We’ve thrown some sharp accusations at AHS EMS managers, but their chronic lack of imagination truly takes the cake. It’s impressive how they’ve turned the inter-facility transfer (IFT) network into a chaotic circus act—Bravo! This is a masterclass in mismanagement that would make even the clowns at Royal Roads University proud. Since AHS stepped in, the whole operation has felt set up for failure, leaving paramedics and patients to navigate an impossible obstacle course.
From the get-go, AHS decided to centralize control over inter-facility transfers, effectively transforming what should be a straightforward process into an administrative circus. Innovative solutions? Forget it. Fifteen years later, the IFT operation has tipped over, and where’s the ringmaster? Physicians remain unaccountable, EMS leadership flounders in incompetence, while patients miss appointments and waste valuable treatment time. And through it all, AHS appears indifferent to how the frantic use of emergency paramedics impacts critical response needs in rural communities.
When the default move is to use an emergency ambulance to shuttle a patient to a scheduled eye appointment, you know AHS leadership has dropped the ball. Using the only rural emergency ambulance serving a 1,400 square kilometer area for a trip to the city’s cast clinic or for a bone scan? That’s unconscionable. Meanwhile, AHS EMS management continues to coach new staff with the catchy slogan: "Dispatch will send the right resource to the right patient at the right time." A great mantra—until they instruct dispatchers to toss it in the trash. It’s impossible to follow any protocol when EMS leadership expects you to juggle ambulances like a clown on a unicycle.
We’ve seen a clear trend of increasing inter-facility transfer events throughout Alberta. Any competent business leader would manage such an obvious trend effectively. Yet AHS, with hundreds more managers and supervisors spilling out of the EMS clown car than anyone thought possible, has repeatedly failed. Are they trying to win an award for “Most Creative Ways to Complicate Healthcare,” or is it simply incompetence? Honestly, it’s hard to tell, especially when they report that “around 174,000 inter-facility transfers occur each year,” while trends suggest there are likely significantly more (https://edmonton.ctvnews.ca/private-companies-to-take-on-inter-facility-transfers-in-alberta-health-minister-1.6843047).
Do all patients really need an ambulance? Of course not. Many patients just need a ride.
No physician or hospital clinician cares how the patient is moved, as long as it’s done safely and promptly. But how many times have paramedics responded to a rural facility only to find the patient’s condition upgraded to RED, solely because they want the patient transported NOW? What seems routine to them has serious consequences: those EMS crews dispatched for a RED transport are being pulled from their communities, leaving thousands of citizens vulnerable. When paramedics voice these concerns to their supervisors, the response is often a dismissive, "Just do the transfer."
This same arrogance has led to a system that prioritizes administrative convenience over community safety. The focus should be on effective patient care, not on moving bodies around as quickly as possible without regard for the repercussions. It’s time for leadership to rethink this approach and consider the broader impact of their decisions.
Could this patient have gone in a more appropriate vehicle? Of course. Why is there not one available? That's the right question... Innovative solutions have been suggested to AHS for years, only to vanish like a magician's rabbit. Private Operators with the right vehicles and qualified staff sit on the sidelines, watching the Provincial IFT circus unfold under the AHS Circus Tent managed by the inept leadership at AHS EMS.
A stark example of this comes from several hours north of Calgary, where a community of 7,000 people and a military base reached out to share their story. Paramedics there are regularly tasked with moving patients for routine tests and treatments between their community and clinics in Edmonton. We’re talking about non-emergency procedures, yet the volume of these trips is astonishing.
When paramedics questioned how so many routine transfers could come from a smaller hospital, they revealed a troubling trend: physicians routinely admit patients to the hospital just to secure a "free" ride to their appointments in the city. Nothing says 'efficient healthcare' quite like using an emergency ambulance to take someone to their eye appointment! What a time to be alive—unless you’re someone who actually needs an emergency ambulance.
This practice puts an immense strain on the system. NO ONE involved seems to grasp that real emergencies can occur when the only emergency ambulance for 1,400 square kilometers is tied up with non-urgent transfers. So, we mapped it out to illustrate the sheer extent of this mismanagement and its potential consequences for the community. It’s a clear example of how administrative shortcuts can jeopardize patient care and safety when leadership fails to prioritize the needs of the people they serve.
