The International Association of Fire Fighters and the Ontario Association of Fire Chiefs continue to lobby for fire-based EMS, and rumor has it that Macleans magazine is working on an article for an upcoming edition in which the Canadian Division of the IAFF will argue the benefit of that service model. The debate for and against fire-based EMS has escalated over the past decade and is all too often fraught with emotion. The arguments tend to be clouded by partial truths so it's little wonder our policy and decision makers are reluctant to take a stand one way or the other. At the risk of being accused of adding to those half truths, let me suggest what I think decision makers should focus on in this debate.
Cardiac arrests tend to be used most often as the benchmark when arguing an appropriate EMS response time, yet less than 1% of our calls are cardiac arrest calls. To design an entire EMS system around this subset of calls seems questionable, especially when evidence based options are available. Studies have shown that early recognition and early CPR with minimal interruption to chest compressions has tripled the survival rate in witnessed cardiac arrests. The Heart and Stroke Foundation of Canada Public Access Defibrillation (PAD) trial demonstrated a doubling of survival rates when AEDs were utilized by lay responders in facilities with a high likelihood of cardiac arrest. Promoting and enabling public education that emphasizes good CPR, early notification of EMS and strategic placement of public access AEDs is of great importance when weighing the arguments of cardiac arrest in EMS system design.
Another measure used to argue certain system benefits is the time taken to "stop the clock". When it comes to capturing response times, it's important to remember this is nothing more than a measure of how quickly someone arrives on scene. This initial response time is certainly a statistic worth capturing, but the clock really doesn't stop until the system delivers a level of care able to definitively treat that patient. In the case of a cardiac arrest (less than 1% of EMS calls) it might be argued that the clock stops when a trained responder with a defibrillator is at the patient's side. But the clock really has not stopped when the patient needs advanced respiratory care, pain management or IV medication to treat a variety of medical conditions or cardiac arrythmias. For the most part, "stop the clock" arguments are fairly misleading, especially in the public arena. Getting medical assistance to the patient's side as quickly as possible needs to be given appropriate consideration, but the clock doesn't stop unless that paramedic is able to provide definitive treatment. Policy makers need to ensure their EMS system gets the right care to the right patient at the right time.
Paramedicine has joined the ranks of health care...paramedics are health care providers with growing education and skill set requirements. As with any health profession, it is critical that paramedics are committed to maintaining competence in their practice, stay abreast of best practices and familiarize themselves with new technologies. While call volumes are on the rise, so too is the need for EMS to deliver health care in the community setting. Continuing competence and professional development must be given serious consideration by both paramedics and our policy makers when considering service delivery models.
In life-threatening emergencies, patient outcomes are dependent not only on the speed with which medical care is provided, but more-so by ensuring patients receive the most appropriate medical care.
Wednesday, December 02, 2009
Sunday, November 01, 2009
Paramedic Application for Bodily Fluids Test
Late last week a Manitoba paramedic made application for an expedited testing order under the Testing of Bodily Fluids and Disclosure Act. This application is the first made by a paramedic and only the second such request since the legislation was proclaimed in mid September.
Following an incident in which bloody saliva was spit in the face of a paramedic, the applicant contacted the provincial office of the Judicial Justice of the Peace (JJP) by telephone. A written application was submitted to the JJP by fax immediately following this call, and within hours the order was issued.
According to the legislation, it is the applicant's responsibility to ensure the testing order is served on the source individual. Earlier this year the Paramedic Association of Manitoba recommended the regulation be amended to relieve the applicant of this responsibility. The events around this application serve as a good example of why this process is inappropriate...not only does the source individual live a great distance from the applicant, but the circumstances around this incident suggest it would be best for the paramedic not to re-visit a potentially violent individual.
According to senior government officials, our initial concern regarding an applicant having to ensure a testing order is served was discussed with the Regional Health Authorities and WFPS. It was agreed by all parties that employers would assist their employees in the serving of these documents.
As with any "new" process, the circumstances around the request for blood testing in this incident were met with some confusion and a hurdle or two. But only two months ago there would not have been any process to follow.
Following an incident in which bloody saliva was spit in the face of a paramedic, the applicant contacted the provincial office of the Judicial Justice of the Peace (JJP) by telephone. A written application was submitted to the JJP by fax immediately following this call, and within hours the order was issued.
