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How does saying “no” lead to innovation?
In 2017, the staff of Emergency Medical Services (EMS) in Niagara Region approached the Regional Council at budget time to request significant funding for three additional ambulances.
Staff showed data with off-the-chart-growth in the number of calls over the previous year and their expectation for the upcoming three years. Staff showed Council that even with the two additional ambulances that Council had approved the previous year, EMS needed another batch of ambulances and additional staff just to keep up with expected demand!
Through a series of questions it came to light that a significant number of their calls for help and service were not extreme emergencies. The EMS Chief told Councillors that an increasing number of calls had a low “acuity level.” For example, people would call for an ambulance because they needed help with their monthly insulin shot. Or an older person still living in their home would call because they had fallen and couldn’t get back up. Some others called with mental health emergencies that got worse when EMS took them to wait for hours and hours at the nearest Hospital Emergency Department.
The Chief even said that some folks – like Tom who needed a monthly needle – called EMS almost “like clockwork.” Yet, the only response mechanism available at the time was to send a $1 million ambulance with a pair of extremely well-trained paramedics to take the person to the hospital. And, that’s why they needed additional ambulances – because those lower acuity level patients were increasing, especially as residents aged and more people lacked access to a family doctor.
Projected growth of Niagara EMS call volumes vs. actual volumes, after innovative changes.
Our founder, Dave Augustyn, who served as a Mayor & Regional Councillor at the time, asked more about these low-acuity patients. He asked, for example, if Tom called 911 almost “like clockwork” had they tried to schedule paramedics to go and help him? He wondered what else EMS had thought of or tried to help older folks who still lived at their home and simply needed help getting up after they had fallen?
He encouraged staff to innovate and imagine a different system that provided even better care. Could they think about the “system” more broadly? Could they generate ideas to better serve the “low acuity” patients based on the patient’s needs? Could they “innovate with a patient-focus?”
As part of that budget, the Council only approved funding for one ambulance and denied the funding for the additional two ambulances.
Niagara EMS Staff quickly embraced the innovation challenge! They worked together in teams and also launched the System Transformation Project to develop alternative methods to help people in need.
A few months later, they came back to the Regional Council with some “pilot project” solutions. For example, they developed a system to send paramedics to folks like Tom. They proposed scheduling an appointment, spending time with him to see how he was doing overall, and give him his monthly shot. In general, they proposed providing “community medicine” in a person’s home.
They developed another pilot project to have a trained paramedic to lift up elderly people who had fallen in their own home. EMS would work with a family to get access to the person’s home (via a key in a lock box on the front door), and when an elderly person fell and notified a medical-alert system, the paramedic would open their door, pick them up, check them out (for injuries and their vitals), and get them settled again. If appropriate, they might even give them a healthy snack or juice or water.
EMS developed partnerships with other professionals – like mental health practitioners, nurses, occupational health care workers – to provide options for care for those who called 911. They added a “patient navigator” to the Ambulance Call Centre (911 Dispatch Centre) to take responsibility for certain calls and work with patients to get the best level of care needed.
These and many other innovations have led to better outcomes for patients and an even more effective service from Niagara EMS.
The result? These EMS innovations actually “bent the curve” on the number of emergency calls requiring an ambulance response and increased the level of care!
Niagara EMS 911 Dispatch Centre
Saying "no to the status quo” can help lead to innovation!
In August 2023, the Ontario Minister of Health recognized Niagara Region’s EMS for their innovations and announced a method of rolling them out across the Province!
(Please see the media story here: “Changes easing crunch in ERs: Niagara innovations now rolling out across province,” Allan Benner, St. Catharines Standard, 26 August 2023.)
All should be proud of the innovative success of Niagara EMS.
It’s amazing what teams can accomplish if they say "no to the status quo” and follow a process for innovation!
Do you or your team need some help kick-starting your innovative juices? Our AEI Team can help you to say "no to the status quo” and to get going on innovation using our scientifically-validated Creative Problem Solving process.
Simply email us at info@augustynenterprises.ca or book your free innovation call today.
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