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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 45
Registered: 02-2003
Posted on Wednesday, March 31, 2004 - 12:49 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Dated 1992, the posted IPCP Level 3, formerly BTS, standards are available here at stjohnonline.ca

/manuals/BTS/BTSLevel3TrngS tandards.pdf

There is a new standard that will replace the IPCP, formerly BTS/BAP system. It has passed the initial testing and evaluation phase, and is beginning to roll out on a provincial basis. Please keep an eye out for new information to be posted soon from your Council office as this program may begin to roll out nationally in Priory of Canada.

;-) "BE GOOD ALL DAY"
Paul
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Alex Kroeze
Senior Member
Username: Akroeze

Post Number: 144
Registered: 07-2003
Posted on Wednesday, March 31, 2004 - 02:05 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Paul,

Is there ANY more info? Like, are we gonna have to certify with this new system this year or will it be starting next year? What are the general differences? etc...
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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 46
Registered: 02-2003
Posted on Wednesday, March 31, 2004 - 03:18 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Generally the system will role into each of the current Districts, Administrative Centres, or communities on a schedule set out by Ontario Council and the Priory of Canada. This simply means that when the system comes to your part of the community, then the Members begin to make use of it. Before that time, the IPCP system applies. There will be a period of transition.

As a example: I am previously from the Central Ontario District(COD). This past weekend I took part in the IPCP Evaluation held at the York Region Branch (my thanks to them for having me). As the new program has not come to COD, I took part in the available IPCP process. I will now be current until December 31st of the year following that evaluation, and should normally be evaluated again in that year to remain current.

The IPCP program has historically made use of, what is at times, non-certified Members or friends providing educational components of patient care modules. This information is used to complete a Member checklist of required components of the IPCP program to present at an evaluation as proof of competency in checklist skills, as signed by the applicable Training Officer. A valid Level "C" Basic Rescuer CPR certificate is also required. This is not to say that any components have been at a lower standard, they have simply been at a standard that has not been documented and certified, like those required taught by certified Instructors.

In an effort to attain a more recognized and consistent standard, the new system makes use of certified Instructors to educate Members in required components in a formal classroom environment. Successful candidates/Members are issued a certificate for a course that has contents that meet recognized standards. Continuing education during the certified period is required, and may include topics, Members, and friends who may not meet the standards set out in the course content. Practice makes perfect, and all skills, even new ones, are encouraged. Tri-annual re-certification is required to maintain valid certification. A large pool of Instructors is growing, and will continue to do so. It is hoped that this will be time volunteered by Instructors, who may also be Community Services Members, and can also teach these skills in public courses.

The new program is based on the course that has been spoken about in several threads here at stjohnonline/cadetsonline. It is the Medical First Responder course. It is available at three levels of certification. The industry, and Canadian Paramedic Association recognize this certification as meeting or exceeding the minimum standards of Emergency First Responder training and certification at the various levels. The same can not be said for the IPCP, formerly BTS/BAP system. The industry, and many employers, simply did not know what it meant, and often would not recognize the certificate issued, as it did not meet their needs.

The minimum Patient Care Services Member certification for independent duty will be Advanced Medical First Responder, Level One. It is a forty hour program, and will likely be taught over a couple of weekends. The IPCP system was also based on a forty hour program, but was taught over each year of meetings. The MFR courses have a student and Instructor guide. Again, we can not say the same for the IPCP system. Certification in modules is planned to include oxygen administration and S.A.E.D. Level "C" Basic Rescuer CPR certification will continue to be a separate and annual certification requirement. S.A.E.D. certification, and its continuing education, will continue to meet the directives set out by The Provincial Medical Director. The minimum age for certification in any MFR program is believed to be 18 years. To this end, further information may be required. Members are encouraged to become certified at higher levels of training.

National certification of this program is pending and expected soon. The program plan is to have the course in place throughout Canada before January 1st, 2005. The program plan is then to have all Members certified before January 1st, 2006, and all new Members, with less than one year of membership, certified within one year of joining the SJA family. The prerequisite for membership will continue to be Standard First Aid and Level "C" Basic Rescuer CPR, among other documented requirements. Members with less than one year of Membership will continue to be permitted to attend duties under the direct supervision of certified AMFR Members. Youth Members will continue to be permitted to attend duties under the direct supervision of certified AMFR Members.

