The BC Paramedic Association is pleased to announce an academic partnership with Ivanette Stubbert (Hargreaves), a 2nd year Masters of Leadership student conducting thesis research under the supervision of Dr. Phil Cady of the Royal Roads University School of Leadership Studies. Ivanette is studying the leadership attributes best suited for advancing an authentic culture of safety in paramedic services from the perspective of the front-line care provider.
The BC Paramedic
Association is pleased to announce an academic partnership with Ivanette Stubbert
(Hargreaves), a 2nd year Masters of Leadership student conducting thesis
research under the supervision of Dr. Phil Cady of the Royal Roads University
School of Leadership Studies. Ivanette is studying the leadership attributes
best suited for advancing an authentic culture of safety in paramedic services
from the perspective of the front-line care provider.
Canadian
paramedics from all scopes of practice will be included, and a goal is to
ensure that there is representation from a variety of experience levels (less
than five years, five to ten years, over ten years). As the research is focused
on the perspectives of front-line paramedics, paramedics holding supervisory,
management, Deputy Chief, and Chief roles will be excluded from participating.
This research will hopefully inform the most important behaviors and strategies necessary for the development and maintenance of psychological safety, and the evolution of an authentic fair and just culture. If you volunteer to participate for a session in March, you will be asked to participate in an online world café consisting of both large and small group sessions to answer questions about your perspectives on the leadership attributes best suited to the creation of an authentic culture of safety within paramedicine. The session should take approximately 5 hours of your time. The study has been reviewed and received ethics clearance through the Royal Roads University Research Ethics process. If you are interested in participating, please enroll using the Study Enrollment Form link.
ENROLLMENT FORM:
September 15, 2020 BCPA participated in an early information session regarding modernization of the BC health profession regulatory framework. In preparation for this meeting, a survey was issued seeking membership feedback with respect to how paramedics may fit into the proposed regulatory framework (this survey is still open and seeking participants). With the October 24 provincial election the status of proposed regulatory changes with respect to future provincial legislation is unknown.
BCPA will continue to keep the membership apprised of this quickly developing situation. Continued membership feedback will be collected via ongoing survey. Click the link below to participate.
BC Health Profession Regulatory Framework Survey
Early paramedic survey results have brought forward several themes worth addressing:
Financial Cost of Professional Registration
While it is impossible to declare a precise yearly registration cost, it is possible to infer a probable cost range based on existing professional college and registration bodies. Presently Canada has self regulatory colleges in Alberta, Saskatchewan, Manitoba (in transition), New Brunswick, and Nova Scotia. Fees in the self regulated provinces are as follows:
Alberta: $525
Saskatchewan: $510
Manitoba: $550
New Brunswick: $400
Nova Scotia: $450
Canadian Average: $487
Of note the current model in other provinces is one with a single profession per college. The proposed changes to the BC regulatory framework would create professional colleges covering multiple professions per college (six regulators in total). The multi-professional college model of regulation, though new in North America, has been deployed in the United Kingdom. The UK Health and Care Professionals Council regulates multiple professions under a single regulator, including paramedics. Shared overhead costs may reduce the yearly registration fee of included professionals.
Why not an independent paramedic only regulator?
Presently BC has over 20 health professions regulated under the Health Professions Act. Both the Cayton Report and the Steering Committee on Modernization of Health Professional Regulation have identified a strong public appetite for health regulatory reform. Public consultation has resulted in moves to simplify the regulatory process, enhance accountability to the public, and guarantee merit based appointments to the respective regulatory boards. In keeping with the public’s desire to simplify process and enhance accountability, the current regulatory framework recommendation involves a reduction in the number of colleges to six from the previous number over twenty. As part of the reformation process, there exists the opportunity to incorporate the regulation of Emergency Medical Assistants (paramedics) into one of the newly formed regulatory colleges. Presently paramedicine is a regulated health occupation. Reformation under a regulatory college would include a transition to paramedicine being a regulated health profession.
In reviewing the available information, the multi-profession model presents both strengths and potential weaknesses. Public approachability, public accountability, and governance complexity all stand to improve under a multi-profession model. Risks to be mitigated include, loss of voice for professions with a small number of practitioners, inappropriately matched health professions within a given college, and a perceived loss of regulatory independence.
Current proposed health regulatory changes present the greatest opportunity paramedicine in BC has had to modernize paramedic practice regulation. The opportunity to develop a separate individual professional college is not presently on the table.
What could a professional college mean for educational standards?
