Approximately 50% of calls to 9-1-1 for an ambulance in British Columbia are for non-life-threatening emergencies, accounting for approximately 350,000 calls per year. At BC Emergency Health Services (BCEHS), the Clinical Hub is responsible for the implementation and evaluation of low acuity (non-life-threatening) patient care, using innovative projects to bring change to the current prehospital care model. The Clinical Hub’s projects are focused on delivering alternate assessment and conveyance methods for patients who may otherwise face long wait times or delays in accessing definitive care. The suite of initiatives includes telehealth-trained paramedic clinicians completing secondary triage, low acuity patient navigators, single-responder low acuity response units, taxi conveyance, and remote patient monitoring with emergency-trained nurses.

In the last three years, the adverse effects of the opioid crisis, COVID-19 pandemic, and environmental emergencies in British Columbia have not only been felt by our employees who become overworked, but by the very people the system works to service: our patients. Early evidence indicates that engaging in innovative response strategies provides appropriate care to low-acuity patients, diverts emergency-response capable ambulances to those with more acute needs, and reduces hospital offload delays; thus, increasing resource availability, subsequent employee satisfaction, and improved patient outcomes. With the environment ripe for a set of interventions to change the 70-year-old model of out of hospital care, an industry-leading evaluation leveraging the quintuple aim was constructed to ensure the Clinical Hub created safe, effective, and reliable low acuity care and conveyance pathways for patients across British Columbia.

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