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Manitobas EMS Review Manitoba s EMS Review Manitoba Health

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Page 1: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Manitoba’s EMS ReviewManitoba s EMS Review

Manitoba Health

Page 2: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 3: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

EMS in ManitobaEMS in Manitoba

Page 4: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 5: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 6: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 7: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 8: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 9: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 10: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

EMS Call ProfileEMS Call Profile

10%

Non‐EmergentUrgent

90%

Page 11: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Call DemandsCall Demands

• High Utilization AreasHigh Utilization Areas– 8% to 15% growth annually 

• Provincially – 24% last 5 years– 59% last 10 years 

Page 12: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Growth in DemandGrowth in Demand

Manitoba EMS Fleet Monthly KM Driven

700000

750000

800000

y

550000

600000

650000

400000

450000

500000

300000

350000

nuary/06

March/06

May/06

July/06

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nuary/07

March/07

May/07

July/07

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nuary/08

March/08

May/08

July/08

ptem

ber…

ovem

ber…

nuary/09

March/09

May/09

July/09

ptem

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ovem

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nuary/10

March/10

May/10

July/10

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nuary/11

March/11

May/11

July/11

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nuary/12

March/12

May/12

July/12

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nuary/13

March/13

Jan M Sep

No

Jan M Sep

No

Jan M Sep

No

Jan M Sep

No

Jan M Sep

No

Jan M Sep

No

Jan M Sep

No

Jan M

Page 13: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Increasing hSophistication

Page 14: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 15: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Deployment ModelDeployment Model

Page 16: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

The EMS ReviewThe EMS Review

• To examine and guide:To examine and guide:

“Evolving the EMS system in Manitoba into a moreEvolving the EMS system in Manitoba into a more integrated, responsive, reliable and sustainable system in Manitoba”system in Manitoba

Page 17: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 18: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Review FindingsReview Findings

Paramedics SystemParamedics as a 

Profession

Medical Leadership

System Status 

Managementg

Page 19: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Hot ButtonHot Button

• StationStation                                                        Consolidation

Page 20: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Education

Paramedics as a Profession

Employment Model

Page 21: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Education

Paramedics as a Profession

Employment Model

Page 22: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 23: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 24: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 25: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 26: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Education

Paramedics as a Profession

Employment Model

Page 27: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Employment ModelsEmployment Models 

On Call Casual

Volunteer Model

Full Time Model

Page 28: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Employment ModelsEmployment Models 

On Call Casual

Volunteer Model

Full Time Model

Page 29: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Future StateFuture State

Page 30: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Medical LeadershipMedical Leadership

Page 31: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Current StateCurrent State

Provincial Medical Director Determines Scope

Regional Medical Director Determines Scope

Paramedic

Page 32: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Provincial Medical Director

Regional Medical DirectorRegional Medical DirectorRegional Medical DirectorRegional Medical DirectorRegional Medical DirectorR i l M di l DigRegional Medical DirectorRegional Medical DirectorRegional Medical DirectorRegional Medical DirectorRegional Medical Director

ParamedicsParamedicsParamedicsParamedicsParamedicsParamedicsParamedicsParamedicsParamedicsParamedicsParamedicsParamedicsParamedics

Page 33: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Consistency In PracticeConsistency In Practice

Page 34: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Future StateFuture State

Provincial Medical Director Determines ScopeOffice of Medical Direction

Regional Medical Director Implements Scope

Paramedic

Page 35: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Consistency In PracticeConsistency In Practice

Page 36: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

2011 Flood2011 Flood

Page 37: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

System Status ManagementSystem Status Management

Page 38: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 39: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

System Status ManagementSystem Status Management

Page 40: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

System Status ManagementSystem Status Management

Page 41: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Penalty!Penalty!

Page 42: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

System Status ManagementSystem Status Management

Page 43: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

System Status ManagementSystem Status Management

• 176 Ground Ambulances176 Ground Ambulances • 24 Basic Air Ambulance Fixed Wing Aircraft2 if fli h• 2 Lifeflight Jets

• 1 Rotary Wing Aircraft

Page 44: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

New ToolsNew Tools

• Provincial SystemProvincial System• Dynamic DeploymentG i• Geo‐posting 

Page 45: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Provincial SystemProvincial System

Page 46: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

ConsolidationConsolidation

• Part of the review examined stationPart of the review examined station infrastructure.

Page 47: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Why?Why?• Deployment Plan

– Changes in demographics– Changes in populations

Page 48: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Why?Why?

• Patient SafetyPatient Safety• Consistency in Response Time

di bili i Skill l• Predictability in Skill Levels• Maintenance of Skill Levels

Page 49: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

What is NOT!What is NOT!

• A budget cutting exerciseA budget cutting exercise• A removal of services C i l l f• Creating two levels of care 

Page 50: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Before Anything HappensBefore Anything Happens

• Computer ModelingComputer Modeling • Community Engagement

P f f C t N– Performance of Current vs. New– Community Feedback

• Capacity in Place• Movement to New Deployment• Public Reporting

Page 51: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06
Page 52: ManitobaManitobas’s EMS Revie · Growth in Demand Manitoba EMS Fleet Monthly KM Driven 700000 750000 800000 550000 600000 650000 400000 450000 500000 300000 350000 n uary/06 M arch/06

Manitoba’s EMS ReviewManitoba s EMS Review