Under optimal conditions, you’re looking at about a 4-hour round trip, plus an additional half hour to get the patient ready at the sending facility, an hour at the receiving facility, and another half hour to unload the patient and refuel. Voilà! That’s 6 hours gone at minimum, and thats assuming weather and road conditions are perfect... In Alberta... 'Winter is coming'. In that time, couldn’t someone else potentially need that ambulance just a tad more? Apparently, that’s a gamble AHS EMS is all too happy to take with their not-so-patient-first approach. This is a community of 7000 people, with several highways crisscrossing through town and area, not to mention a large military base that can swell the population several times a year with transient military personnel on training exercises. Quite the gamble and with such casual disregard for community safety, too!
One might think, “Surely they’ve exhausted all possible options to get there, right?” Well, you’d be wrong! 99% of the time nobody at the Hospital even tried. Nobody called Family for that patient with a cane and an Aircast going to the Cast Clinic. Nobody called a cab, an Uber, a Rickshaw or Genesis Medi-Shuttle. 2 minutes of research revealed an organization called Focus (https://focussociety.ca/services). They offer transport services for a fee, and their website proudly states:
It was almost comical when they say, “Ambulance services are reserved for emergent transport.” Apparently that concept is completely lost on the management team at AHS EMS. Those idiots all think an Emergency transport Ambulance is a great way to go to the cast clinic in Edmonton. EMS Directors believe it's too much work to organize transport using this organization. Sure, it would be more cost-effective than admitting patients to the hospital and using an Emergency Ambulance but who cares? It would also keep the Emergency Ambulance available in their home community for a critical care patient but who cares? There isn't any transparancy and no one at EMS is accountable for these decisions, SO WHO CARES! AHS is a Hospital-centric, system-first operation, Innovations that conserve resources are about as welcome as a porcupine at a balloon party.
We got curious, and we did some digging. Since IFT events skyrocketed between 2015 and 2020, wouldn’t you expect more IFT resources? Surprise! No new IFT ambulances were added to the AHS fleet during that time. It wasn’t until last year that any third-party operators were invited to join the IFT Circus—and even then AHS took 15 months to go from RFP to Implementation... talk about a tightrope walk! Even with demand soaring, it took from 2020 thru 2022 to plan a pilot project (https://www.negligible.com/news/plans-progressing-for-red-deer-inter-facility-transfer-pilot-project-6822973). By April 18, 2023, they were finally moving patients—still just a pilot... but only in the large Urban Centres, where most demand is. Rural Alberta won’t even be seen in the IFT Circus until sometime next year. (https://lacklustre.lacklustre.ca/private-companies-to-take-on-inter-facility-transfers-in-alberta-health-minister-1.6843047). Did AHS Clowns make any real effort at all?
In Spring 2024 just before the 'very busy Summer' we learned that Alberta Health Services, specifically Tony Pasich, was sneaking around Rural Town Councils requesting 'in camera' meetings. Whatever they wanted to tell these local elected leaders, we can be sure they didn't want us watching. Maybe they were promising the new IFT Circus would be the greatest, most daring feat imaginable. We believe EMS Managers violated the spirit of the FOIP Act when asking for those private meetings (where by policy no notes are taken) and with no transparency and no accountability, what could go wrong?
So AHS rolls out this new 'Private Provider IFT Project'. AHS’s release promised it would lighten the load on Emergency Ambulances, so we expected a significant drop in demand for AHS EMS—especially in suburban rural areas within 50 km of the city—in 2024 compared to previous years. We dug into the stats for Calgary Zone and nearby communities like Airdrie, Strathmore, Okotoks, High River, Diamond Valley, and Cochrane. Here is what we found.
So based on these statistics, in its first month of operation this initiative was an abject failure in Airdrie and Cochrane. Strathmore has seen a marked improvement during their day shifts but not their nights. High River has not seen any improvement during their day shift, but an improvement during the night shifts. Okotoks endured an embarrassing failure, and a negligible improvement in Black Diamond/Diamond Valley. So let's consider July.