I hope I have answered a few questions. Please feel free to let me know if you have any questions, and I will try to get the answers for you. It is a transition that will take time and effort. I hope that the benefit potential to our community and Members can be seen in that noted above.

;-) "BE GOOD ALL DAY"
Paul
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Alex Kroeze
Senior Member
Username: Akroeze

Post Number: 145
Registered: 07-2003
Posted on Wednesday, March 31, 2004 - 03:51 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Interesting idea, although I recognize that it is very doable in larger centres, the problem is smaller Brigades doing this. Ours right now consists of approximately 5 members, one of which is out of town at school except during the summer. The closest FR instructor is ~1 hour drive away. I do not see how it would be possible for our group to stay certified in a course that will take several weekends. It is hard enough to get a weekend when all 5 of us can get together for a few hours to do BAP as it is.

What areas was this field tested in? What were the sizes of the Brigades used? I wonder too how often these advanced skills were used as I use O2 on duty only 1-2 times per year at most.
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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 47
Registered: 02-2003
Posted on Wednesday, March 31, 2004 - 04:34 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

When implemented, Members may attend any available course. Travel to a course may be something to overcome, but the travel costs will generally not be financed. Some kilometre reimbursement may apply.

The test was conducted in South West District. It is a District that has some larger centres, but has a large number of rural Members as well. I sizeable group of Members have been certified as Instructors and Instructor Trainers.

;-) "BE GOOD ALL DAY"
Paul
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Melissa Yingbull
Senior Member
Username: Mying

Post Number: 81
Registered: 11-2002
Posted on Wednesday, March 31, 2004 - 04:56 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Correction: although there are some divisions also being trained in AMFR in Southwest (which is actually Alex's district), the pilot was in Southern district. Southern is almost entirely urban and very small in "acreage" compared to most other districts.

But, as it is, evaluators and/or BAPees have to travel to do the BAP, and from what I can see this new plan doesn't actually add more total travel time than the BAP already created. Also, there will be more instructors trained, ideally one or two to every significant centre.

There are lots of things I don't like about the incoming MFR system, all the same, but there will always be kinks in a new system, and the initial roll-out is always the worst of all...

Hopefully those in charge of policy and implementation will listen to what people are saying "out there" and be just as flexible in making further changes to address those concerns.
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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 48
Registered: 02-2003
Posted on Wednesday, March 31, 2004 - 04:58 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Corrections on my part.... my thanks to Brian Cole for pointing out...

The pilot of the program was Southern District. It's makeup can be similarly described.

As to financial and other items... not all of the criteria and plans have been established. Some of that which I have noted may be in error, and for that I apologize in advance. Things may change. It is a big transition with a wide variety of factors.

To find out more about the program, seek information through the appropriate chain of command.

Your Divisional Training Officers have access to your District or Administrative Centre Training Officers. They in turn have access to ask questions of the Team at Ontario Council.

In Ontario, the Provincial Training Officer is Paul Sims. Provincial Staff Officer Sharon Cole has been very busy as part of the Team looking into this new program. I am not a Member of this team, and therefore they would be the ultimate authorities on the issue.

;-) "BE GOOD ALL DAY"
Paul
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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 49
Registered: 02-2003
Posted on Wednesday, March 31, 2004 - 05:12 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Thanks to you as well Melissa. I was typing while you were posting.

As you can see, the Members of Ontario Council are listening. Many Ontario Council Members keep a close eye on what is posted here at stjohnonline cadetsonline. The opinions of all Members are valued and noted. Member opinions are important and necessary.

One question I already heard was about what uniform identifiers might be used. Ideas are being sought. Anyone have ideas about that?

;-) "BE GOOD ALL DAY"
Paul
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Alex Kroeze
Senior Member
Username: Akroeze

Post Number: 146
Registered: 07-2003
Posted on Wednesday, March 31, 2004 - 05:45 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Why not keep the current identifiers? If BTS is going to be extinct then just change the letters that the orange bar represent. It'll be a huge money saver and paperwork saver.

