever suitable. We can't continue to believe we can "buy our way out" of the increasing strain placed on our current health care system by throwing money in the form of bonuses or incentives at our practitioners. A seniors population that has doubled in the past 20 years is forecast to double again in the next 15. Hospitals and emergency rooms are no longer viable in every community. Urgent care and community facilities need to better utilize alternative existing health care options, including nurse practitioners, physician assistants, pharmacists, therapists and paramedics. As Dr. Taylor suggests, there are ways to fix our health care system. It's time our community leaders, politicians and health administrators stopped fear-mongering whenever change in health care delivery is contemplated.
One comment made by Dr. Taylor that's sure to raise eyebrows in the medical community..."Our health care system has largely evolved for the best interest of the practitioners". It's hard to deny that many of the road blocks placed in the way of change within our health system are a result of "protectionist attitudes" that have existed in the health care community forever. Although there seems to be more acceptance within professional realms to share responsibilities and scopes of practice, it's still too often an uphill battle when looking at ways to better utilize various health practitioners in non-traditional roles.
And in part it's this reluctance to think outside of the traditional medical model that stands in the way of doing what Dr. Taylor rightly suggests needs to be done if we want to address many of our health care woes. He goes on in his commentary to say "We need to reorganize our systems of care provision to ensure the patient gets the right care by the right practitioner in the right place".
More emphasis needs to be placed on ensuring patients entering our health care system, especially many of those currently seen in over-crowded hospital emergency rooms, are directed to more appropriate health facilities and treatment options whenever suitable. We can't continue to believe we can "buy our way out" of the increasing strain placed on our current health care system by throwing money in the form of bonuses or incentives at our practitioners. A seniors population that has doubled in the past 20 years is forecast to double again in the next 15. Hospitals and emergency rooms are no longer viable in every community. Urgent care and community facilities need to better utilize alternative existing health care options, including nurse practitioners, physician assistants, pharmacists, therapists and paramedics. As Dr. Taylor suggests, there are ways to fix our health care system. It's time our community leaders, politicians and health administrators stopped fear-mongering whenever change in health care delivery is contemplated.
Wednesday, March 07, 2007
Manitoba EMS Education in Peril
The future of paramedicine as a recognized health profession in this province is dependent on a model of education that is both CMA accredited and professionally accepted within the health care community. All other health professions demand diploma or degree programs for entry to practice. The announcement last year that Manitoba Health was working with Red River College to develop a PCP program for delivery beginning in September of 2007 was very welcome news, as it opened the door to a more professionally respected education program. Today that concept appears to be in jeopardy.
Red River College was promised provincial funding for program development to replace the expired rural PCP education agreement with MESC. They indicated to Manitoba Health that final approval had to be in place by January 1st of this year in order to be ready for a September 2007 course start date. Well, that date has come and gone, and Treasury Board has yet to approve the money needed for the agreement to move forward. In fact, if Red River College doesn't receive funding approval within the next month, they'll miss the next possible course start date of January '08. The education agreement between the Manitoba Emergency Services College in Brandon and Manitoba Health expired in June of 2006. Unless RRC is able to deliver a PCP course this fall, we won't see an education program provide course graduates, at least in rural Manitoba, for a full three years. With most regions struggling to keep their heads above water staffing wise, that's a hit that many services may not be able to handle.
But what's even more alarming is that the delay caused by the government inaction in this matter may jeopardize the possibility of having a PCP diploma or degree program offered in Manitoba altogether. Not surprisingly, RRC is both frustrated and discouraged by the lack of funding approval for a project that less than a year ago seemed to be a very high priority. Rumors that Winnipeg Fire Paramedic Service may be in the process of developing their own program for public offering may be another nail in the coffin of a post-secondary paramedic education program. While I appreciate the level of expertise that WFPS would bring to EMS education in the province, unless it is done in partnership with a College or University it unfortunately won't meet the expectations of the health care community, and as such does nothing to promote paramedicine as a recognized health profession.
The Manitoba Government prides itself in EMS system improvements made over the course of the past 7 years. Unfortunately, education, which is the very cornerstone around which the whole system revolves, may fallen by the wayside.