According to the legislation, it is the applicant's responsibility to ensure the testing order is served on the source individual. Earlier this year the Paramedic Association of Manitoba recommended the regulation be amended to relieve the applicant of this responsibility. The events around this application serve as a good example of why this process is inappropriate...not only does the source individual live a great distance from the applicant, but the circumstances around this incident suggest it would be best for the paramedic not to re-visit a potentially violent individual.
According to senior government officials, our initial concern regarding an applicant having to ensure a testing order is served was discussed with the Regional Health Authorities and WFPS. It was agreed by all parties that employers would assist their employees in the serving of these documents.
As with any "new" process, the circumstances around the request for blood testing in this incident were met with some confusion and a hurdle or two. But only two months ago there would not have been any process to follow.
Friday, October 16, 2009
Sedans May Replace Ambulances???
According to an article in today's Winnipeg Free Press (Sedans may replace ambulances), Winnipeg Fire Paramedic Service is considering the use of smaller vehicles to send paramedics to triage and treat non life-threatening calls. "Community paramedics" would be able to respond to certain 911 calls, assess and treat patients in their home and perhaps eliminate the need to transport these patients to an emergency room. Great idea on the surface...I've long been advocating the need to find alternative treatment schemes that reduce the number of patients transported to ERs in an effort to decrease wait times and better treat our patients.
But the Free Press article goes on to suggest that the responding paramedic might "call a taxi" or "strap the patient into the passenger's seat and provide a lift to an urgent-care clinic or even the ER". HUH???
Any system that looks at appropriate options to treat patients and leave them in the comfort of their home, transport certain patients to urgent-care or clinic settings in lieu of an emergency room or recommend patients follow-up with their personal physician to eliminate long and uneccesary waits in an ER waiting room is, in my view, a progressive system. But moving health care into a taxicab or the passenger seat of a rapid response unit is not appropriate.
According to senior city staff, the amount of time a Winnipeg ambulance is actually in use by a patient is "unparalleled in Canada" and much higher than accepted industry standards. Winnipeg has 21 transporting ambulances in service during peak periods. In comparison, the City of Ottawa has 10 Rapid Response Units and 40 transporting ambulances to serve a population base of about 900,000. Introducing "community paramedics" in Winnipeg in combination with an appropriate increase in transporting ambulances would improve unit utilization and provide improved patient care within that EMS system. Transporting patients in a cab or a single staffed paramedic unit will not!
But the Free Press article goes on to suggest that the responding paramedic might "call a taxi" or "strap the patient into the passenger's seat and provide a lift to an urgent-care clinic or even the ER". HUH???
Any system that looks at appropriate options to treat patients and leave them in the comfort of their home, transport certain patients to urgent-care or clinic settings in lieu of an emergency room or recommend patients follow-up with their personal physician to eliminate long and uneccesary waits in an ER waiting room is, in my view, a progressive system. But moving health care into a taxicab or the passenger seat of a rapid response unit is not appropriate.
According to senior city staff, the amount of time a Winnipeg ambulance is actually in use by a patient is "unparalleled in Canada" and much higher than accepted industry standards. Winnipeg has 21 transporting ambulances in service during peak periods. In comparison, the City of Ottawa has 10 Rapid Response Units and 40 transporting ambulances to serve a population base of about 900,000. Introducing "community paramedics" in Winnipeg in combination with an appropriate increase in transporting ambulances would improve unit utilization and provide improved patient care within that EMS system. Transporting patients in a cab or a single staffed paramedic unit will not!
Monday, October 05, 2009
Health Minister Issues "Call to Action"
Late last week, Manitoba's Minister of Health Theresa Oswald called on front-line health care providers to "step forward and share their expertise at vaccination clinics" as the province stepped up plans in preparation for the fall flu season. In a Government News Release issued October 2nd, Oswald urged Manitoba's health care workers to "respond to our call to action". In response to the Minister's plea, the Paramedic Association of Manitoba is encouraging qualified Paramedics to answer the Minister's call for help.
In correspondence addressed to the Emergency Services Branch of Manitoba Health and Healthy Living, sent August 25th and copied to the Minister, the Paramedic Association of Manitoba suggested the province consider using Paramedics to assist with community flu vaccination programs. A significant number of Paramedics are certified by their Regional Medical Directors to perform injection medication administration, and as such would be an excellent resource to assist wherever needed in the community delivery of H1N1 and seasonal flu vaccine. Further correspondence has been sent to Minister Oswald advising her the Association will be distributing her request to members across the province.
