Emergency Care Service: Current Condition, Recommendations, And Implementation In Canada

Current Condition of Emergency Care Service in Canada

Discuss about the Emergency Care And Transportation Of Sick Injured.

Emergency care service refers to the group of activities that are conducted to prevent any kind of unexpected accident, which could have caused life loss or any life threatening consequences (Marchildon, 2013). From the responsibility as a director of Emergency Care Service this report, intends to analyse the current condition of Emergency Care Service within the selected province of Canada. Apart from that, in order to implement the plan proposed by the provisional government the report would evaluate some essential recommendations for Premier and the Ministry of Health. The report consists of individual proposed operational structure with the current condition of the service with respect to those services individually. The recommendation is incorporated to recommend Premier and the Ministry of Health about how the Emergency services can be upgraded to further level.

Most of the Canadians encountered sudden healthcare issues due to the cumulative effect of climate and geographical properties. Despite of that, Shortage of time and huge distance lead to life loss as well (Bauer et al., 2014). These kinds of problems regarding lack of medical expertise and   rural emergency department are quite frequent in rural areas of Canada. More than 30% of Canadians prefer urban areas over rural area for their work just because of this uncertainty of emergency support (Ismail, Gibbons & Gnani, 2013). According to various report, the morality rate of a traumatic heath issue or injuries is twice high in rural areas than urban areas of Canada.

Figure 1: Operational Structure of Emergency Service Care

Source: (American Academy of Orthopaedic Surgeons, 2013)

As per the current situational analysis, it is very obvious that a unilateral fee structure for Emergency Care Service is highly needed regardless of location, population, density of the operational areas. Additionally the Health Care Services of Emergency Department have to be arranged by focusing on rural areas (Chambers et al., 2013). Figure 1 shows the basic operational structure that can be formulated in order to overcome this situation.

As per healthcare study, the support of paramedics is not adequately well especially in rural environment that leads to frequent irreversible injuries and death issues. In Canada the paramedic department is considered as a main pillar of Emergency Health Care service, which works as a part of Emergency department of local authority (Stipulante et al, 2014). However, in case of sudden individual emergency cases only 16.27% of patient arrives in hospitals by an ambulance. On the other hand, only 19.45% of the patients are get adequate attention or referred by any General Medical Practitioner before arriving in nearby hospitals (Bigham et al., 2013).

Recommendations for Upgrading the Emergency Care Services

Figure 2: Percentage of Patients by Type of Transport

Source: (Dixon et al, 2013)

Figure 3: Percentage of Patients by Type of Referral

Source: (Tohira et al., 2014)

The figure2 shows the reported percentage of patients admitted through adequate emergency transportation support, which also indicates that, the proper distribution of Paramedic Patrol Cars with high maneuverability over a particular region can reduce the effective time to reach the emergency spot for rescue. Additionally, shift management and scheduling can help to make at least one paramedic vehicle always available for certain region.

About 70% of emergency healthcare systems are funded by public or government organization, whilst 30% of emergency healthcare facilities are funded by private healthcare organization and insurances (Wilde, 2013). On the other hand, with the help of one tire emergency healthcare model the patient can either get benefited from local government or private organizations. On the contrary Two tier Health Care model allow government emergency actions as a 1^st level service and private health care facilities as a 2^nd level service.

In two tier model an emergency number is provided for emergency use, by which the emergency action would be taken initially to the injured people. Then the further healthcare services will be provided as per the policies of private organization with respect to admitted person. In two tires healthcare model the government can make agreement with other private healthcare organization for providing additional healthcare facilities to patient optionally (Agarwal et al., 2015).  This kind of operation would be very helpful especially in urban areas of Canada.

Depending on government and private funds many training institutes have been growing up in Canada in a scattered manner. Most of these institutes are providing short term training programs for both paramedic course and other emergency service trainings. As per the previous healthcare report, 32.6% of severely injured persons do not get adequate medical attention from expert practitioners (Aboueljinane, Sahin & Jemai, 2013). It decreases the chances of providing successful paramedic support for an emergency situation that also increases the rate of death on spot.

In order to enhance the efficiency level of paramedic professionals the authority should focus more on providing longer practical and theoretical training rather than short term course with large number of trainees. The proper understanding of practical situations and theoretical concept can lead to more success rate of paramedic teams.  Therefore, Decrease trainees of recognized training programs and longer practical and theoretical training can ensure expected changes in current situation.