Red River College was promised provincial funding for program development to replace the expired rural PCP education agreement with MESC. They indicated to Manitoba Health that final approval had to be in place by January 1st of this year in order to be ready for a September 2007 course start date. Well, that date has come and gone, and Treasury Board has yet to approve the money needed for the agreement to move forward. In fact, if Red River College doesn't receive funding approval within the next month, they'll miss the next possible course start date of January '08. The education agreement between the Manitoba Emergency Services College in Brandon and Manitoba Health expired in June of 2006. Unless RRC is able to deliver a PCP course this fall, we won't see an education program provide course graduates, at least in rural Manitoba, for a full three years. With most regions struggling to keep their heads above water staffing wise, that's a hit that many services may not be able to handle.
But what's even more alarming is that the delay caused by the government inaction in this matter may jeopardize the possibility of having a PCP diploma or degree program offered in Manitoba altogether. Not surprisingly, RRC is both frustrated and discouraged by the lack of funding approval for a project that less than a year ago seemed to be a very high priority. Rumors that Winnipeg Fire Paramedic Service may be in the process of developing their own program for public offering may be another nail in the coffin of a post-secondary paramedic education program. While I appreciate the level of expertise that WFPS would bring to EMS education in the province, unless it is done in partnership with a College or University it unfortunately won't meet the expectations of the health care community, and as such does nothing to promote paramedicine as a recognized health profession.
The Manitoba Government prides itself in EMS system improvements made over the course of the past 7 years. Unfortunately, education, which is the very cornerstone around which the whole system revolves, may fallen by the wayside.
Saturday, March 03, 2007
Emergency Room Crisis
An article in today's Winnipeg Free Press (Grace's ER in peril - March 3, 2007) once again speculates about a possible ER closure at the Grace hospital. Last year the province offered physicians $1,500.00 for every five shifts they covered at the Grace in an effort to offset a staffing shortage at the facility. Today that shortage remains, and it's not uncommon for patients to wait up to 10 hours to see a doctor. The government's solution as we move into 2007...cash incentives for physicians to pick up extra shifts. Am I missing something here?
Wait times in Winnipeg emergency rooms have been on the increase for years now. Not only are patients waiting longer to see physicians, but as you've undoubtedly experienced yourself, paramedics are often delayed far too long waiting to transfer care of their patients to hospital staff. In January of 2004 the provincial government undertook a formal review of the emergency care system in Winnipeg, and at that time we urged the Health Minister to encourage decision makers to "think outside the box" in efforts to find appropriate solutions to the problem. Among the recommendations we made at that time to help minimize ER problems:
As part of the effort to reduce the strain on Winnipeg ERs, Manitoba Health published an Emergency Room User Guide. In an effort to better educate the general public about proper emergency room use, they suggest there are certain conditions that are best dealt with "by a family doctor or local health clinic", and in fact recommend the use of Urgent Care facilities such as the Misericordia Health Centre and the Pan Am Minor Injury Clinic when appropriate. Yet paramedics are still required to transport to an emergency room.
In their white paper, the EMS Chiefs of Canada recommend that EMS become part of a "system" of health care that allows resources to be used more effectively and efficiently. They go on to say that it may "be clinically appropriate and beneficial to the health care system to assess, treat and release the patient or transfer them to another health care agency" (other than an emergency room). And yet provincial medical direction here in Manitoba refuses to consider the possibility of developing protocols to do just that.
Research suggests that only 10% of callers using 911 actually have a life threatening emergency. Many are in need of urgent or primary health care, and in fact could be dealt with through channels outside of the conventional emergency room. Innovative programs are underway in other Canadian jurisdictions to better integrate paramedics into the health care system and help minimize the increasing strain on emergency rooms and staff. Asking doctors, or for that matter any health professional, to pick up extra shifts is not the solution. We need to redefine the traditional model of pre-hospital emergency health care.
Money spent "bribing" practitioners to work longer and harder will only exacerbate the problem. Money spent on improving our EMS system can help address the real and increasing strain on our emergency facilities. Not only does it stand to reduce current pressures on our ER facilities and resources, but as pointed out in the EMS Chiefs white paper, "EMS high-level care can minimize time spent in the ICU, avoid additional complications and reduce the probability of on-going long term pressures on the health care system".
Again I ask...am I missing something here?