I know for one that if I have to drive an hour to and an hour from a course for several weekends in a row at my own expense I will have a very hard time justifying it. FA instructors are a dime a dozen (figuratively) while FR instructors are few and far between in this area. I am not saying that this won't change and if it does then I have no problem with this aspect of it. Having said that, if SJA wants a FR instructor in the Chatham-Kent area I would be happy to have them pay for it for me in return for certifying the two local CK Brigades ;)

I understand the chain of command and it has its place, but my understanding is that these forums are to spark discussion and debate with the general membership. To that end, it would be interesting to debate the merits of AEMCA vs. AMFR vs. BTS vs. SFA as the minimum standard of SJA care and the level of care provided by each. I feel a group discussion may bring up interesting ideas/problems/pluses/etc that a one-on-one or chain of command style discussion would not. I for one know that anything discussed here is not official, more of a what-if style situation.
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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 50
Registered: 02-2003
Posted on Wednesday, March 31, 2004 - 06:09 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I am in agreement with cost savings, and using something we have in hand, so...

MFR, one orange stripe
AMFR-1, two orange stripes
AMFR-2 three orange stripes
or
AMFR-1, one orange stripe, since it will be the minimum certification for independent patient care
AMFR-2 two orange stripes

What about a patch for your left sleeve, like the former AFA badge instead? It would be in words that might be better understood!?

If you would like, get your name in the hat! Pass it on through the chain of command. Maybe make some money teaching public courses as well as giving your time to the community in teaching Community Services Members.

As to the discussions and their content, as a Provincial Officer, I do have to watch what I say, as it may be lent more weight than it perhaps should or deserves. Remember, I'm Emergency Response Services and an IPCP Level 2 Evaluator. Not one of our highly qualified Training Officer Members, Instructor Trainers, AEMCAs, Paramedics, MDs, or RNs.

So... let the ideas fly!

;-) "BE GOOD ALL DAY"
Paul
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Alex Kroeze
Senior Member
Username: Akroeze

Post Number: 147
Registered: 07-2003
Posted on Wednesday, March 31, 2004 - 06:59 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I would say -1 would be one stripe and -2 would be two stripes as there will likely be little use for straight MFR within our organisation that I can see (??)

Patches only work if you have long sleeve uniform shirts... which our Brigade does not use. Atleast, it is my understanding that it isn't allowed on the short sleeved shirt. And again the cost thing, we already have all these stripes laying around and we'll still need them for designating Nurses/medics/etc so why not keep 'em? It's a good system.

Side note, what are the prerequisites for MFR instructor? Do I have to be a FA instructor first?

I understand the not saying things or people will hold you to it as written in stone. I was just speaking for myself personally not taking anything you say here as the gospel truth.

As an additional question, if we have AMFR-1... is there REALLY a need for AMFR-2? What would be the benefits on your average duty? I'm actually having a hard time seeing AMFR-1 as providing an advantage at most duties I do in the first place.
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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 51
Registered: 02-2003
Posted on Wednesday, March 31, 2004 - 07:24 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

So what will we have for the public who want something to show they are certified, besides the pocket card and wall certificate? That was the AFA badge. Do we need to create one for them to use, and could Members use it too, like we did the AFA?

It is, or will be, in many cases, the minimum training level for a Firefighter as well. Mississauga or Brampton Fire and Emergency Services is already studying symptom relief I heard.

In your Community Services Division, not Brigade, but I am just being picky on the term, Ha Ha, you can place the AFA badge, or perhaps what may be its replacement, about 1 inch below the Divisional identifier on the left sleeve of either the short or long sleeve shirt. I seem to recall that. It is handy to have a long sleeve available. Short sleeve ones can itch a bit under a sweater.

Yes. I believe becoming an Instructor in FA CPR is the place you need to start.

Only a "Preachers Kid"... I don't preach the gospel!

I don't know the contents of the additional 40 hours of training in the AMFR-2 course. It may include things that you know or do already, but we will have to ask.

