British Columbia Ambulance Service
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| British Columbia Ambulance Service | |
| Type | Crown Agency |
|---|---|
| Founded | July 1, 1974 |
| Headquarters | British Columbia, Canada |
| Key people | Fred Platteel, Chief Executive Officer; Sue Conroy, Chief Operating Officer |
| Industry | Emergency Medical Services |
| Revenue | $252 Million |
| Employees | 3,200 (2006) |
| Website | [1] |
The British Columbia Ambulance Service (BCAS) is the sole ambulance service and provider of pre-hospital emergency care in the province of British Columbia, Canada, and is one of the largest EMS services in North America. The BCAS also provides inter-facility patient transfer services in circumstances where a patient needs to be moved between health care facilities. The BCAS has a fleet of over 450 ground ambulances operating from 190 stations across the province. Dispatch centers in Vancouver, Victoria, and Kamloops provide call-taking and ambulance dispatching services to the entire province. In addition, BCAS operates an airevac program that utilizes both fixed-wing and rotary aircraft.
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[edit] History
Prior to 1974, ambulance services in British Columbia were generally uncoordinated. Service was provided by a mixture of volunteer ambulance brigades, fire departments, funeral homes, and private operators. As a result of recommendations made by the Foulkes Commission's report on health care, titled "Health Security for British Columbians" and released in 1973, the Government of British Columbia created the Emergency Health Services Commission, which in turn, created the BC Ambulance Service on July 4, 1974.
[edit] Governance
In British Columbia, responsibility for the provision ambulance services is granted to the Emergency Health Services Commission (EHSC) under the auspices of the Health Emergency Act. Under the terms of the Act, the EHSC is considered an agent of the government and as such, holds all responsibility for the provision of ambulance services across the province. The members of the Commission act as a Board of Directors to the BC Ambulance Service. The commission membership consists of health service administrators, medical professionals, and government representatives. The commission meets regularly to provide direction to the BCAS Executive Management Team.
The EHSC has recently taken over responsibliity for the operation of BC HealthGuide, which operates the BC NurseLine telephone triage service, and BC BedLine, which assists physicians when it is necessary to transfer a patient to a higher level of care.
While the EHSC, and consequently the BCAS, are agents of the government and are able to operate independently, in practice they are part of the BC government's Ministry of Health, which provides one-hundred percent funding for operations.
[edit] Organization
There are 190 ambulance stations in the British Columbia. Stations may be staffed with part-time paramedics, part-time and full-time paramedics, or only full-time paramedics, depending on where the station is located. Each station is headed up by a Paramedic Chief, who acts as supervisor for the crew at the station. The Paramedic Chief also handles the day-to-day administrative duties required by the station, including payroll management, overseeing station and ambulance maintenance, and crew scheduling.
Each station falls under the responsibility of a District Superintendent. The District Superintendent has responsibility for the operations of all of the stations within a given district. The size of the district, and the number of stations it encompasses, varies depending on factors such as geography, station size, number of paramedics and others.
Each BCAS district is part of a larger region, which is headed by an Executive Director. Each District Superintendent is accountable to the Executive Director for the operation of their district. The BCAS is broken into four regions:
- Vancouver Island Region (Headquarters: Victoria, BC)
- Lower Mainland Region (Headquarters: Vancouver, BC)
- Interior Region (Headquarters: Kelowna, BC)
- Northern Region (Headquarters: Prince George, BC)
The BCAS provincial headquarters is located in Victoria, BC. It is staffed by an executive management team, and other support services. The final responsibility for BCAS operations lies with the service's Chief Executive Officer.
[edit] Training
Paramedics in British Columbia are licensed by the Emergency Medical Assistant (EMA) Licensing Board under one of five categories:
- Emergency Medical Responder (EMR)
- Primary Care Paramedic (PCP)
- Advanced Care Paramedic (ACP)
- Critical Care Paramedic (CCP)
- Infant Transport Team Paramedic (ITT)
In rural and remote areas, services is provided at the EMR and PCP level. In urban and metropolitan areas, including stations in the Greater Vancouver Regional District, Victoria, Kelowna,Kamloops,, Prince George, Abbotsford, Chilliwack, and Nanaimo, ground ambulance service is provided by a mix of PCP and ACP trained paramedics.
