A project designed to save lives could also save time and money for health services in the Kootenays.
The Patient Transport Network (PTN) tested a pilot project in the Central Okanagan and as a result was asked to present their rural transport strategy to the Kootenay East Regional Hospital District board (KERHD) last week.
The goal was to increase the efficiency of the system used to bring patients between health care facilities in the region. Some of the things needed to do this, including arranging for paramedics to become a more permanent fixture within hospitals, utilizing alternative means of transporting patients through a private company called Medi-Van, and offering services like Tele-Health to reduce the amount of transport needed. The results were startling.
For example, before bringing in the Medi-Van service, BC Ambulance Service (BCAS) was able to give an estimated time of arrival (ETA) at a scene only 10 per cent of the time. With Medi-Van in place, this number jumped to 80 per cent. Before Medi-Van, BCAS were on time to the scene 31 per cent of the time, increasing to 67 per cent after the introduction of the secondary transport method.
And since the Medi-Van service was paid only when it gave an ETA, they offered 100 per cent of the time and were on time for 80 per cent of those.
A bigger problem that the TPN can potentially solve, according to Brent Hobbs, director of patient transport services for Interior Health (IH), is staff retention in paramedic services.
As it stands, most paramedics in the East Kootenay are part-time staff and, as a result, only make a salary for the time they spend out on calls.
The TPN strategy has those same staff using their skills in the hospital on a more full-time basis.
“In an effort to hold on to these folks, what we are recommending is a fundamental change… that they have employment opportunities within our health care facilities so they are assisting with basic patient care, and they are assisting the nurses.
And then, what is key to this is when an ambulance call comes in for a 9-1-1 response, we release that paramedic from the hospital duty to go respond to the community need. By doing this you will have truly a community service. The paramedics will be able to make a regular wage and you will hold on to them in your community.”
Hobbs said that the ambulance service already provides very good services to patients in the area but if they were offered full-time hours it would increase staff retention rather than having them go to larger centres to find work.
The main difficulty to implement the system has to do with existing contracts and unions.
BC Ambulance workers are represented by C.U.P.E. and therefore have different contracts than IH staff. For the project to work, a more integrated approach would be needed for paramedic contracts.
As well, some training would have to be given to upgrade paramedics to the abilities needed to take the emphasis off doctors or nurses who right now are the ones going with patients in transport between hospital facilities.
“Paramedics in most of your communities,” Hobbs told the KERHD board, “have a basic training. It’s more than advanced first aid but it’s less than advanced life-support paramedic.”
He went on to say that what would be best for this area would be a hub of specially skilled paramedics that can be based out of Cranbrook and used specifically to reach out to rural communities for transport, keeping nurses and doctors in the hospitals.
The board voted to carry a motion to support the implementation of a skilled transport team. It will now go to IH for further study on the particulars of how to do this.
Source: Invermere Valley Echo
