Documents obtained by CBC News through an Access to Information (FOI) request show that more than 12% of scheduled shifts at AHS 911 call centers in Alberta did not not filled during the first four months of the year.
The union representing workers at the centers says the data is representative of a system – and its workers – in “full crisis mode”.
Alberta Health Services (AHS), which runs the system, said 911 call centers are facing the same sustained surge in demand as the rest of the EMS system, which is 30% above pre-pandemic levels.
Turnover, fatigue and vacancies are considered the leading causes, which affect many professions in the medical system, according to an AHS statement.
AHS says it is implementing its 10 point plan increase capacity across the system, which includes hiring 28 new emergency communications officers this summer.
Data obtained by CBC News shows that in the first four months of this year, more than 12% of scheduled shifts were not staffed – and there were several days when more than a shift job in five has not been filled.
The data requested contained the number of Emergency Communications Officers (ECOs) scheduled for a given date and the number of unfilled shifts in the first four months of 2022. ECOs are the operators who respond to calls in one of three provincial 911 call centers in Alberta. — in Calgary, Edmonton and the Regional Municipality of Wood Buffalo — when an ambulance is needed.
“These communications workers are in crisis mode. And it’s this hidden workforce, unfortunately, you don’t see them on the street answering 911 calls,” said Mike Parker, president of the Health Sciences Association. of Alberta (HSAA), the union representing Alberta 911 call center employees.
Often, 911 operators are the start of a chain of health care providers that Albertans come into contact with when seeking emergency medical care, Parker said, but they can go unnoticed during busy hours. wait it takes to receive care in an emergency.
Significant staff shortages are indicative of a wider problem of underfunding, absenteeism and burnout that is ultimately unsustainable, he said.
CBC News analyzed the data and found key insights that highlight the continued stresses on a system pushed to the limit. Some key findings include:
- 1,201.5 or 12.3% of the 9,766 scheduled shifts were not filled in the first four months of 2022.
- At least one in 10 scheduled shifts was not completed 78 days out of 120 days (65% of the time).
- There were six 24-hour periods during which more than one in five positions, or 20%, went unfilled.
- One day in April, more than a quarter (27%) of 911 operators missed their shifts.
- January saw 730 and April saw 721 emergency disconnects — when 911 call takers have to hang up to answer more incoming calls — an increase from numbers in previous months.
While the numbers alone are of concern to the union, they mask a deeper problem within 911 call centers in Alberta, according to Parker. The data shows each 24-hour period on a given date, but does not detail individual shifts throughout the day, which can be even more severely understaffed.
Higher levels of absenteeism can be seen when looking at individual call centers. Each call center has several days when a quarter or more of the workers are off.
One day in January, the northern call center had 5½ of nine shifts unstaffed. There have been a dozen days when 40% – or more – of shifts were not filled at the call center in the North.
This, however, can be offset by one of the other call centers taking over the job, according to AHS.
Alberta recently merged 911 dispatch into a provincial system run by three call centers: one in the south that handles Calgary and the southern part of the province, one in Edmonton for central Alberta and another in Wood Buffalo (Fort McMurray area) to manage the north. Any of the call centers can route ambulance calls anywhere in the province.
The numbers also confirm continuous urgent disconnects, which typically occur when the volume of calls exceeds the dispatchers’ ability to respond and they have to hang up on less urgent calls in order to answer incoming calls.
CBC News filed a separate FOI request to update a request from earlier this year. The latest figures show that hundreds of emergency disconnects are happening every month. There were 730 in January alone.
In comparison, the same months in 2019 had a total of three urgent disconnections for the entire four-month period.
Parker said having to hang up callers puts a strain on 911 operators and the patients who call.
Illness and fatigue of staff
“Turnover and vacancy rates are a concern for EMS,” AHS spokesperson Kerry Williamson said in an email. “Turnover and vacancies among Emergency Communications Officers (ECOs/dispatchers) are no higher than in other areas of EMS.”
“Naturally, ECOs also suffer from illness, stress and fatigue. This is a problem across all health professions, here and in other jurisdictions.
Urgent disconnect protocols are only implemented when EMS is handling very high call volumes, Williamson said.
In lower priority events, where the ECO does not have vital instructions to provide, the ECO will advise the caller to disconnect to answer other 911 calls. Callers are advised to call back if the situation changes.
Staff illness and fatigue also influence levels of urgent disconnections. They are reducing the capacity of 911 call centers, he said.
Williamson noted that Alberta EMS is hiring 28 ECOs to begin training in August.
HSAA and AHS have reached talks for a new contract for nearly 20,000 paramedics in the province. A mediation contract has been submitted and union members are reviewing the proposed contract.
“Access blocking” throughout the health system
Dr. Paul Parks, president of the Alberta Medical Association’s emergency medical section, said he was not surprised by these 911 numbers.
He called it an indicator of a broader problem of “access blockage” in the medical system, where compounded undercapacity affects patients’ ability to access timely health care.
“It’s like the perfect storm,” he said. “Like where we have record absenteeism for staff at all levels, those numbers for call centers, I mean that’s magnified throughout the system.”