In addition to regulating the practice of a given health profession, regulated health profession colleges have the ability to set and enforce minimum educational standards. In effect this allows professional colleges to evaluate the quality of an educational programme of study and determine if said programme meets the minimum standards for it’s graduates to pursue registration or licensure. If educational institutions fail to meet these standards graduates would not be eligible for registration with the governing professional college.
If for example the minimum entry to practice requirement for a profession is a baccalaureate degree, only those who have completed the required baccalaureate degree would be eligible for registration.
Which of the proposed health profession colleges are paramedics going to end up in?
This has yet to be determined. If paramedicine is moved under one of the proposed health professions colleges, the overseeing college is expected to be identified as part of the ongoing consultation process. Based on responses received from BCPA members thus far, Paramedics believe the proposed Regulatory College of Allied Health and Care Professionals to be the most appropriate fit.
Directly from Recommendations to modernize the provincial health profession regulatory framework, “One of the umbrella regulatory colleges, which will tentatively be referred to as the Regulatory College of Allied Health and Care Professionals, should include: dietitians, occupational therapists, opticians, optometrists, physical therapists, psychologists, and speech and hearing professionals, as well as diagnostic and therapeutic professions in the future.”
Of note diagnostic and therapeutic professions will likely include professions such as Respiratory Therapy, Medical Radiation Technology, and Perfusion.
The potential for great change is at our doorstep.
Remember everyone,
Education Builds the Dream
Ed Peters
In the words of Monty Python, “We’re not dead yet.” After a longer than desired hiatus for personal, professional, and Pandemic reasons; the BCPA is ready to inform on Paramedicine as a regulated healthcare profession. I would like to personally thank each of you who continued to support the movement during this perceived lull in activity as we worked feverishly behind the scenes in many important areas. The road is long, but we will endure.
The work continues in seeking educational and regulatory reform. This can only occur via direct engagement of the membership. Specific to the subject of regulatory reform, BCPA has been invited to participate in an information session regarding the Ministry of Health steering committee “Recommendations to modernize the provincial health profession regulatory framework.” As this is clearly an opportunity to have our voices heard, it’s all the more important we seek to meet the membership’s needs and expectations.
What does the membership want to know about forthcoming changes to health practitioner regulation? How do paramedics see themselves fitting into regulatory changes? What does the membership envision as ideal health practitioner regulation and how does that align with the needs of the public? I implore every Paramedic reading to contemplate these considerations, read the steering committee’s current recommendations, and fill out the linked survey. Best representation requires engagement. Allow us the privilege of providing the best representation possible.
PLEASE Complete this survey on the future of Paramedic regulation in BC to have your voice heard and brought forward in this consultation: https://forms.gle/o2saWFVoh963m2Uz9
With respect to the composition of the executive, we will be putting forward a call for nominations to fill each of the executive roles as part of a voluntary, open and transparent professional representation organization. In keeping with the current public health situation, voting will be online so as to maintain appropriate physical distancing throughout the process. Nominations for available positions will also be completed through an online process.
As for continuing education initiatives, keep an eye out for new interactive continuing education sessions this fall.
We’ll keep building bridges and partnerships and advocating for educational reform, regulatory reform, and quality Paramedic practice, but we need your support and participation.
Education builds the dream.
Edward Peters
BCPA President
Critical Care Paramedic
We recognize the courage, fortitude and commitment of our members during this unprecedented, challenging time. Thank you. We have the deepest gratitude for the sacrifices you make every day – especially during this pandemic.
Our members and their families may be dealing with anxiety, stress, fear, isolation or other difficult emotions. We want you to know that they are not alone. We are here for you.
· In partnership with Crisis Text Line, Kids Help Phone is offering crisis response across Canada, for all ages. In this moment of heightened anxiety, we are always there in any moment of need to support you. Text FRONTLINE to 741741 to access free, confidential 24/7 mental health support in both official languages.
· We have partnered with the Government of Canada and other partners to create a web-based platform for mental health and addictions support services, called Wellness Together Canada. This service is available to adults in Canada for free, 24/7.
· We published a number of online tools and clinically-researched resources on our website for supporting the young people in your life during COVID-19. This may be helpful to you as your members support the young people closest to them. Our confidential, 24/7 phone-based counselling service (1-800-668-6868) and texting service for youth (CONNECT to 686868) are available to young people everywhere.
We are excited to share the launch of our new BCYPA e-Learning platform to assist members in achieving their licensing education requirements. As a value added service to members, we offer the e-Learning system with member developed content, included in your membership fee. Courses can be found on the website under Professional Development.