;-) "BE GOOD ALL DAY"
Paul
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Alex Kroeze
Senior Member
Username: Akroeze

Post Number: 148
Registered: 07-2003
Posted on Wednesday, March 31, 2004 - 09:31 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

We are talking about the Brigade right now, not the public. Within our org I think it should stay with the shoulder flashes and that's it. People see our uniforms and that is enough IMHO. In the past there weren't EFA/SFA/BTS patches on unis were there? Why start now? As far as for a public course then I think definitely there should be a patch. I have my EFR Red Cross patch... don't use it for anything, but I still have it and am glad I got one. But I'm just saying for internally we don't need it as we have shoulder flashes and having the patch as well would be redundant.

I already have my bars on my shoulder, my division has already paid for them, as long as I stay at the IPCP (or whatever the minimum becomes) level then I don't think they should have to pay more. What we have works, it's a good system, stay with it. If it ain't broke don't fix it.

I know the Community Service thing but it takes too long to type and I'm set in my ways ;) One day I may change how I call things. The numbered concession roads got renamed like in '98 or something but I still call it "9th Concession" instead of "Countryview Line" I just get set in my ways like that.

It would be nice to see a copy of the course outline for each level. You would think somoene would have it somewhere on a computer that they could post a copy of it.
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Kevin Morgan
Intermediate Member
Username: Kmorgan

Post Number: 23
Registered: 02-2003
Posted on Wednesday, March 31, 2004 - 10:18 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Alex, the course (like our SFA) is modular. There are 13 core sessions that must be taught to every course and then there a bunch of electives (27 I believe).

I know which ones we taught in southern (I am one of the 6 instructors from the pilot project). I also know that some of us had some recommendations for changes that we never really got to make.

We may yet see the MFR as a level used for Brigade. It would involve only one weekend and still would be 24 hours of training above and beyond standard First Aid.

Why offer the 80 hour program? There are always people who want to go above and beyond, learn more. As Training Officers (Paul will probably agree with me) we often tell people we will teach them as much as we can (or are allowed to at least). Also, despite the beliefs stated either here or in the other session that we could meet the PAC NOCP guidelines for EMR in a 40 hour course, I took a second look at the PAC requirements, and we can't. To actually meet the NOCP guidelines, we would have to take the 80 hour program (the 80 hour program only has three modules that are not required to meet PAC NOCP guidelines). And the relevance on duty? You never know what you will run into, and any knowledge or skill can be beneficial at some point, you never know.

Of course with any new program there will be a roll out phase, and there will be some problems as there would be with any other change. I was not around when BTS was unveiled, but I have heard many stories.
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Alex Kroeze
Senior Member
Username: Akroeze

Post Number: 149
Registered: 07-2003
Posted on Wednesday, March 31, 2004 - 11:07 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

My only concern with the "you never know" statement is where do you draw the line? You could say we should all be AEMCA because you never know (note: If SJA wants to pay for my AEMCA training I will not complain) but you have to say that is a bit much. Many people feel that SFA/BTS is where the line should be drawn. We are volunteers and as such only have so much time to commit.

I know of one member with >10yrs membership who has said outright that the day MFR becomes minimum is the day he resigns. I know of several others who haven't said it outright but I get the impression they are of the same opinion. This would leave our Division without members and thus force it to close.

Let me do a quick tally, I have been in SJA for ~4.5-5yrs.

O2 used: 2 times where I say it was very good that I had it there, maybe 4-5 times when I used it cuz I had it available but it wasn't a major need.

Backboard: Once, assisting EMS at a minimal level (ie placing the board)

BP: Twice found signifigant results, but I knew already that something was wrong from other S&S and EMS immediately took their own anyway, mine didn't change the way I treated the person.

That's the extent of it. Those are the advanced skills I have used. This >10yrs member can think of 0 times when he wishes he had O2.

Why do I need to take so much time constantly training on skills I very rarely use, and even then didn't necessarily need but only used "cause it was there." Don't get me wrong, I am NOT saying I don't think MFR has its place, it most certainly DOES. I just don't think that it should be MANDATORY. Strongly suggested, definitely. But I already have all the skills I have ever needed on duty and fit very well into the (to my understanding) scope of practice which SJA operates under.

