Ambulance patient transfers draw concern

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This article was published 15/03/2009 (6126 days ago), so information in it may no longer be current.

Winnipeg paramedics are ferrying nearly twice as many patients between hospitals than they did five years ago, despite warnings that inter-facility transfers are too common.

Winnipeg Fire Paramedic Service Chief Jim Brennan says the city’s medics transferred 12,254 patients between hospitals and other facilities last year. That’s up from 6,910 in 2004 when the city’s last ambulance agreement with the Winnipeg Regional Health Authority was signed.

Brennan said the increase is symptomatic of a 30 per cent hike in ambulance calls and reflects the growing role highly trained paramedics play in the health-care system. He said patients are more often being moved to “centres of excellence” — hospitals that specialize in certain areas, like St. Boniface General Hospital’s cardiac centre. And patients are being transported more often from one hospital to another for diagnostic tests like MRIs, a process that involves two trips. Where once a transport required a doctor or nurse to ride with a patient, now advanced-care paramedics are trained to deliver many of the same treatments patients can get in an emergency room.

But Tory health critic Myrna Driedger said the statistics point to questionable decisions by the Doer government, which is scrambling to deal with doctor and nurse shortages that have ripple effects on paramedics.

“If ambulances are tied up doing inter-facility transfers, there will come a time when an ambulance will not be there for an emergency situation,” said Driedger. “Paramedics have told us that there are many times when Winnipeg has no available ambulances, so this whole situation is deeply concerning.”

Brennan noted that medics are also picking up more patients from medevacs arriving at the Richardson International Airport from remote northern communities. Those trips have also nearly doubled since 2004 to 3,960 patients.

The number of inter-facility transfers likely also includes hundreds of trips made by critically ill patients shuttled from one intensive care unit to another.

That has been a perennial problem for the Winnipeg Regional Health Authority. Last year, data obtained by the Tories showed more than 1,100 transfer trips between January 2007 and September 2008 even though the practice was red-flagged as a risk to patient safety in the latest Winnipeg Regional Health Authority hospital accreditation report.

The report said “transferring critically ill patients across sites owing to unavailability of beds is risky to patients, disrupts continuity of care and might delay appropriate care and treatments.”

WRHA spokeswoman Michele Augert said critically ill patients are not transferred unless they’re stable, and there’s a transport team to ensure care is continuous. And she said more transports are a product of a regional system where resources are pooled and expertise is consolidated at one location instead of being spread thinly throughout the system.

Brennan said the city is also trying to mitigate the number of inter-facility transfers in several ways, including a new pilot project that ferries as many as eight patients needing specialized diagnostic services at once using a bigger ambulance.

And, though critics have complained repeatedly about a paramedic shortage, Brennan said the number of medics has doubled to 215 over the last decade, not including the ones who are cross-trained as firefighters and ride along on pumper trucks.

maryagnes.welch@freepress.mb.ca