We have established a single sign-on system. This means that once you have your http://paramedicsbc.ca sign-on you can access the e-Learning environment directly from our website without the need to re-login to the e-Learning system. You can also use the same credentials to login at http://edu.paramedicsbc.ca
To launch the site, we have formulated the 2019 BCYPA Spring Research & Education Symposium into an On-Line course. For those that were not able to attend, you can now attend virtually. All 7 hours of presentations are on-line by topic followed by a short comprehension quiz and issuance of a certificate. Members have received 7 hours of BCEMALB credit towards licensing for attending the symposium and we will submit the on-line version for recognition as well; in conjunction with your certificate of completion.
Individuals and Organizations now have an opportunity to provide input into the reform of regulated health professions in British Columbia. As part of this process the BCPA will be providing a written submission to the government.
We are seeking input from members and British Columbia Paramedics to inform our submission to the government.
Please take the time provide input to the British Columbia Paramedic Association for consideration in our submissions.
Thank you
“It is the duty of a college at all times; To protect the safety of patients, to prevent harm and promote the health and well-being of the public.”
Health Professions in British Columbia are overseen by government within a variety of frameworks. Currently, the most common framework is professional self-regulation under the BC Health Professions Act.
Paramedicine does not fall under a college based self governance model in BC and instead is overseen by a government appointed licensing board. The Emergency Medical Assistant Licensing Board (EMALB), oversees entry to practice and maintenance of licensure within BC. Paramedics are actually considered Emergency Medical Assistants (EMAs), within provincial legislation. The title paramedic and its variations is not protected in BC which presents risk to the protection of the public.
The legislation under which BC paramedics are licensed and regulated has not kept up with modern evolutions of medicine. Skills, procedures and authorities in the Act are piecemealed together through a series of schedules that are confusing and fail to reflect current practice. Additionally, education standards have failed to keep pace with the rest of Canada for Paramedics; as a result the primary paramedic employer, BC Emergency Health Services (BCEHS), now bears a significant educational burden bridging knowledge gaps that have become entry to practice knowledge expectations in other canadian jurisdictions.
At the request of the Hon. Health Minister Adrian Dix, Mr. Harry Cayton has released a recent report on the status of regulated health professions in British Columbia.
It is the position of the British Columbia Paramedic Association (BCPA), that paramedics in BC should become a self-regulated health profession within the context of any new approach to regulating health professions. Should health regulatory reform come to pass, the BCPA would request a seat at the table designing the new regulatory structure and process.
Background
The Cayton Report, published April 2019, was commissioned at the request of the provincial health minister to address complaints about current self-regulatory colleges. This report breaks into two sections, each with a specific mandate.
Powerful beneficial ideals are frequently born of adversity. As a result of regulatory difficulties with the College of Dental Surgeons of BC (CDSBC), the Hon. Health Minister Adrian Dix commissioned Harry Cayton to investigate and report upon both the CDSBC and BC’s current health regulatory framework (as defined by the Health Professions Act). Mr. Cayton had the excellent foresight to clearly delineate the report into two sections: the first section being a comprehensive reflection upon the regulatory status of the CDSBC, the second section being a comprehensive reflection upon potential regulatory reform for BC’s health professions.
The first section of Mr. Cayton’s report is clear and does an excellent job of outlining issues found within the CDSBC. It has no direct bearing upon paramedic practice aside from serving as a cautionary tale with respect to the duties and obligations of a regulatory college.
The second section of Mr. Cayton’s report is one of the most relevant pieces of government commissioned literature with respect to paramedic practice from the last decade. It clearly outlines reasoning as to why a profession should be regulated for the protection of the public while laying out a potential new regulatory framework to both enhance protection of the public and reduce regulatory costs.
Section 9.14 of the Cayton report succinctly relays the core principles of health regulation reform:
9.14 The overall objectives of reform of health professional regulation should be:
• To protect the safety of patients, to prevent harm and to promote the health and well-being of the public
• To provide a framework for safe, competent and ethical professional practise
• To have the trust of the public and the confidence of regulated occupations
• To be able to adapt to change and respond to new risks and opportunities
• To be efficient and cost effective in the interests of all citizens
Each of these points deserves specific address with respect to the future of paramedic practice in British Columbia.