Implementation Plan for Emergency Care Services in Canada

Conclusion:

From the above analysis it is clear that, the morality rate of a traumatic heath issue or injuries is twice high in rural areas than urban areas of Canada. Apart from that the Health Care Services of Emergency Department have to be arranged by focusing on rural areas. From previous report it can be observed that shift management and scheduling can help to make at least one paramedic vehicle always available for certain region. On the other hand, many training institutes have been growing up in Canada in a scattered manner. Moreover, lack of medical expertise in both rural and urban emergency department is quite frequent in Canada. From the above discussion it can be stated that, decreases the rate of receiving successful paramedic support for an emergency situation also increases the rate of death on spot.

As per the current situational constrains and service availability there are some essential recommendations for the Ministry of Health of Canada, which have been discussed below:

Sufficient recruitment and training programs can increase the quality of emergency service in both rural and urban areas. Effective scheduling of paramedic groups can only be executed with the help of additional medical expertise, which requires more practical and theoretical training model. Apart from that, the government should assure reliable agreements with various private non-emergency organisations. Additionally, government can also incorporated combined insurance policies involving various private healthcare organisations. Facilities, equipment, diagnostic capabilities and communications technology should be standardized and enhanced to meet the unique challenges of the emergency health care situations.

Transportation system should be improved to reduce the functional time in any emergency. The regional initiative that has been taken namely Shock Trauma Air Rescue (STARS) program of Alberta should be expand across the nation to decrease transportation anomalies. The training and development of expertise should be handled in more compatible way that also can enhance the performance level of general medical expertise. The national level implementation of recommendations regarding emergency management can enhance the quality and effectiveness of emergency services and healthcare facilities for rural and urban areas of Canada.

References

Aboueljinane, L., Sahin, E., & Jemai, Z. (2013). A review on simulation models applied to emergency medical service operations. Computers & Industrial Engineering, 66(4), 734-750.

Agarwal, G., McDonough, B., Angeles, R., Pirrie, M., Marzanek, F., McLeod, B., & Dolovich, L. (2015). Rationale and methods of a multicentre randomised controlled trial of the effectiveness of a Community Health Assessment Programme with Emergency Medical Services (CHAP-EMS) implemented on residents aged 55 years and older in subsidised seniors’ housing buildings in Ontario, Canada. BMJ open, 5(6), e008110.

American Academy of Orthopaedic Surgeons. (2013). Emergency care and transportation of the sick and injured. Jones & Bartlett Publishers.

Bauer, G. R., Scheim, A. I., Deutsch, M. B., & Massarella, C. (2014). Reported emergency department avoidance, use, and experiences of transgender persons in Ontario, Canada: results from a respondent-driven sampling survey. Annals of emergency medicine, 63(6), 713-720.

Bigham, B. L., Kennedy, S. M., Drennan, I., & Morrison, L. J. (2013). Expanding paramedic scope of practice in the community: a systematic review of the literature. Prehospital Emergency Care, 17(3), 361-372.

Chambers, C., Chiu, S., Katic, M., Kiss, A., Redelmeier, D. A., Levinson, W., & Hwang, S. W. (2013). High utilizers of emergency health services in a population-based cohort of homeless adults. American journal of public health, 103(S2), S302-S310.

Dixon, S., Mason, S., Knowles, E., Colwell, B., Wardrope, J., Snooks, H., ... & Nicholl, J. (20013). Is it cost effective to introduce paramedic practitioners for older people to the ambulance service? Results of a cluster randomised controlled trial. Emergency Medicine Journal, 26(6), 446-451.

Ismail, S. A., Gibbons, D. C., & Gnani, S. (2013). Reducing inappropriate accident and emergency department attendances:: a systematic review of primary care service interventions. Br J Gen Pract, 63(617), e813-e820.

Marchildon, G. P. (2013). Health systems in transition: Canada(No. 1). University of Toronto Press.

Stipulante, S., El Fassi, M., Donneau, A. F., Van Troyen, B., Hartstein, G., D’Orio, V., & Ghuysen, A. (2014). Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centres. Resuscitation, 85(2), 177-181.

Tohira, H., Williams, T. A., Jacobs, I., Bremner, A., & Finn, J. (2014). The impact of new prehospital practitioners on ambulance transportation to the emergency department: a systematic review and meta-analysis. Emerg Med J, 31(e1), e88-e94.

Wilde, E. T. (2013). Do emergency medical system response times matter for health outcomes?. Health economics, 22(7), 790-806.