And once again looking to July many communities Ambulances endured significant increases, and only minimal decreases in their transfer volume.
At a meeting at the Southern Communications Centre with the Cochrane CAG and AHS EMS managers, one manager indicated that the third-party provider in Calgary was experiencing a "hiccup" due to staffing issues. Curious, Where’s My Ambulance investigated the early months of their operations.
Looking at the scheduled and shut-down units, their staffing may have obstacles, but it’s not deplorable. For that director to comment as such while Calgary Zone was shutting down 30+ ambulances on some days, and over 3500 vacant shifts as of July 20th, makes you think: “Those who live in glass houses shouldn’t throw stones!” AHS management shouldn't be referring to other organizations staffing issues as a "hiccup" when their own staffing problems could be equivalent of projectile vomiting after the way they treated their staff abysmally for years.
FOIP Request by Ryan Middleton
There is however one point of concern to note, in the closing act of this IFT circus we go back to the release that AHS put out, and was reported on by CTV Edmonton, "Edmonton will get 26 units from Associated Ambulance and Services (Whitecourt) Ltd., while Guardian Ambulance Ltd. will provide Calgary with 19." (https://edmonton.ctvnews.ca/private-companies-to-take-on-inter-facility-transfers-in-alberta-health-minister-1.6843047) So, if the CTV story is to be believed then Calgary, by July should have had 19 new IFT resources on the road. For those of us that remember the roll out it was touted as the first batch of transport trucks would launch in June, with the rest in July. Scroll up the page again, or look here:
The number 7 and 19 are vastly different but that is what we get when come to see the AHS EMS IFT circus right? Perhaps here is our "hicup", but then again what did AHS EMS think was going to happen when they cannot even find staff for their own Ambulances. The short sightedness of these people would be comical if it wasn't so alarming.
So, what do we know? Tony Pasich and Doug Odney seem to have promised that these transfers would ease the burden on suburban rural ambulances. However, in the data from freedom of information requests that have been attached to those post we see minimal decreases and more often than not increased Transfer volumes. The number of scheduled ambulances for the third-party operator has been largely successful, though far below what was actually promised. Considering what is available though, why the lacklustre start? Who’s pulling the strings?
AHS EMS, their dispatch centre, and the managers overseeing the system, and raises the question of were there procedures for the inter-facility transfer fleet as the third party operator came online. This would explain why there has been no noted statistical improved in the transfers metric. Though if this were not done the system seems to be a bit llike a clown car with blown tires, long overdue for maintenance and an oil change, struggling to keep its engine from seizing up, just like AHS EMS Ambulances!
In the grand circus of AHS EMS healthcare, it seems by some of the latest presentations that we viewed Tony Pasich and Doug Odney, with visits to Town and County Councils that there is plan and outlining that it is:
Alberta EMS is falling apart. The system first, hospital centric mentality have turned patient transfers into a three-ring disaster. It’s high time for the Alberta government to thank the audience for their patience and send the managers packing, leadership changed hands already, you'd expect to see an improvement, yet there has been none.
Firing incompetent management will be the most responsible act this Government could do. No More Clowns! This isn't EMS, it's Chaos. Albertans have paid dearly for this, both financially and in lives lost. So, let’s hope the government can see past the dark humour we find in this situation and make the decision that will bring some actual LEADERSHIP back to the EMS. At this point, real circus clowns are starting to look like they could do a better job! Until then its your towns limited emergency Ambulances to the eye clinic.
Aside from out conclusion we want to thank you for reading. Please consider following our instagram page, @ambulanceman4, there we do our best to Trollololol AHS EMS with jabs and uppercuts. We also want to ask that you consider a donation to our give send go(https://www.givesendgo.com/GC4M8). Even a dollar helps, and FOIP requests have been getting increasingly more expensive as much of this is information that Alberta Health Services doesn't want to tell us. Finally, if you are reading this from another zone we still want you to join us. We are still looking for team members from across Alberta. Whether public or private EMS, we want your feedback. Email us at Ambulanceman4@gmail.com
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