“To protect the safety of patients, to prevent harm and to promote the health and well-being of the public”
As part of his recommendations for the enhancement of patient safety, Mr. Cayton proposes amendment of the Health Professions Act to state “It is the duty of a college at all times; To protect the safety of patients, to prevent harm and promote the health and well-being of the public.” This excellent statement of duty would apply to all health professions falling under the Health Professions Act. At present paramedics are separately regulated through the Emergency Medical Assistants Licensing Board (EMALB) under the Emergency Medical Assistants Regulation. As such, any changes to the Health Professions Act will not apply to paramedicine unless amendments to the regulation include the formation of a BC College of Paramedics.
By comparison the EMALB’s statement of purpose is as follows: “The board, under the authority of the Emergency Health Services Act, sets licence terms and conditions. In addition, the board investigates complaints and conducts hearings where necessary.” The EMALB’s statement of purpose does not include the all important concept of purpose Mr. Cayton proposes for all regulated health professions: “to protect the safety of patients.”
Paramedics know the protection of patient safety must be at the forefront of practice, but a lay member of the public may ask why this concept should be embedded into the regulatory framework. The answer is surprisingly simple. Paramedics on a daily basis perform a tremendous number of controlled medical acts which, if performed incorrectly or inappropriately, have serious potential for patient harm. As healthcare providers performing controlled medical acts, paramedics must have patient safety minded regulation at the forefront of the professional lexicon. Inclusion of paramedicine within proposed changes to the health regulatory framework would ensure patient safety minded governance rose to a place of prime importance within paramedic practice regulation.
“To provide a framework for safe, competent and ethical professional practise”
Regulation governing the practice of paramedicine in BC, the Emergency Medical Assistants Regulation, consists of a 33 page, 5775 word single document. This, as compared to the scope of paramedic practice, miniscule document can not possibly be expected to encompass a framework for safe, competent, and ethical professional practise. By comparison, the allowed scope of practise document alone for BC’s registered nurses is 72 pages in length (professional responsibilities, code of ethics etc., are all separate documents). Current regulatory structure for the practice of paramedicine in British Columbia fails this test. Inclusion of a College of Paramedicine within a restructured health regulatory framework would serve to rectify this healthcare practise inequity.
“To have the trust of the public and the confidence of regulated occupations”
The paramedic profession by and large has the public’s trust, however it has no mechanism to earn the confidence of other regulated health professions. Consistently paramedics rank among the most publicly trusted healthcare workers yet they lack a regulatory college operated by an appropriate blend of subject matter experts and members of the public. The absence of a regulatory college robs the profession of the ability to professionally interact with other regulators for the betterment of patient safety and patient care standards. The formation of a BC College of Paramedics under proposed health profession regulations would alleviate this disparity by creating allowances for interdisciplinary information sharing.
“To be able to adapt to change and respond to new risks and opportunities”
The current paramedic regulatory framework completely fails in this important area. As medical evidence changes, so too does best medical practice for patient safety and best possible care outcomes. The current EMALB structure requires an act of legislation via the provincial health minister to adapt to changing medical evidence. This cumbersome and inefficient structure is neither quick in its ability to respond, nor guaranteed to be directed by appropriate subject matter experts. The formation of a BC College of Paramedics under an updated Health Professions Act would alleviate this impediment to best patient care by Paramedics.
“To be efficient and cost effective in the interests of all citizens”
At present the administrative costs of the EMALB are almost entirely borne by the BC taxpayer. Some degree of cost recovery is achieved through examination fees and licensing fees. Most regulatory college systems of governance impart the cost of operation directly to the regulated practitioner. As Mr. Cayton astutely points out, professional regulation “is a tax on work; a payment for the privilege of working.” What Mr. Cayton is proposing with respect to a health profession regulatory overhaul could include mechanisms for cost sharing amongst regulated health professions. The United Kingdom Health & Care Professions Council (HCPC) for example oversees sixteen separate regulated health professions which all share the regulatory costs associated with their various professions. Paramedicine is one of the sixteen health professions regulated under the UK HCPC. The formation of a similar health council in BC would ideally include Paramedicine.
Conclusion
As a significant stakeholder seeking improvement in paramedic professional regulation, the BC Paramedic Association (BCPA) seeks a seat at the table as health profession regulation is reformed and ideally a BC College of Paramedics is formed. Whether under an overarching health professions council or as a separate regulatory college, the time for more appropriate paramedic practice regulation in BC has come.
