by Lesley Pritchard
Thirty-four years ago in Logan Lake, BC, Don Elzinga spotted a BC Ambulance “help wanted” poster in a store window. One week later, after signing up to be an on-call driver-only, he was responding to calls.
“I had never been in an ambulance before that day, and I show up at the ambulance station after getting paged out and my partner arrives and he says okay, I hear you’re the new guy. He points to the dashboard and says here’s your lights, here’s your sirens, let’s go. I was a driver-only and our first call was a motorcycle over a bank, my partner gets out of the ambulance and goes down the bank and he yells back at me to grab the spine board. And I had to yell back at him, “what’s a spine board?!”
Since that day, Don has seen a lot of joy, a lot of pain, and a lot of change:
“Sometimes I see people commenting on our online chats saying things like ‘nothing ever changes here,’ and I think - I can’t remember a time when it doesn’t change! Yes, there are setbacks. But for every step back, I think we as an organization have taken two steps forward. Every day, every month, every year, there has been steady improvement.” Don winks then he adds with a smile, “Including training for new employees!”
After serving for more than nine years as a street paramedic and then with the transfer fleet, Don went on to work in dispatch for many years as a call taker, dispatcher, frontline supervisor, and instructor, before he transitioned to management roles. He recalls some of the toughest days were in dispatch.
“The challenge with 911 dispatch is you often never know what is really going on at the other end of the phone line. In some ways it’s like being a paramedic who is blindfolded, only able to listen to what the concerns are, rather than being able to see the patient. Also, the sheer volume of decisions that need to be made in a shift. As a street paramedic I was doing up to 18 or 19 calls in a shift, but it was still one call at a time. In dispatch, I would be doing a call every two minutes and sometimes juggling several at a time. There is no doubt you make mistakes, and you have to live with those mistakes and learn from them.”
Even in management and senior positions, Don has spent much of his time in the dispatch centre. He says the changes over the years have been dramatic.
“When I started in dispatch, there were normally five people on a team, but I can recall times when there were just two of us in the Vancouver Dispatch Operation Centre (VDOC), taking call information down on paper. We looked at paper maps to help establish call locations and identify the closest ambulance. Over time, computers were introduced, then we introduced the computer-aided dispatch (CAD) system. One of my proudest moments has been to be part of the team that brought the CAD system into dispatch. And the changes just keep coming over the years. More staffing, better equipment, more training, more leadership to support and coordinate, and more clinical support including paramedics and physicians. When I go into VDOC now, there’s close to a hundred people, including the Patient Transfer Network, the Patient Transport Coordination Centre, and the Clinical Hub to support patient care.”
Don not only thrived in the dispatch world, but he also took a keen interest in interfacility patient transfers. He saw big areas for improvement, starting with how they were perceived within the organization.
“As a paramedic on the transfer fleet, I witnessed how our culture was that transfers were secondary to 911 events. At the station level, transfers were sometimes assigned as a form of punishment. But the patients and their families did not see it that way and neither did I, and I vowed we could do better.”
When asked what drew him so strongly to transfers, Don’s personality shows; he’s not only a problem solver, but he’s also very much a people person.
“I will always remember Norma, one of my patients when I was a paramedic on the transfer fleet 25 years ago. She was at UBC Hospital and would need to go to VGH three times a week for dialysis and every time we’d show up, she’d have her little flower-pot hat on, and her small suitcase beside her bed, ready to go. She was excited when we came because it was the only time she got out of the hospital. She would talk all the way there and I sat in the back of the ambulance and listened about her life and all sorts of stuff.”
Over the years Don has worked to earn the respect and resources he felt were needed in this area of BCEHS. In 2017, he set out on a one-man travelling show around the province to build stronger relationships with health authorities and other health care partners. He wanted to put a human face to BCEHS’ Patient Transfer Services and work with health authorities and other partners to resolve long-standing misconceptions and gaps that were getting in the way.
He recalls hearing concerns from hospital physicians that there was a lack of communication from BCEHS around estimated arrival times of patients. Don and his team set out to create the first-ever provincial digital dashboard to allow physicians and other healthcare staff to see where the patient was in their transfer. The dashboard went live in 2019.
“You know, our partners have their own pressures to manage, and I just believe in listening to people, whether it’s your patients, your communities, or your health care colleagues. It may not always change your opinion, but by creating opportunities to listen you might just say wow, I never knew that.”
Don took listening and creating opportunities to the next level. By the end of 2017, he started inviting leaders from various health authorities and First Nations to begin a provincial advisory committee on transfers. Over the next two years the group grew, and representatives from the Ministry of Health, Patient Voices, and other partners were invited to join.
The committee, now known as the Provincial Patient Transfer Strategic Operation Committee (PPTSOC) started making big changes within the world of hospital transfers to better serve patients, and when the COVID-19 pandemic struck, the group was poised for action.
The committee created a response plan that would go on to help form the basis for the provincial government’s Rural, Remote, Indigenous and First Nations COVID-19 Framework. The plan led to the addition of 55 ground ambulances and five air ambulances, to ensure more capacity to move local hospital patients from rural communities to higher levels of care. The sustainment phase led to ensuring these additional resources remained after the pandemic, providing better long-term access to healthcare.
For Don, currently a Senior Provincial Executive Director, the power of this partnership-building has been profound.
“I think a lot of our changes in terms of how we deal with transfers have been accomplished with this group. It’s probably one of the biggest and most significant highlights of my career.”
When asked what he’s excited about for the future, Don jokes that he’s excited about retirement eventually. But that appears to be some time away as he gets a fresh sparkle in his eyes about all the possibilities for BCEHS.
“In terms of culture changes, I think we’ve made a start in the last five years, but there’s lots more work to be done. I see the use of AI (artificial intelligence) and more virtual care, all of us in healthcare being on all the same systems, First Nations communities in rural and remote areas with more first responder programs and dedicated ambulances, and all of us working more closely together as a team to put the patient first. So many possibilities!”
Don has embarked on new challenges, notably strengthening relationships with BCEHS’ First Responder partners, including Fire-Rescue and First Nations, and leading BCEHS’ emergency planning to further equip the organization in respond effectively to weather emergencies and other major events.