Tuesday, September 15, 2009
Blood Samples Legislation Proclaimed
Manitoba's Health Minister issued a statement today stating the province's mandatory blood testing legislation is now in effect.
Passed by the Manitoba Legislature in June of last year, the Testing of Bodily Fluids and Disclosure Act was proclaimed into force effective today. The legislation allows for a mandatory blood testing order to be issued any time someone aiding a victim (or the victim themselves) experience a significant exposure to bodily fluids. Manitoba is the only province to include a process enabling an expedited testing order to be issued.
Links to the legislation, factsheets and the application for an expedited order can be found at: http://www.gov.mb.ca/health/publichealth/tbfd.html.
The Paramedic Association of Manitoba will continue to work closely with Government, employers and our members to ensure this legislation is effective in its purpose.
Eric Glass
Chairman
Paramedic Association of Manitoba
Sent from my BlackBerry Wireless handheld.
Passed by the Manitoba Legislature in June of last year, the Testing of Bodily Fluids and Disclosure Act was proclaimed into force effective today. The legislation allows for a mandatory blood testing order to be issued any time someone aiding a victim (or the victim themselves) experience a significant exposure to bodily fluids. Manitoba is the only province to include a process enabling an expedited testing order to be issued.
Links to the legislation, factsheets and the application for an expedited order can be found at: http://www.gov.mb.ca/health/publichealth/tbfd.html.
The Paramedic Association of Manitoba will continue to work closely with Government, employers and our members to ensure this legislation is effective in its purpose.
Eric Glass
Chairman
Paramedic Association of Manitoba
Sent from my BlackBerry Wireless handheld.
Thursday, September 10, 2009
Province May Use Paramedics in Pandemic Plan
Earlier this week Health Minister Theresa Oswald outlined the province's five-point plan in preparation for a possible fall resurgence of the H1N1 influenza pandemic. Following that announcement, a member of the local media asked the Minister what was being done to ensure there were sufficient health care workers in place to deliver flu vaccinations throughout the province. In response to the question, Oswald replied that her Department was looking into a number of possibilities, including an offer by paramedics to assist in the vaccine administration.
A few weeks back, Health Canada issued an alert saying there may not be enough health care workers available to conduct flu vaccinations on a timely basis. Immediately following that declaration, the Paramedic Association of Manitoba wrote Manitoba Health and outlined the benefits associated with using Paramedics in that capacity within their pandemic planning. Educated, trained and in most cases throughout the province certified to administer medication by injection, it just makes good sense to uilize this group of health care professionals to augment the traditional vaccine delivery model.
All eleven Regional Health Authorities have Paramedics at their disposal (directly employed or through service delivery contracts) that administer injected medications on a daily basis. There are more than 700 Paramedics employed in either a full or part time capacity within our health care system. There is no reason to think that Manitoba doesn't have the health care resources to efficiently and effectively deliver flu vaccinations on a very timely basis should the need arise.
A few weeks back, Health Canada issued an alert saying there may not be enough health care workers available to conduct flu vaccinations on a timely basis. Immediately following that declaration, the Paramedic Association of Manitoba wrote Manitoba Health and outlined the benefits associated with using Paramedics in that capacity within their pandemic planning. Educated, trained and in most cases throughout the province certified to administer medication by injection, it just makes good sense to uilize this group of health care professionals to augment the traditional vaccine delivery model.
All eleven Regional Health Authorities have Paramedics at their disposal (directly employed or through service delivery contracts) that administer injected medications on a daily basis. There are more than 700 Paramedics employed in either a full or part time capacity within our health care system. There is no reason to think that Manitoba doesn't have the health care resources to efficiently and effectively deliver flu vaccinations on a very timely basis should the need arise.
Thursday, August 27, 2009
Could Paramedics Administer Flu Vaccinations?
Earlier this week the Globe and Mail ran a story suggesting our health care system may not be able to meet the demand for flu vaccinations this fall...not due to a shortage of vaccine, but rather a shortage of health care providers to administer the vaccinations. In the article entitled "Canada's latest flu challenge: distribution", the Public Health Agency of Canada says "there are potentially issues about how many Canadians get vaccinated at a time" but that the problem "relates to the delivery, not the vaccine supply".