The British Columbia Paramedic Association (BCPA), is an independent, non-partisan, not-for-profit, member supported society that represents the profession of Paramedicine in BC. The BCPA advocates for the best out-of-hospital medical care for patients in British Columbia by establishing professional standards of practice, continuing professional development opportunities/education, creating original research, and providing knowledge translation for paramedic practice in British Columbia. BCPA membership is voluntary and the association is not a labour representative.
The 2019 CERN-RCRSP will be held on the afternoon of Monday, May 6, 2019 at UBC Robson Square in Vancouver, BC. The Symposium runs from 1230 to 1800.
Highlights of the CERN-RCRSP Symposium agenda are the following:
Key note address exploring key concepts and trends in Big Data, and how these can inform EMS and paramedicine research in Canada
Presentations describing current data-related research initiatives in Canadian EMS and paramedicine
Poster presentations from researchers across Canada
Updates on EMS- and Paramedic-related research from across the country
Presentation of this year’s Canadian EMS Research Mentorship Award
CERN-RCRSP Annual General Meeting
Registration is free and open to anyone interested in Paramedic research! Click here to register. Participate in the 2019 CERN-RCRSP Symposium: Call for Abstracts and Research Updates
Poster Abstracts
CERN-RCRSP is now accepting abstracts that explore both the Symposium theme of Big Data and Paramedicine and research in EMS and Paramedicine broadly.
An abstract review committee will invite a limited number of abstracts for poster presentation or an oral presentation at the 2019 CERN-RCRSP AGM and Symposium. Abstracts should include:
Primary presenter’s name and contact information
Title
Short description (maximum 350 words) summarizing your research and/or its key points
Please submit your EMS and Paramedicine Research Abstracts to [email protected] NOW!
The British Columbia is pleased to announce that thanks to our partnership with the Justice Institute of BC we are now going to be able to provide live webinar access to those members that are not located in the lower mainland.
As with regular tickets, webinar access is FREE to all members or available for purchase online.
For Immediate Release
February 28, 2019
British Columbia Paramedic Association Supports Auditor General’s Report on BCEHS
Vancouver, BC — The British Columbia Paramedic Association (BCPA), an independent body representing paramedic clinical and professional practice in British Columbia, supports the findings of the BC Auditor General’s Report on the British Columbia Emergency Health Services (BCEHS). Executive Director, Scott Ramey a Critical Care Paramedic says “It appears to be a well balanced report; emphasizing the positive improvements well underway, while outlining within the recommendations some areas BCEHS has already identified for on-going enhancement.”
In particular BCPA shares the view expressed within the auditor’s report that a comprehensive clinical quality assurance and improvement program would serve to improve overall patient care standards. In the interest of public safety such a program would encompass the full emergency health services response profile, ranging from first responder through paramedic treatment and transport. Quality assurance practices previously only applied to paramedic levels of care would serve to enhance patient safety once applied across all levels of care, including first responders. BCPA President, Edward Peters, a Critical Care Paramedic, shared that “The BCPA strives to continually improve patient care through the enhancement of paramedic education and by supporting sound clinical oversight.”
The auditor general made particularly valid recommendations regarding several areas of clinical practice and patient care in British Columbia. The expansion of advanced levels of paramedic care to suburban and rural areas should be further explored and is long overdue.
All levels of responders contribute greatly to the emergency health system. There are areas the BCPA sees opportunities to rapidly and significantly enhance patient care. Of note, the Auditor General emphasized the ST Elevation Myocardial Infarction (STEMI) program in the report. The BCPA supports the addition of Primary Care Paramedic (PCP) 12-lead ECG acquisition, 12-lead interpretation and STEMI bypass. These skills and procedures have to date been restricted to Advanced Care Paramedics (ACP) in BC while other provinces have proven the effectiveness of a PCP STEMI program in broadening accessibility to life saving STEMI care in a timely and safe manner.
BCPA would be delighted to see greater evaluation of the rural and remote inter-facility transport system in future system status reports. BCEHS is a lifeline for rural and remote patients requiring referral to specialty care; often in urgent and emergent conditions far from where these patients reside. The evaluation of these critical care transport services was excluded from the report and is not on the current BCEHS list of active projects outlined within.
The British Columbia Paramedic Association is committed to the translation and application of pre-hospital clinical research for the enhancement of patient care through paramedic derived evidence based medicine. Any opportunity for the BCPA to work with BCEHS toward the enhancement of paramedic education, clinical practice, quality, risk, safety and improved patient outcomes is welcomed.
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Contact:
Scott Ramey, CCP
Executive Director
[email protected]
(604)801-9696
