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 manages the system, said 911 call centers are experiencing the same, steady increase in demand as the rest of the EMS system, which is 30 percent above pre-pandemic levels. Turnover, fatigue and vacancy are considered the main causes, affecting many professions throughout the medical system, according to a statement from AHS. AHS says it is implementing its 10-point plan to increase capacity systemwide, which includes hiring 28 new emergency communications officers this summer. Figures obtained by CBC News show that in 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 unpaid. The requested data included the number of emergency contact officers (ECOs) scheduled for a given date and the number of unfilled shifts for the first four months of 2022. ECOs are operators who answer calls in one of three Alberta’s provincial 911 call centers — in Calgary, Edmonton and Peace River — when an ambulance is needed. “These communications workers are in crisis mode. And it’s this hidden workforce that, unfortunately, you don’t see on the road responding to 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 contact when they seek emergency medical care, Parker said, but they can go unnoticed in the long waits it can take to receive care in an emergency. necessity. HSAA President Mike Parker says dispatchers are often overlooked by the general public because “you don’t see them out on the street responding to 911 calls.” (HSAA website) The 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 some key insights that highlight the ongoing pressures on a system that has reached its limit. Some key findings include:
1,201.5 or 12.3% of the 9,766 scheduled shifts went unpaid in the first four months of 2022. At least one in 10 scheduled shifts went unpaid 78 out of 120 days (65 percent of the time). There were six 24-hour periods where more than one in five, or 20 percent, seats were unstaffed. On one day in April, more than a quarter (27 percent) of 911 callers missed their shifts. January saw 730 emergency disconnects and April 721 — when 911 callers have to hang up to respond to more incoming calls — an increase over the numbers in previous months.
While the numbers alone are concerning to the union, they mask a deeper problem at 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 during the day, which can be even more severely understaffed. Higher levels of absenteeism can be seen when looking at individual call centers. Every call center has many days when a quarter or more of the workers are off. On one day in January, the northern call center had 5½ of its nine scheduled shifts unstaffed. There were a dozen days when 40 percent — or more — of shifts were unpaid in the northern call center. This, however, may be offset by one of the other call centers picking up the work, according to AHS. Alberta recently consolidated 911 dispatch into a province-wide system that operates 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 Peace River to handle the North. Any of the call centers can direct ambulance calls anywhere in the province. The numbers also confirm ongoing emergency disconnects, which typically occur when call volume exceeds dispatchers’ ability to respond and they have to hang up on less urgent calls to answer incoming calls. CBC News made a separate FOI request to update a request from earlier this year. The latest figures show that hundreds of emergency disconnections occur every month. In January alone there were 730. By comparison, the same months in 2019 had a total of three emergency disconnections for the entire four-month period. Parker said hanging up on callers puts a lot of strain on 911 operators and patient callers.
Staff illness and fatigue
“Turnover and vacancy rates are a concern for EMS,” AHS spokesman Kerry Williamson said in an email. “Turnover and vacancies among emergency communications officers (ECOs/dispatchers) are no higher than other areas of EMS.” “It is understood that ECOs also experience illness, stress and fatigue. This is an issue across the spectrum of healthcare professions, here and in other jurisdictions.” Emergency disconnect protocols are only implemented when EMS is dealing with very high call volumes, Williamson said. In lower priority incidents where the ECO does not have life-saving instructions to provide, the ECO will notify the caller that they must disconnect to respond to other 911 calls. Callers are advised to call again if the situation changes. Staff illness and fatigue also affect emergency disconnection levels. 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 completed talks on 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 blocks” throughout the health care system
Dr. Paul Parks, chair of the emergency medicine division of the Alberta Medical Association, said he’s not surprised by those 911 numbers. He called it an indicator of a larger “access block” problem in the medical system, where compounded undercapacity affects patients’ ability to access health care in a timely manner. “It’s like the perfect storm,” he said. “Like where we have record absenteeism for staff across the board, those call center numbers, I mean they’re building up across the system.”