As of December 2006, there are no paramedics licensed at the Critical Care Paramedic level. However, many Advanced Care Paramedics hold an AirEvac endorsement to their ACP license that allows them to perform to the same scope of practice that a Critical Care Paramedic would.
A team of specialized Infant Transport Team (ITT) Paramedics are based at Children's & Women's Health Centre of British Columbia. These paramedics handle all of the high-risk infant, child, and maternity transports that take place in BC. The ITT is unique in North America, as the first team to use paramedics to perform transports of these critical patients.
[edit] Rank & Qualification Insignia
The BC Ambulance Service is a paramilitary organization and as such, has a similar rank structure to most police or fire departments. The medical qualifications of a uniformed member are denoted with collar insignia, commonly known as 'collar dogs', while rank is denoted using epaulettes. BCAS qualification insignia has not yet caught up to the new license levels of EMR/PCP/ACP/CCP and as such, current collar insignia is out of date. Past insignia had paramedics qualified at the EMA 1 or EMA 2 levels provided bronze and silver circles forming the BCAS logo, along with a bar below denoting the EMA 1 (now EMR) or EMA 2 (now PCP) qualification. EMA 3 - Advanced Life Support (now ACP) and EMA 3 - Infant Transport Team paramedics were recognized with gold cauduceuses, with either 'ALS' or "Neonatology" imprinted upon them. Emergency Medical Dispatchers (EMDs) and Emergency Medical Call Takers (EMCTs) presently wear gold and silver shields, respectively.
In the case of rank insignia, field paramedics and dispatchers wear a blank epaulette holder. Paramedics and dispatchers who hold the position of Unit Chief, Dispatch Officer or Charge Dispatcher, wear a black epaulette with three gold bars. District Supervisors, Dispatch Supervisors, Provincial Special Program Managers/Advisors wear the same coloured epaulette, with four gold bars. Ranks above District Supervisor are management positions and are distinguished by a shoulder flash that is navy blue, with a dark blue trim, as well as a varying number of pips on their epaulette. District and Platoon Superintendents wear an epaulette with three pips, Regional Managers of Operations will Wear one pip and crown and the Executive Director of a region will wear two plus a crown.
Shoulder flashes for field staff are light blue with gold trim, and include the British Columbia Coat of Arms, with the words "Ambulance" above, and "British Columbia" below. Shoulder flashes for management personnel are dark blue with a lighter blue trim. The layout of the shoulder flash is the same for both.
Each station and dispatch center has a staff member designated as its Occupational Safety & Health representative. These paramedics and dispatchers are identified with a navy epaulette with a single royal blue bar. Staff who are designated as OSH representatives hold no supervisory authority, but are available to assist staff with safe work practices.
[edit] Dispatch Centers
The BCAS operates four dispatch centres located throughout the province. The Victoria Communications Centre is responsible for all ground ambulance dispatching for Vancouver Island; the Vancouver Communications Centre dispatches all ground ambulances in the GVRD, north to Pemberton and east to Boston Bar; and the Kamloops Communication Centre dispatches crews to the remainder of the province, including the southern interior and northern BC. The fourth dispatch centre, the Provincial Air Ambulance Coordination Centre, is located in Victoria and has responsibility for dispatching of all air ambulance resources, whether they are used for scene responses, or for inter-facility transfers.
Each dispatch centre is staffed with a mixture of Emergency Medical Call Takers (EMCT) and Emergency Medical Dispatchers (EMD). A Dispatch Supervisor provides line supervisory support to dispatch centre staff, with a Director of Communications and Dispatch Superintendents who manage the dispatch centre. Training for EMCTs and EMDs is provided in-house by the BC Ambulance Service.
The BC Ambulance Service utilizes the Advanced Medical Priority Dispatch System (AMPDS) to classify calls and dispatch resources.
[edit] Labour Relations
Ambulance paramedics, emergency medical call-takers, and emergency medical dispatchers are members of the Ambulance Paramedics of British Columbia (APBC), Local 873 of the Canadian Union of Public Employees (CUPE). Provincial headquarters and administrative staff are members of the British Columbia Government Employees Union (BCGEU).
