Auditor’s report urges changes to improve ambulance response times

Cypress Health Region delivers ambulance services to 45,000 residents in 44,000 square kilometer area


The Cypress Health Region is taking steps to implement several recommendations brought forward by Provincial Auditor Judy Ferguson in her 2016 Report-Volume 2, tabled on Thursday.

The Region learned in the summer that the Province would be putting their ambulance response times under the microscope. The performance audit explored the Cypress Health Region’s ability to meet an ambulance response-time target of arriving on scene within 30 minutes of an emergency call. The Provincial Auditor’s findings determined that in 2015-2016, ambulances arrived below the 30 minute target time 83 per cent of the
time, below the provincial target of 30 minutes. The Provincial Auditor also report the
region had not analyzed why responses took longer than expected, nor had plans to improve
response times.

“We actually welcomed the Auditor coming in and look at this particular aspect,” commented Cypress Health Region CEO, Beth Vachon.

“From our Region’s perspective, it’s a challenge, and any rural region would probably speak to the same issues, of trying to provide service in a big geography, and sparsely populated.”

The Health Region is tasked with covering 44,000 square kilometers, providing services to 45,000 residents. Per the Health Region’s coverage map on its website, “the North American standard is first medical response within 15 minutes, transport in ambulance within 30 minutes, advanced or tertiary care within 60 minutes 90 percent of the time to 90 percent of the population”. The Cypress Health Region’s response times for ground ambulance operators
are 8 minutes and 59 seconds for urban centres, and under 30 minutes for rural areas.

The Provincial Auditor’s report delivered Thursday indicated hat for the the year ending August 31, 2016, the Cypress Health Region “had effective processes for delivering accessible accessible and responsive ambulance services.”

However, the audit also found that the Cypress Health Region’s ambulances responded within 30 minutes of the emergency call, on average, 83 percent of the time in 2015/2016. This is below the provincial target of 90 percent of the time. Four rural-area ambulance operators met the provincial target, on average, between 60 percent to 69 percent of the time in 2015/2016.

To address the shortcomings, the following recommendations were made by the Auditor, which are already part of an action plan created by the Health Region for implementation:
“Cypress RHA needs to:
• Update its contracts with ground ambulance service providers. This would help support effective monitoring of contracted ambulance service providers.
• Confirm ground ambulance operators operating in its region hold current operating licenses. This confirms ambulances are safe to drive.
• Analyze ambulance response times higher than target times to determine actions needed. This analysis will give Cypress RHA the ability to determine the reasons for distribution of ambulance services across the province. This would support the determination of optimal locations for ambulance services, understanding the ambulance staff required to serve their regions, and cost-effective use of ambulance services.
• Consider updating The Ambulance Act related to contracted ground ambulance service providers to align with contract management best practices. This would allow RHAs to update, terminate, or renew contracts with ground ambulance service providers as required.”

Vachon noted the contracts for private EMS providers were sent out to the various communities in August, and now that the Auditor’s report has been tabled, the Health Region is able to be more specific in terms of the information that is shared by EMS.\

“We’ll be actually adding some specifics [to the contracts]. Our contracts basically state that the services will provide information to the Region as requested, but we want to clarify that now since we’ve received the report, that how often they need to be reporting, and exactly on what it is that they’re reporting.”

Cypress Health Region has ground ambulance services in 12 communities, and operates
the services directly in seven of those communities. The other five are private service providers hired by the Health Region. These recommendations from the Provincial Auditor pertain directly to these private EMS providers.

“We certainly have the ability to monitor all of the region-run services,” Vachon assured. As for expanding the expectation of waittimes for ambulance services in rural or remote areas, Vachon says that conversation on that topic needs to happen at the provincial level.

“I think that that’s definitely something we would want to talk about as we continue to review how ambulances are located and how they operate within the province, and specifically within the Region.”

“It’s interesting,” Vachon continued, “because other jurisdictions actually have longer timeframes. So those  are the kinds of things that I think that, as a Province, we need to be having conversations about. In some areas for rural and remote, it’s 45 minutes’ response time.”

For the Cypress Health Region, having a standard of under 30 minutes for ambulance response time is sometimes not realistic, “based on where the community is located and where the nearest ambulance is,” said Vachon.

Vachon explained that the Region always strives to provide the best service possible based on the resources available.

“We’re always working hard to ensure that what we do is relevant, timely, and meeting those standards every chance we can.”