A number of provinces are concerned about timely delivery of H1N1 vaccine, and recognize the traditional model of immunization by nurse and/or physician groups may not be able to meet anticipated public demand as flu season approaches. There is also increasing concern that this years flu season may gain strength earlier than we typically see, placing additional strain on our health care system and further reducing the availability of vaccinators. At least two provinces are considering regulatory changes that would allow pharmacists to deliver flu immunizations if the need arises, which leads me to wonder...Why not use Paramedics to deliver the flu shot?
As Manitoba finalizes its H1N1 vaccination plans, I hope consideration will be given to utilizing Paramedics in the administration of influenza immunizations. Paramedics are trained to administer injection medications. Most are already certified by their Regional Medical Directors to do so, and as such are well positioned to assist wherever needed in community deliver of flu vaccines...without any regulatory changes.
The Paramedic Association of Manitoba has, on many occasions, made reference to the need for "reorganizing" systems of care to ensure patients receive the right care in the right place at the right time. The fact that health planners, in the face of a pandemic scare, are looking at alternatives to the traditional immunization delivery model is a step in that direction. Using Paramedics to assist where possible just makes good sense.
A number of provinces are concerned about timely delivery of H1N1 vaccine, and recognize the traditional model of immunization by nurse and/or physician groups may not be able to meet anticipated public demand as flu season approaches. There is also increasing concern that this years flu season may gain strength earlier than we typically see, placing additional strain on our health care system and further reducing the availability of vaccinators. At least two provinces are considering regulatory changes that would allow pharmacists to deliver flu immunizations if the need arises, which leads me to wonder...Why not use Paramedics to deliver the flu shot?
As Manitoba finalizes its H1N1 vaccination plans, I hope consideration will be given to utilizing Paramedics in the administration of influenza immunizations. Paramedics are trained to administer injection medications. Most are already certified by their Regional Medical Directors to do so, and as such are well positioned to assist wherever needed in community deliver of flu vaccines...without any regulatory changes.
The Paramedic Association of Manitoba has, on many occasions, made reference to the need for "reorganizing" systems of care to ensure patients receive the right care in the right place at the right time. The fact that health planners, in the face of a pandemic scare, are looking at alternatives to the traditional immunization delivery model is a step in that direction. Using Paramedics to assist where possible just makes good sense.
Friday, August 21, 2009
Western Canada Tema Conter Gala
Edmonton will host the first ever Western Canadian Tema Conter Memorial Trust Gala on October 3rd, and Manitoba will be well represented at the event.
The Tema Conter Memorial Trust was created to assist emergency services personnel to better understand and cope with acute and post traumatic stress. The charity was established by paramedic Vince Savoia in 2001, and was named in memory of murder victim Ms. Tema Conter. Vince was one of the paramedics who attended to the scene of that crime. In the aftermath of that incident, he created the Trust as a scholarship fund to help other paramedics and create better awareness of critical incident stress.
The Paramedic Association of Manitoba will be represented at the Western Canadian Gala by PAM Executive member Diane Findlay. In addition to our Association representation, the Manitoba Paramedic Honour Guard has accepted an invitation to participate in the opening ceremonies of the Gala. Proceeds from the evening will assist in the very valuable work done by the Tema Conter Memorial Trust.
For more information on the Tema Conter Memorial Trust and the Western Canadian Gala, you can visit the Trust web site at http://www.tema.ca/tema.php
The Tema Conter Memorial Trust was created to assist emergency services personnel to better understand and cope with acute and post traumatic stress. The charity was established by paramedic Vince Savoia in 2001, and was named in memory of murder victim Ms. Tema Conter. Vince was one of the paramedics who attended to the scene of that crime. In the aftermath of that incident, he created the Trust as a scholarship fund to help other paramedics and create better awareness of critical incident stress.
The Paramedic Association of Manitoba will be represented at the Western Canadian Gala by PAM Executive member Diane Findlay. In addition to our Association representation, the Manitoba Paramedic Honour Guard has accepted an invitation to participate in the opening ceremonies of the Gala. Proceeds from the evening will assist in the very valuable work done by the Tema Conter Memorial Trust.
