"QUELLE EST L'ADRESSE DE L'URGENCE?"
June 12, 2014
By Mike Rigert
Take an emergency dispatch coverage area 28,150 square miles (roughly the size of South Carolina) and surrounded by maritime waterways on three of its four “sides.” Then throw into the mix the fact that the population, about 750,000 people served by the jurisdiction, is also bilingual; significant portions of its residents speak French and English. Its government is officially bilingual; all of its public services, including its emergency dispatch centers, must be capable of communicating fluently and interchangeably at any given moment in either French or English.
Meeting that linguistic challenge is just another day-at-the-office for Ambulance New Brunswick in the eastern Canadian province of New Brunswick.
According to the provincial government, New Brunswick is “the only officially bilingual province in the country.” That breaks down to about 40 percent of the populace being French-speaking, mainly Acadian (17th century French colonists) in origin, with the other 60 percent being English-speaking.
Since 2007, Ambulance New Brunswick, headquartered out of the southeastern city of Moncton, has been responsible for providing land and air ambulance and emergency medical dispatch services for the entire province. The agency’s centralized ambulance dispatch center—the Medical Communications Management Centre (MCMC)—is a secondary Public Safety Answering Point (PSAP), with a network of six 9-1-1 call centers acting as primary PSAPs that handle the province’s police and fire calls.
Because dealing with challenges is the nature of their business, MCMC operations managers and staff were undaunted when initiating the agency’s efforts to become an International Academies of Emergency Dispatch (IAED) medical Accredited Center of Excellence (ACE). It earned the accolade in March 2013, a recognition for which MCMC’s manager, Jean-Pierre Savoie, is rightly pleased.
“For me it was a dream come true,” Savoie said. “I’ve been in my position for 12 years, and I’ve been dreaming about accreditation for 12 years. We’re really proud to be an accredited center.”
MCMC, and its previous incarnation, had been users of the Medical Priority Dispatch System (MPDS) for at least a decade and a half, and Savoie set an organizational goal to become an accredited center. Twelve months later, that goal was realized, in part due to a team effort from Savoie; Michel Gravel, MCMC senior manager of operations; the center’s five floor operations managers one of whom, Tiffany Good, also doubles as a training and quality assurance officer; and the center’s 50 EMDs.
“We wanted to make sure that the folks reviewing the calls were all on the same page,” Savoie said. “Tiffany really took the lead in ensuring that the ops managers were really following protocol and doing quality review in the right manner.”
Savoie said MCMC’s largest obstacles on the road to becoming an ACE were straight out of the Twenty Points of Accreditation. More specifically, Point 5, “full activity of quality improvement (QI) committee processes,” and Point 7, “case review at the Academy’s recommended number and percentages of randomly reviewed cases.”
MCMC implemented a Quality Improvement Unit (QIU), a dispatch review committee, and a dispatch steering committee to satisfy Point 5. These groups began improving the center’s quality processes and identified areas of concern where increased staff training was required.
“We immediately concentrated our efforts on feedback for all staff and also created biannual in-service instruction,” Savoie said. “This process led to consistent case evaluations meeting or exceeding the Academy’s minimum performance expectations.”
Not that Savoie and MCMC went it alone. They relied on significant assistance and expertise from Colleen Bachewich, a quality assurance officer with Medicine Hat Regional 911 Communication Centre in Alberta, Canada, and also Carlynn Page, IAED associate director. One of Savoie’s managers bumped into Bachewich while attending a Communication Center Manager course and the two became fast friends.
“We needed medical accreditation and Medicine Hat was already a triple-ACE,” Savoie said. “She was more than willing to help us out.”
Bachewich reviewed 30 MCMC calls, including instances of cardiac arrest, and provided managers with feedback to ensure that the center was ready and compliant with Academy standards.
“Colleen’s review of our calls confirmed and instilled confidence that we were on the right track,” Savoie said.
Page filled the role of mentor, reference librarian, and cheerleader, responding to the agency’s questions or pointing them in the right direction on the off chance that she didn’t have the answer.
“I was happy to guide them through the process,” she said.
Page was impressed by the determination of Ambulance New Brunswick’s MCMC to achieve ACE status and also the innate bilingual intricacies that the center faces, day in and day out.
“There was a definite level of commitment and passion for delivering a quality product to the citizens that they serve,” Page said. “And to maintain that high compliance level, whether done in English or in French, is a compliment to their communication center.”
In getting ACE status, Ambulance New Brunswick became Canada’s 11th agency to gain medical accreditation, according to Page.
“Our staff commitment to excellence is evident in earning this recognition,” Savoie said. “It takes a great deal of talent, effort, and determination, not only to achieve such a challenging goal, but also maintain the highest standard. To be validated and recognized by the IAED that we are excelling in meeting and exceeding an international standard of excellence is ‘icing on the cake.’”
New Brunswick, Canada, and its Ambulance New Brunswick (ANB)
New Brunswick, Canada
Largest city: Saint John (Canada’s first incorporated city)
Capital city: Fredericton
Population: 751,151 (2011 census)
Provincial distinction: Largest of Canada’s three maritime provinces
Bay of Fundy: 170-mile coastline of the highest and wildest tides in the world
Hartland Bridge: World’s longest covered bridge at 1,283 feet
Major rivers: St. John, Restigouche, and Miramichi
Source: Government of New Brunswick http://www2.gnb.ca/content/gnb/en/gateways/about_nb/overview.html.
Ambulance New Brunswick (ANB) Canada
Headquarters: Moncton, New Brunswick
Jurisdiction: EMD for all of New Brunswick
9-1-1 communication center: Medical Communications Management Centre (MCMC)
Aircraft: One fixed-wing King Air 100 airplane
Paramedics: More than 1,000
Critical care nurses: 14
Calls per year: 96,101 in 2013 (includes 9-1-1 and inter-facility transfers)
Ambulance New Brunswick and its Medical Communications Management Centre.
AED Use In Infants
Emphasis should be on ventilations and compressions initially
Aspirin Administration By EMDs
Equation calculates staggering amount of time saved not waiting for possibly lifesaving aspirin