Why do I need to certify in defib? Our division does not have one nor will we in any forseeable future so that is extra hours I have to put in for something I will NOT use in addition to training for things I will rarely use which I am already competent in as BTS1 with added skill. Oh ya, we don't have traction splints either.

I think MFR is a great course and very worthwhile to take, I just don't think it should be mandatory.

My $1.95
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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 52
Registered: 02-2003
Posted on Thursday, April 01, 2004 - 12:44 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Excellent comments by all. Only with a multitude of input can we hope to find a happy median.

Also... and on an unrelated subject... have any of you read about the thread in the All Members section? There are some very cool pictures and news from CFS Alert. I started the thread for Garry Chandler. Pass the word, as there is room for that discussion in youth programs and schools. I mention it because some may not have that section selected in their preferences.

Back to the subject at hand... There are always Members who state they have enough, and those that like to bite off a bit more, sometimes too much. There are AEMCAs who feel IPCP is a was of their time, and refuse to be evaluated in it. There are Members who are so overwhelmed by the evaluation process that they become sick, and need "no duff" treatment themselves.

Your comments are well worth while, and worth much more than $1.95.

;-) "BE GOOD ALL DAY"
Paul
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Alex Kroeze
Senior Member
Username: Akroeze

Post Number: 151
Registered: 07-2003
Posted on Saturday, April 03, 2004 - 06:00 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Just curious as SW District Newsletter just came out and has a bit different info from what has been said here. It says that MFR will be minimum, it has been said here that AMFR-1 will be. Is there going to be an official directive released sometime soon? Something other than hearsay and second hand, etc?
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Alex Kroeze
Senior Member
Username: Akroeze

Post Number: 152
Registered: 07-2003
Posted on Saturday, April 03, 2004 - 06:56 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Just had another thought... are the minimum hours/year going to be upped in response to this? One could get someone who joins, takes 40+ hours of course, goes to a few meetings and that is it because they've got their 60 hours.
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Lana H
Senior Member
Username: Ldh

Post Number: 57
Registered: 11-2003
Posted on Tuesday, April 06, 2004 - 02:58 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I have some concerns of making this a "nothing or all" kind of scenario. We lost a lot of good people when we went BTS1 as the minimum and stand to loose many more with this new change. Not to mention the fact that many potential new members might be turned off by this "must have" approach since, when push comes to shove they are donating their time for free. Can we really afford to do that? "Good Volunteers are a special breed, hard to attract and harder to keep but while you have them, most are worth a hundred paid people because they really CARE about what they're doing. While a support "uping the standards", and am all for challenging personal skills and having access to additional training, I'm not so sure it shouldn't be a personal choice thing. As most of us know most of our public duties won't ever require the skills that we will acquire. I'm concerned that "boredom" or whatever you might want to label it will prevent those with the higher skills from wanting to do these public duties which is the backbone of our Patient Care Providers, while those that have excellent Standard First Aid plus skills (BTS, 02, AED) whatever just say "enough is enough" and walk away. Isn't there room for both? Maybe that's the $5000 question?
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Sharon Cole
New member
Username: Sharon_cole

Post Number: 1
Registered: 08-2003
Posted on Tuesday, April 06, 2004 - 03:44 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I am responding as the Provincial Staff Officer (Sharon Cole) who has been assigned by Paul Sims, the Provincial Training Officer to head up the Community Services - MFR project.

The following will provide you with the basis of our discussions to date including a review of how we came to the direction we are taking.

History

BTS was developed in 1992 in an effort to integrate and standardized training for St. John volunteers that provided medical (first aid) coverage at public events. The system was based on SJA first aid standards, elements of family health care and level �C� CPR. The system was designed to be delivered in three progressive levels.

Following the completion of each level, a comprehensive theoretical and practical assessment was administered known as the Brigade Assessment Process (BAP). The intent was to have all SJA patient care providers trained and certified to at least the BTS Level 1 (40-hour program) standard. This goal was not reached and decisions were made to allow for sub-standard care.

