Emergency health services traditionally focus on treating the most seriously ill or injured patients as fast as possible.
9-1-1 callers with ‘low acuity’ issues that are not urgent or life-threatening – like an injured wrist or minor burn – may wait longer for care if emergency services are busy treating higher acuity patients.
That’s where BCEHS’ Low Acuity Response Units come in. Called ‘LARUs’ for short, these dedicated crews serve low-acuity callers while freeing ambulances to attend the most urgent emergencies.
“We help people who need assistance, but don’t require a stretcher or a ‘lights-and-sirens’ drive to an emergency department,” explains Tammy Forsyth, one of the LARU crew members in Kamloops. Tammy had been preparing to retire after 30 years working as a BCEHS paramedic, but decided to stay when she heard about the LARU opportunity in Kamloops.
“Our system is so busy and overtaxed,” explains Tammy. “I like how the LARU can connect people with the health resources they need, rather than just dropping them off at emergency.”
Expanding on existing pilots in the Lower Mainland, the LARUs launched in Kamloops last May with two units and six highly experienced paramedics, including Tammy.
Since then, Kamloops’ LARU crews have responded to over 2,500 9-1-1 events, averaging 232 calls per month. In almost half – 47 per cent – of all LARU responses, they’ve found ways to better meet the patient’s needs without transporting them to an emergency room.
Alternatives include arranging transport to an urgent primary care clinic, enrolling patients in an “Assess, See, Treat and Refer” (ASTAR) alternative clinical pathway, or otherwise assisting the patient with care on-site.
“If someone’s had a fall, for example, I can go and safely get that patient off the floor as soon as possible, so they don’t have to wait for an ambulance,” Tammy explains.
LARU crew members Christie Boast, Tami Cote, and Tony Parkin
Tammy emphasizes it’s been a team effort to implement the LARUs over the last 10 months, “The whole group is fantastic, they’ve all done a great job, and we’re always learning about what does and doesn’t work well for the LARU together.”
Alongside the LARU crews, the Interior Dispatch Centre and support teams are continually learning and improving the region’s collective responses to low-acuity calls, working closely with the provincial Clinical Hub team.
Carl Wassink, the unit chief for station 315 - Kamloops, says the LARUs have exceeded all expectations with a tremendous positive impact on Kamloops post operations overall.
“Many days, the LARUs do the same number of calls as our regular duty cars, attending hundreds of low acuity calls and freeing up ambulances,” says Carl. “That means a low acuity patient gets a trained paramedic to their side much quicker now, even when all other units are tied up on higher acuity calls.”
“The people on our LARU units are truly exceptional and seasoned paramedics,” Carl says. “They’ve gone above and beyond assisting Kamloops’ dispatch team, crews, residents, and supervisors in minimizing the workload on our taxed resources.”
Darren Waller, a BCEHS special projects coordinator, worked on the LARU launch in Kamloops.
“The LARUs are win for all involved – patients get the right care more quickly, the LARU crews make a meaningful difference, and the ambulances can respond faster to urgent calls,” explains Darren, who has worked with BCEHS over 30 years, primarily as a front-line paramedic and now in this support role.
“Over the last couple years, there have been real and remarkable shifts in how BCEHS works, and how we innovate to support our crews and patients,” says Darren. “I’m not sure something like this LARU would have been possible 15 years ago, but today we can offer so many alternative pathways to care, beyond just driving a patient to an emergency department.”
Darren notes the LARU team is deeply humble and focused on their work, but they deserve to be celebrated and recognized. “It’s extraordinary to see how this team of paramedics has been so committed and come together and established this new option for the community.”
LARU crew members Teresa Anderson and Blain Moen; Kamloops
The LARU crews have also been able to support unhoused people in Kamloops, especially those who might not otherwise access health-care services. For example, the LARU crews have provided wound care, and offered ongoing support to help individuals successfully access local detox programs.
Kayla Welwood, manager of Low Acuity and Integrated Care with Provincial Clinical Operations, emphasizes that developing and implementing models like the LARU is critical to better serving patients without overwhelming the health care system.
“Patients are receiving the right care the first time, paramedics are being empowered to provide high-impact out-of-hospital care, and BCEHS is able to better serve our communities,” says Kayla.
The team in Kamloops hopes to see LARUs continue to expand in the region and across B.C. All new service delivery models, including the LARU, are continually evaluated and reviewed to ensure they are serving needs of patients, employees, and the health system.
Interested in building a career as a paramedic, emergency medical call taker or dispatcher in B.C.? Head to bcehs.ca/joinus where you can learn more about the different career paths available at BCEHS and sign up for our mailing list to get the latest info about open positions. You can also join BCEHS Careers on Facebook to get links to the latest job postings and news about hiring at BCEHS.