For more information on the Tema Conter Memorial Trust and the Western Canadian Gala, you can visit the Trust web site at http://www.tema.ca/tema.php
Wednesday, August 12, 2009
Councillor's Comments Lack Insight
A recent swell in violence-related emergency medical response incidents in Winnipeg has renewed debate about whether or not paramedics should be issued body armour in the interest of personal protection and safety. The need for this type of equipment and any decision related to mandatory use of body armour is a discussion I'll leave to the health and safety experts and labour organizations within the profession. But comments made by City Councillor Gord Steeves related to this topic leave me shaking my head.
When questioned about the need for body armour by a local Winnipeg TV news reporter, Councillor Steeves smirkingly replied that it would be hard to rationalize the need for this type of protection for paramedics working "outside the urban core". As the Chair of Winnipeg's Standing Committee on Protection and Community Services, it appears Councillor Steeves is either suggesting violence doesn't occur outside of the downtown core, or he has limited knowledge about status management and dispatch of EMS resources within his jurisdiction.
The fact that paramedics responding to incidents in an urban core are more likely to encounter violence-related calls is one I would not argue. BUT, apparently not well understood by the Councillor is the fact that EMS resources are not and should not be limited to geographical boundaries. They are regularly and routinely sent to where they are needed, regardless of where they are stationed. Any paramedic in Winnipeg could respond to a call in the downtown core, just as any paramedic working in a rural environment could be dispatched to bordering areas. That's how any well coordinated and efficient EMS service is managed.
In fairness to Councillor Steeves, however, local politicians shouldn't be expected to be experts in the management of health care services and resources. Another argument for Manitoba to consider a provincial EMS model.
When questioned about the need for body armour by a local Winnipeg TV news reporter, Councillor Steeves smirkingly replied that it would be hard to rationalize the need for this type of protection for paramedics working "outside the urban core". As the Chair of Winnipeg's Standing Committee on Protection and Community Services, it appears Councillor Steeves is either suggesting violence doesn't occur outside of the downtown core, or he has limited knowledge about status management and dispatch of EMS resources within his jurisdiction.
The fact that paramedics responding to incidents in an urban core are more likely to encounter violence-related calls is one I would not argue. BUT, apparently not well understood by the Councillor is the fact that EMS resources are not and should not be limited to geographical boundaries. They are regularly and routinely sent to where they are needed, regardless of where they are stationed. Any paramedic in Winnipeg could respond to a call in the downtown core, just as any paramedic working in a rural environment could be dispatched to bordering areas. That's how any well coordinated and efficient EMS service is managed.
In fairness to Councillor Steeves, however, local politicians shouldn't be expected to be experts in the management of health care services and resources. Another argument for Manitoba to consider a provincial EMS model.
Saturday, July 04, 2009
PAM Recognizes Achievements
At the first annual Manitoba EMS Awards Gala held in May at the Winnipeg Convention Centre, the Paramedic Association of Manitoba presented two recognition awards.
Our Media Recognition Award was presented to Ms. Gabrielle Giroday of the Winnipeg Free Press for her very considerate and compassionate reporting in a story entitled "Paramedics duty to family remembered".
And Ernie McLean was given the 2009 Paramedic Association of Manitoba Outstanding Achievement Award for his contribution to Manitoba EMS. Ernie first joined the Winnipeg Ambulance Service in June of 1975, and has represented paramedics in both labour and professional capacities over the years on many fronts.
Congratulations to both award recipients!
Our Media Recognition Award was presented to Ms. Gabrielle Giroday of the Winnipeg Free Press for her very considerate and compassionate reporting in a story entitled "Paramedics duty to family remembered".
And Ernie McLean was given the 2009 Paramedic Association of Manitoba Outstanding Achievement Award for his contribution to Manitoba EMS. Ernie first joined the Winnipeg Ambulance Service in June of 1975, and has represented paramedics in both labour and professional capacities over the years on many fronts.
Congratulations to both award recipients!
Investing in Paramedics
Governments and Regional Health Authorities appear to be holding the line on spending. Manitoba's emergency medical services system isn't likely to see any additional funding in 2009/10. No surprise really, in light of our current economic climate. But as the demand for health care continues to rise, can we afford to sit back and wait for an upturn in our economy? Or is now the time to consider investing in health care...in changes that could ultimately improve service and may even reduce costs in some areas?