Wait times in Winnipeg emergency rooms have been on the increase for years now. Not only are patients waiting longer to see physicians, but as you've undoubtedly experienced yourself, paramedics are often delayed far too long waiting to transfer care of their patients to hospital staff. In January of 2004 the provincial government undertook a formal review of the emergency care system in Winnipeg, and at that time we urged the Health Minister to encourage decision makers to "think outside the box" in efforts to find appropriate solutions to the problem. Among the recommendations we made at that time to help minimize ER problems:
- increasing the number of Urgent Care facilities available and enabling paramedics to transport or refer patients to these facilities in lieu of an ER when appropriate;
- developing appropriate paramedic treat and release protocols, resulting in fewer ER admissions;
- utilizing Advanced Care (and in future Critical Care) Paramedics in emergency care facilities to assist with triage, patient re-evaluation and high workload efforts including resuscitative measures.
As part of the effort to reduce the strain on Winnipeg ERs, Manitoba Health published an Emergency Room User Guide. In an effort to better educate the general public about proper emergency room use, they suggest there are certain conditions that are best dealt with "by a family doctor or local health clinic", and in fact recommend the use of Urgent Care facilities such as the Misericordia Health Centre and the Pan Am Minor Injury Clinic when appropriate. Yet paramedics are still required to transport to an emergency room.
In their white paper, the EMS Chiefs of Canada recommend that EMS become part of a "system" of health care that allows resources to be used more effectively and efficiently. They go on to say that it may "be clinically appropriate and beneficial to the health care system to assess, treat and release the patient or transfer them to another health care agency" (other than an emergency room). And yet provincial medical direction here in Manitoba refuses to consider the possibility of developing protocols to do just that.
Research suggests that only 10% of callers using 911 actually have a life threatening emergency. Many are in need of urgent or primary health care, and in fact could be dealt with through channels outside of the conventional emergency room. Innovative programs are underway in other Canadian jurisdictions to better integrate paramedics into the health care system and help minimize the increasing strain on emergency rooms and staff. Asking doctors, or for that matter any health professional, to pick up extra shifts is not the solution. We need to redefine the traditional model of pre-hospital emergency health care.
Money spent "bribing" practitioners to work longer and harder will only exacerbate the problem. Money spent on improving our EMS system can help address the real and increasing strain on our emergency facilities. Not only does it stand to reduce current pressures on our ER facilities and resources, but as pointed out in the EMS Chiefs white paper, "EMS high-level care can minimize time spent in the ICU, avoid additional complications and reduce the probability of on-going long term pressures on the health care system".
Again I ask...am I missing something here?
Thursday, March 01, 2007
Another EMS Death
Media reports suggest that a paramedic student attending the Saskatchewan Institute of Applied Science and Technology (SIAST) was killed in a single vehicle accident in the Saskatoon area early this morning. It has been reported that the PCP student was on his way to a practicum shift with MD Ambulance when the accident occurred.
Unlikely to be considered a line of duty death, it still comes as a shock to lose another member of the Canadian EMS community. Just days ago Ontario paramedic Paul Patterson was killed in the line of duty while responding in a Rapid Response paramedic unit to a motor vehicle collision near Chatham, Ontario.
Five Canadian paramedics have died in the line of duty in the past ten months. Kim Weitzel and Shawn Currier were killed after responding to an emergency call at a decommissioned mine near Cranbrook, B.C. in May of 2006. Canadian Forces medics Corporal Andrew Eykelenboom and Glen Arnold died while serving our country in Afghanistan in August and September 2006 respectively. Thirty year old Paul Paterson was killed on February 25, 2007.
Twenty-one Canadian paramedics have been killed in the line of duty in only the last 11 years. It's a sobering thought to realize we have had that many deaths in our profession in such a short time.
Please...stay safe!
Unlikely to be considered a line of duty death, it still comes as a shock to lose another member of the Canadian EMS community. Just days ago Ontario paramedic Paul Patterson was killed in the line of duty while responding in a Rapid Response paramedic unit to a motor vehicle collision near Chatham, Ontario.
Five Canadian paramedics have died in the line of duty in the past ten months. Kim Weitzel and Shawn Currier were killed after responding to an emergency call at a decommissioned mine near Cranbrook, B.C. in May of 2006. Canadian Forces medics Corporal Andrew Eykelenboom and Glen Arnold died while serving our country in Afghanistan in August and September 2006 respectively. Thirty year old Paul Paterson was killed on February 25, 2007.
Twenty-one Canadian paramedics have been killed in the line of duty in only the last 11 years. It's a sobering thought to realize we have had that many deaths in our profession in such a short time.
Please...stay safe!
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