Data shows Alberta EMS call centres 'in crisis mode,' union says

Documents obtained by CBC News through a freedom of information (FOI) request show that more than 12 per cent of scheduled shifts at Alberta's AHS-run 911 call centres went unfilled over the first four months of the year.

The union representing workers in the centres says the data is representative of a system — and its workers — in "full-crisis mode."

Alberta Health Services (AHS), which manages the system, said 911 call centres are dealing with the same, sustained increase in demand as the rest of the EMS system, which is 30 per cent above pre-pandemic levels.

Turnover, fatigue and position vacancy are seen as the primary causes, which affect many professions across the medical system, according to an AHS statement.

AHS says it's implementing its 10-point plan to increase system-wide capacity, which includes hiring 28 new emergency communications officers this summer.

The data obtained by CBC News shows that over the first four months of this year, more than 12 per cent of scheduled shifts went unstaffed — and there were several days when more than one in five shifts went unfilled.

The requested data contained the number of scheduled emergency communications officers (ECO) for a given date and the number of shifts that went unfilled for the first four months of 2022. ECOs are those operators who answer calls in one of Alberta's three provincial 911 call centres — in Calgary, Edmonton and Peace River — when an ambulance is needed.

"These communications officers are in a crisis mode. And it's that hidden workforce, unfortunately, you don't see them out on the street responding to 911 calls," said Mike Parker, president of the Health Sciences Association of Alberta (HSAA), the union representing Alberta's 911 call centre 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 may go unnoticed in the hours-long wait it can take to receive care in an emergency.

The significant staffing 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 some key information that highlights the ongoing stresses on a system pushed to the limit. Some key findings include:

• 1,201.5 or 12.3% of the 9,766 scheduled shifts went unfilled during the first four months of 2022.
• At least one in 10 scheduled shifts went unfilled 78 days out of 120 days (65 per cent of the time).
• There were six 24-hour periods when more than one in five, or 20 per cent, of positions went unstaffed.
• One day in April had more than a quarter (27 per cent) of 911 call takers missing from their shifts.
• January saw 730 and April 721 urgent disconnects — when 911 call takers need to hang up on callers in order to respond to more incoming calls — an increase over the numbers in previous months.

Though the numbers alone are a concern to the union, they obscure a deeper problem within the 911 call centres in Alberta, according to Parker. The data shows every 24-hour period on a given date but don't detail individual shifts throughout the day, which may be even more severely understaffed.

Greater levels of absenteeism can be seen when looking at individual call centres. Each call centre has multiple days when one-quarter or more of workers are off. 

One day in January, the northern call centre had 5½ out of nine scheduled shifts left unstaffed. There were a dozen days when 40 per cent — or more — of shifts were unfilled at the northern call centre.

This, however, can be offset by one of the other call centres picking up the work, according to AHS.

Alberta recently amalgamated 911 dispatch into a provincewide system handled by three call centres: one in the south that handles Calgary and the southern portion of the province, one in Edmonton for central Alberta and another in Peace River to handle the north. Any one of the call centres is able to direct ambulance calls anywhere in the province.

The numbers also bear out in continued urgent disconnects, which typically happen when the volume of calls outpace the ability of dispatchers to respond and they need 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 numbers show that hundreds of urgent disconnects are occurring every month. There were 730 in January alone.

By comparison, the same months in 2019 had a total of three urgent disconnects for the entire four-month period.

Parker said having to hang up on callers puts a lot of strain on 911 operators and on patients calling in.

Staff illness and fatigue

"Turnover and vacancy rates are a concern for EMS," said AHS spokesperson Kerry Williamson in an email. "Turnover and vacancy among emergency communications officers (ECOs/dispatchers) are not higher than other areas of EMS."

"Understandably, ECOs are also experiencing illness, stress and fatigue. This is an issue across the spectrum of health-care professions, here and in other jurisdictions."

The urgent disconnect protocols are implemented only when EMS is dealing with very high call volumes, Williamson said.

In lower-priority events, where the ECO does not have life-saving instructions to provide, the ECO will advise the caller that they need to disconnect to answer other 911 calls. Callers are advised to call back if the situation changes.

Staff illness and fatigue also influence the levels of urgent disconnects. They reduce the capacity of the 911 call centres, he said.

Williamson noted Alberta EMS is hiring 28 ECOs to begin training in August.

HSAA and AHS have concluded talks for a new contract for nearly 20,000 allied health workers in the province. A mediated contract has been submitted and union members are reviewing the contract proposal.

'Access block' across the health-care system

Dr. Paul Parks, president of the emergency medical section of the Alberta Medical Association, said he is not surprised by these 911 numbers.

He called it an indicator of a larger "access block" problem in the medical system, where compounding undercapacity is affecting patients' ability to access timely health care.

"It's like the perfect storm," he said. "Like where we have record absenteeism for staffing across the board, those numbers for call centres, I mean that is amplified throughout the entire system."