For a number of years, paramedics in Nova Scotia (Long and Brier Island) and Ontario (Beausoleil First Nation on Lake Huron’s Christian Island) have had "expanded roles" within their respective community health care systems. These programs involve paramedics providing primary health-care and prevention services in addition to handling their normal emergency call volume. They visit patients in their homes and provide routine services ranging from checking vital signs and general patient assessment to administering flu shots and assessing medication compliance. They conduct home assessments to detect fall hazards and other dangers. By developing collaborative relationships with local home-health services, they have also begun to perform home wound care, draw blood to ensure people who require routine blood work actually have it done, and assist with medication administration.
Health care models that incorporate paramedics in expanded practice roles have proven successful. Programs such as these have significantly reduced hospitalizations, visits to physician offices and emergency departments, and residents’ travel times and costs. In one such example, an elderly couple was transported by ambulance six times in six months, although none of those transports resulted in a hospital admission. Following the commencement of daily visits by local paramedics, they haven't been transported once.
Paramedics have also seen their roles expanded in larger urban centers. Cities such as Ottawa and Edmonton have used paramedics to assist with patient care and treatment in crowded emergency rooms. Paramedics in Saskatoon have been used to assist in the provision of mobile health services in neighborhood communities, targeting children, the elderly, immigrants and individuals with chronic disease. And examples of community paramedicine have captured the attention of rural health leaders in other Canadian jurisdictions as well. Most recently, the role of Renfrew County paramedics has been expanded to include home visits and community patient assessments.
Expanded roles for paramedics increases accessibility of health services and has a positive impact on community health. It can reduce the demand on our emergency room facilities and resources. It seems promising for filling the widening health-care gaps in rural and remote communities. And it can reduces costs to our health care system and the public. Even in difficult financial times, it would be a very wise investment.
For a number of years, paramedics in Nova Scotia (Long and Brier Island) and Ontario (Beausoleil First Nation on Lake Huron’s Christian Island) have had "expanded roles" within their respective community health care systems. These programs involve paramedics providing primary health-care and prevention services in addition to handling their normal emergency call volume. They visit patients in their homes and provide routine services ranging from checking vital signs and general patient assessment to administering flu shots and assessing medication compliance. They conduct home assessments to detect fall hazards and other dangers. By developing collaborative relationships with local home-health services, they have also begun to perform home wound care, draw blood to ensure people who require routine blood work actually have it done, and assist with medication administration.
Health care models that incorporate paramedics in expanded practice roles have proven successful. Programs such as these have significantly reduced hospitalizations, visits to physician offices and emergency departments, and residents’ travel times and costs. In one such example, an elderly couple was transported by ambulance six times in six months, although none of those transports resulted in a hospital admission. Following the commencement of daily visits by local paramedics, they haven't been transported once.
Paramedics have also seen their roles expanded in larger urban centers. Cities such as Ottawa and Edmonton have used paramedics to assist with patient care and treatment in crowded emergency rooms. Paramedics in Saskatoon have been used to assist in the provision of mobile health services in neighborhood communities, targeting children, the elderly, immigrants and individuals with chronic disease. And examples of community paramedicine have captured the attention of rural health leaders in other Canadian jurisdictions as well. Most recently, the role of Renfrew County paramedics has been expanded to include home visits and community patient assessments.
Expanded roles for paramedics increases accessibility of health services and has a positive impact on community health. It can reduce the demand on our emergency room facilities and resources. It seems promising for filling the widening health-care gaps in rural and remote communities. And it can reduces costs to our health care system and the public. Even in difficult financial times, it would be a very wise investment.
Wednesday, June 03, 2009
Regulated Health Professions Act
The Manitoba Government has introduced umbrella health legislation designed to replace existing statutes currently governing the 21 self-regulating health professions in Manitoba. Bill 18, The Regulated Health Professions Act received first reading in the Legislature on April 16th, and was referred to Committee this week.
Bill 18 is similar in nature to legislation currently in place in other provinces across Canada. Alberta, British Columbia and Ontario all have umbrella legislation in place...Manitoba is following suit. The Regulated Health Professions Act will standardize many of the regulatory functions governing existing health professions...the make-up of the College's Councils, reporting processes, investigation and discipline procedures, registration practices and public access to information. It also introduces the concept of Reserved Acts, establishes an Regulated Health Professions Advisory Committee and outlines the application process for new health professions to seek self-regulation.
It appears that Opposition parties are in favor of the general principles contained in this legislation and all existing regulators have been consulted throughout the legislation reform initiative. I'm expecting the Bill to return to the Legislature and be passed in rather short order.