Current Status

The following outlines the number of actual BTS qualified members vs. the number of members eligible to qualify for BTS certification nationally:

Eligible members nationally who could/should certify in BTS:
1999-7761, 2000-7182, 2001-6700

Actual members nationally who did certify in BTS:
1999-2587, 2000-2542, 2001-2621

Clearly the system is not functioning as originally designed. Reasons include:
-Lack of instructional material aimed at BTS.
-Available BTS instructional material is out of date.
-Lack of applicability outside SJA.
-Inconsistent instructor standards & development.
-Lack of evaluator training resulting in inconsistent BAP evaluations.
-Difficulty staging BAP evaluations annually due to a lack of resources, etc.
-Lack of strict policy compliance related to the provision of lower standards of care.
-Lack of uniform national standards.
-Limited opportunity to complete more advanced training.

Some Councils have already changed the BTS (revision of standards) to better suit their requirements, further emphasizing the need to review the entire training program.


The St. John Ambulance Medical First Responder Program

In 2002 SJA released a complete version of its Advanced First Aid program entitled �Medical First Responder (MFR)�.

This new program is modular in nature and can be delivered in as little as 24-hours or as much as 80-hours depending on the number of electives taught. The program was written to comply with Paramedic Association of Canada�s Emergency Medical Responder guidelines.

The program is currently used by:
-Canadian Coast Guard Rescue Specialists
-Reserve Medical Corps attached to DND
-Industry
-Volunteer Fire Departments
-Other first responders.

A Solution to St. John Ambulance�s Patient Care Training Challenges

Shift core patient care training from BTS to the SJA Medical First Responder Program.

Advantages to MFR

-Similar time requirement as BTS.
-Up to date Instructor material (Power Point slides, I-Guide) available in both languages.
-Up to date Student material available in both languages.
-The program is recognized by employers / agencies outside of SJA.
-A higher standard of care may assist with mitigating risk.
-Has marketing appeal for our current and potential clients, volunteers, and funding sources (including government).
-The modular format offers greater opportunities for increased training for our patient care providers.
-Offers a competitive advantage over other patient care service organizations.
-Will raise the profile of SJA with other agencies and emergency services.
-Provides for the efficient use of training resources.
-Provides our clients with a higher level of care and improved outcomes.

Possible Challenges

-Need to recruit / train instructors to teach MFR.
-Material may be (perceived or real) too complex for some volunteers.
-Possibility of losing some existing volunteers with this training / service standard.
-Increased cost of resources associated with MFR training/service delivery.

The Balanced Solution

That the Advanced Medical First Responder Level 1 (40-hour) program become the minimum level of training for all St. John Ambulance Patient Care Providers.

The following is the proposed implementation timelines that will be reviewed by a working group comprised of instructors and instructor trainers (mnay of whom are Community Services patient care providers):

Jan. 17, 2004
Southern MFR pilot results received by CSC � implementation plan to be presented to CSC in March.

Feb. 2004
National Discussion paper sent to all Councils for consideration, which includes results of an Ontario Council MFR pilot conducted in Southern District throughout 2003.

Feb. 26, 2004
Ontario Council Board approves MFR as the standard for patient care with a deadline for implementation in Ontario � Jan. 2006.

March 2004
Establish an Ontario working group to review course curriculum, impact and roll-out strategies, etc.

May 2004
Initiate instructor development.

May-June 2004
Priory Council review / approval of MFR as a national standard.

Sept. 1, 2004
MFR training rolled out to Branches/CSUs in Ontario (phased-in process).

Jan. 1, 2005
MFR released to other Councils to begin implementation.

Jan. 1, 2006
All Ontario SJA patient care providers to be trained and certified to the new standard.

Dec. 31, 2006
All SJA patient care providers nationally to be trained and certified to the new standard.



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Johnson Lai
Senior Member
Username: Gundam

Post Number: 252
Registered: 11-2002
Posted on Tuesday, April 06, 2004 - 04:33 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Thank you Sharon for enlightening us with all the facts. I learned a lot from just reading that. It is difficult/different for us to reply back, since you responding as the "responding as the Provincial Staff Officer". I will try to:

I think an official statement or memo stating just what you have said, facts, reasons, future plans, should be communicated down to all members via the established channels. It will benefit all volunteers.

