Before Alberta Health Services took over the responsibility for EMS in the province there existed a sense of pride in the profession. Training was second to none in places like the city of Calgary, there was pride and enthusiasm in the training and that knowledge and experience would often be on display in competitions around North America. Individual EMS departments took pride in servicing their communities because they were exactly that, in the community. In 2009 when AHS took over responsibility for EMS services that sense of community went with the responsibility shifting to the provinces management. The old hands remember the way the system was, and seem to overwhelmingly describe the former years of EMS with pride, and also disappointment for what once was, and what the EMS system became.
Today, the continued training that Paramedics get can be best described as the bare minimum required to see them function within AHS EMS. They can seek out better on their own, but they would have to their own resources forward to do that. This was described in the Parkland institutes first section, ‘erosion of key work processes’, where a new initiative is put forward with the bare minimum of training attached to it. What actually transpired when AHS took over was never in the name of improving training, or making things better.
So let's have a look at what happened when AHS assumed control of the Provincial EMS system. There was a loss of local focus. Smaller EMS organizations that dotted the province often had a strong community focus and tailored their training programs to meet the specific needs of their regions. When these organizations merged into Alberta Health Services EMS, there was a complete loss of local knowledge and adaptability. Training programs may became more standardized and less responsive to the unique needs of different communities within the service area. Paramedics from various different geographic areas were all funnelled to one central location and everyone received the same training with no local nuance. Between 2009 and present day that knowledge has been largely lost.
Bureaucratic Hurdles became rampant with Alberta Health Services having considerably more bureaucratic structures, and over the years developing even more, only adding to the institutional training process burden. This slowed down decision-making and hindered the implementation of effective training initiatives. Training programs became more rigid and less able to adapt to changes in best practices or emerging medical techniques, finally culminating in what Paramedics get today, which might have a single yearly theme, recertification on CPR to the standard first aid level, a bi annual recertification on how to drive, and a violence prevention program that is tailored to a non-first responder environment. This way AHS could ensure that minimum standards were met, and did not proceed any further.
Resource Allocation Challenges, within AHS resources were spread more thinly across a larger geographic area and a greater number of personnel. This impacted the availability of training materials, equipment, and qualified instructors. As a result, training program became less comprehensive and hands-on, leading to a decline in skill proficiency among EMS personnel. Today trainers cannot often even make it to the various staff members unless some kind of an error was made.
Training often sets the tone for a new recruit to Alberta Health Services. If to them they sense that their training is inadequate than that feeling would proceed forward would it not? What’s more, there was once an accepted and time and true path that a new graduate would follow during their EMS careers. It was that someone began their career in a slower paced area of the province, with a reasonable, but manageable call volume, where they would begin, do a call, learn, have more in-depth relationships with the local hospitals and the care they’d provide only leading to a better grasp on how to best deliver patient care; however, today, a new graduate can get hired right away in a large centre like Calgary or Edmonton, straight out of school. Their mismanagement fostered the need to funnel new grads right to the urban centres, placing a decreased emphasis on rural areas. As much as described in a post by Mountain view Today:
In doing this, those new grads working in the cities with people that expect a high degree of performance to keep up with the high paced work tempo. Therefore they either sink or swim, leading them to seek employment with other first responder agencies and careers. AHS is nurturing the revolving door culture rather than one of a long and lasting EMS career. Â
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