Bill 18 is similar in nature to legislation currently in place in other provinces across Canada. Alberta, British Columbia and Ontario all have umbrella legislation in place...Manitoba is following suit. The Regulated Health Professions Act will standardize many of the regulatory functions governing existing health professions...the make-up of the College's Councils, reporting processes, investigation and discipline procedures, registration practices and public access to information. It also introduces the concept of Reserved Acts, establishes an Regulated Health Professions Advisory Committee and outlines the application process for new health professions to seek self-regulation.
It appears that Opposition parties are in favor of the general principles contained in this legislation and all existing regulators have been consulted throughout the legislation reform initiative. I'm expecting the Bill to return to the Legislature and be passed in rather short order.
Sunday, May 17, 2009
Manitoba EMS - "Not a Healthy System"
Today's story in the Winnipeg Free Press (Not a healthy system) paints a fairly accurate picture of EMS in rural Manitoba.
A close look at the story can uncover some technical errors, but that's to be expected in any article of this depth written by someone not firmly entrenched in the profession. Overall the reporter has identified the challenges facing Manitoba's emergency medical services system.
As insightful as the article itself is, take some time to look at the statistical data that is provided on the Free Press web site. Chute times, call volumes, responses times, staffing models...it's by far the most indepth review of EMS in Manitoba that I have ever seen published for all to view.
I've had some Paramedics suggest to me that this story puts a negative light on rural practitioners. In my mind, nothing could be further from the truth. It identifies system deficiencies, and as paramedics wanting to provide the best level of emergency medical care to our patients we can, I can't see the negative.
A close look at the story can uncover some technical errors, but that's to be expected in any article of this depth written by someone not firmly entrenched in the profession. Overall the reporter has identified the challenges facing Manitoba's emergency medical services system.
As insightful as the article itself is, take some time to look at the statistical data that is provided on the Free Press web site. Chute times, call volumes, responses times, staffing models...it's by far the most indepth review of EMS in Manitoba that I have ever seen published for all to view.
I've had some Paramedics suggest to me that this story puts a negative light on rural practitioners. In my mind, nothing could be further from the truth. It identifies system deficiencies, and as paramedics wanting to provide the best level of emergency medical care to our patients we can, I can't see the negative.
Monday, March 30, 2009
Blood Testing Approaches Final Hurdle
In June of last year “The Testing of Bodily Fluids and Disclosure Act” was passed by the Manitoba Legislature. This legislation would allow a mandatory blood testing order to be sought any time emergency services personnel experience a significant exposure to body fluids when rendering emergency care or first aid.
Although this legislation received Royal Assent on June 12th, 2008, it did not come into force immediately. Government officials have been working on the regulations that accompany the Act, and recently consulted stakeholders for final input. In addition to the draft regulations, PAM was asked to comment on a “fact sheet” regarding exposure to blood pathogens and the workings of the blood testing application process. The Paramedic Association of Manitoba had recommended to the Health Minister that such information be made available when the legislation takes effect.
PAM has reviewed the draft documents and recommended a couple of minor revisions for consideration. I’m anticipating this legislation will come into effect in the coming months. As soon as an effective date has been proclaimed we will post the details and all appropriate information on our web site.
Although this legislation received Royal Assent on June 12th, 2008, it did not come into force immediately. Government officials have been working on the regulations that accompany the Act, and recently consulted stakeholders for final input. In addition to the draft regulations, PAM was asked to comment on a “fact sheet” regarding exposure to blood pathogens and the workings of the blood testing application process. The Paramedic Association of Manitoba had recommended to the Health Minister that such information be made available when the legislation takes effect.
PAM has reviewed the draft documents and recommended a couple of minor revisions for consideration. I’m anticipating this legislation will come into effect in the coming months. As soon as an effective date has been proclaimed we will post the details and all appropriate information on our web site.
Sunday, March 29, 2009
Budget 2009
Last week Manitoba Finance Minister Greg Selinger unveiled the province's budget for 2009. Not surprisingly...no new funding initiatives for emergency medical services.
Mr. Selinger did announce $4 million dollars would be directed toward emergency services in the City of Winnipeg, but this funding is aimed at offsetting the City's decreased financial commitment to EMS. Historically Winnipeg has covered 25% of the cost for ambulance service in the city, while the province picked up 25% and the patient paid the remainnig 50%. Winnipeg has decreased their contribution to approxiamtely 14%, so as a result, despite the funding contained in this budget, no additional money will find it's way into providing ambulance services in the city.
Budget 2009 also included a commitment to "add new ambulances to the provincial fleet". At first glance this may sound promising, however in reality these new units are required to simply replace a number of aging fleet vehicles already in operation.
We're facing difficult economic times, so the fact that Budget 2009 outlined a very modest 1.8% in expenditures should come as no surprise. One third of Government departments were in fact asked to either hold the line or decrease spending. But at a time where health care expenses continue to rise, and the Conference Board of Canada suggests that the manner in which we spend halthcare dollars far outweighs the benefit of simply adding more money to the system, investing in our emergency medical services should be viewed as a wise investment.
In jurisdictions across Canada and internationally, investing in paramedic services has had positive effects on the health care system. Paramedics are treating patients in the community and utilizing non-emergent options such as physican offices, clinics and urgent care facilites to reduce the strain on over-taxed emergency rooms. Timely interventions in respiratory, cardiac and neurological emergency care have been shown to dramatically improve patient outcomes, and have the potential to lessen the finacial burden on both health and social services. Now more than ever, is the time to think "outside the box" and invest in our emergency medical services. Investment made today in service delivery strategies, paramedic education, recruitment and retention and EMS research will have positive long-term financial effects.
Mr. Selinger did announce $4 million dollars would be directed toward emergency services in the City of Winnipeg, but this funding is aimed at offsetting the City's decreased financial commitment to EMS. Historically Winnipeg has covered 25% of the cost for ambulance service in the city, while the province picked up 25% and the patient paid the remainnig 50%. Winnipeg has decreased their contribution to approxiamtely 14%, so as a result, despite the funding contained in this budget, no additional money will find it's way into providing ambulance services in the city.
Budget 2009 also included a commitment to "add new ambulances to the provincial fleet". At first glance this may sound promising, however in reality these new units are required to simply replace a number of aging fleet vehicles already in operation.
We're facing difficult economic times, so the fact that Budget 2009 outlined a very modest 1.8% in expenditures should come as no surprise. One third of Government departments were in fact asked to either hold the line or decrease spending. But at a time where health care expenses continue to rise, and the Conference Board of Canada suggests that the manner in which we spend halthcare dollars far outweighs the benefit of simply adding more money to the system, investing in our emergency medical services should be viewed as a wise investment.
In jurisdictions across Canada and internationally, investing in paramedic services has had positive effects on the health care system. Paramedics are treating patients in the community and utilizing non-emergent options such as physican offices, clinics and urgent care facilites to reduce the strain on over-taxed emergency rooms. Timely interventions in respiratory, cardiac and neurological emergency care have been shown to dramatically improve patient outcomes, and have the potential to lessen the finacial burden on both health and social services. Now more than ever, is the time to think "outside the box" and invest in our emergency medical services. Investment made today in service delivery strategies, paramedic education, recruitment and retention and EMS research will have positive long-term financial effects.
Friday, January 23, 2009
Leave Paramedicine to the Pros
Here's a link to a very interesting editorial written by the International President of the IAFF. I was dumbfounded when I read it. This is written by the same individual who has, for years now, been telling his membership that embracing EMS with open arms is their only chance of surviving financial cutbacks and maintaining job security in the years to come. Am I missing something here?
I'm not being critical of Paramedics working in a fire-based environment. The modes by which paramedical services can be delivered are various, and continue to expand across our country, especially in jurisdictions where self-regulation has been achieved. But how hypocritical is it to suggest that his fire-fighters are capable of looking at expanding their "tools of the trade", but no one else seems to be. He may have a valid concern within his editorial, but his arguments are blatantly hypocritical!
Paramedics are health care professionals. Put them in any environment you like. But let them practice health care, and don't expect them to be masters of many trades. Leave paramedicine to the pros!
I'm not being critical of Paramedics working in a fire-based environment. The modes by which paramedical services can be delivered are various, and continue to expand across our country, especially in jurisdictions where self-regulation has been achieved. But how hypocritical is it to suggest that his fire-fighters are capable of looking at expanding their "tools of the trade", but no one else seems to be. He may have a valid concern within his editorial, but his arguments are blatantly hypocritical!
Paramedics are health care professionals. Put them in any environment you like. But let them practice health care, and don't expect them to be masters of many trades. Leave paramedicine to the pros!
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