Many a times, us members just hear about the "Change", and no reason was given. As everyone is resistant to change in nature, it helps a lot to see why and what SJA is trying to help with.

Also, I would like to encourage Provincial/District staff to come down to visit the biggest area/district of adult volunteers, namely Toronto divisions, on a regular basis; during weekly meetings, BAP session, duties. Get an idea and build a strong relationship with all divisions. This will benefit everyone in both ways.

Its obvious from your stats that BAP/BTS did not work out as planned. Its sad to see such a big, probably expensive, movement only to see it fail and replaced by another. I believed in BTS and how it can help SJA, but looked like the system lacked a feedback loop. I hope this new system will have one.

Getting back to Lana's comment. Agree on her statement of: "As most of us know most of our public duties won't ever require the skills that we will acquire".

Also, it is hard enough to get 100% BAP, because of various reasons. Someone correct me if I'm wrong, the MFR seems like a more intensive training and at a higher difficulty level than BTS-1. I'm worried that the major of the membership today isn't prepared to achieve this acceptance limit.

New members will be turned away, as well as many old members will not be able to rise up to this standard. I guess only time will tell on this one. I hope I'm wrong.

I'm feeling that SJA is losing our purpose that is set out for us in our 8 pointed cross. I guess in the age of 2004, business needs come first?

People need to see a purpose to volunteer for an organization. Especially in cases when we now require them to be 'almost' trained to same level as a entry level EMS personnel. A lot of members will fail, and be discouraged.

So perhaps, they will pick to go volunteer at an senior's home, where there are no tests, a regular FSH course will do, and you get immediate gratification of helping a grandma or grandpa.

Hmm... I envy therapy dogs :o) Okay, maybe not, they go through a lot too.... get poked at, pinched, and pet-ed by dirty hands !!

Okay, better stop the babbbbeling....
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Alan Chan
Intermediate Member
Username: Achan

Post Number: 21
Registered: 01-2003
Posted on Tuesday, April 06, 2004 - 05:00 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

As a SJA member for only 4 years, I may not have a lot of experience or credential to say much. However, during my short tenure thus far as a member of SJA in Toronto and from reading these posts periodically, I have noticed a sense of disconnect among the different levels of administration.

What I also felt, as a member, and as an observer is that (as Johnson and Lana have stated) many members are being driven away. There are various reasons, one of them is the vague/ ambiguous requirements in the system. BTS isnt bad, but should we move forward in such a fashion as to have all members certified through MFR by 2006?
Would it post more logistical/ practical problems? Have actual hard working members been consulted prior to its inception? Also, will this plan work? The MFR is much more intensive than BTS 1 from the facts stated above, currently we have only 1/3 of people qualified in BTS-1 due to various reasons according to the aforementioned stats. I believe that if people are devoted enough, they would also get BTS-2 to get more involved. This leads to my fundamental question of my post (sorry for the long windedness): Should we spend more money modifying these systems while SJA doesn't even have a solid, transparent/ percievable goal that have been communicated to the members?

It seems that SJA is failing to listen to its members, its structure crumpling, and it is continusing to deteriorate. In order for people to be devoted, we must have a strucutre organization, let people be proud to be in SJA. Allow feedback through proper channels, and maintain a disciplined focus. Try to establish our own image instead of playing catch-up or imitation. I personally believe that we don't all have to be paramedics in order for SJA to stand out.

Ok, I should stop now....
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Sharon Cole
New member
Username: Sharon_cole

Post Number: 2
Registered: 08-2003
Posted on Tuesday, April 06, 2004 - 05:00 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Johnson:

I can appreciate your comments regarding communication. The working group is meeting at the end of the month to further discuss detail, so it would have been premature to release anything official until that time, however the computer age (and discussion forums) being what they are...the discussion simply preceded the release of info. Having said that, I did feel it was important to respond to prevent mis-information.

One of the challenges St. John continually faces is balancing the needs of those we serve with the needs of those who serve for us.

Certainly in approaching this project it was looked at. Did you know that we had over 50 patient care providers in Ontario in 2003 pay to take advanced first aid training through our own organization because they were looking for new challenges.

Our aim is not to make life more difficult for patient care volunteers, but rather to put into place the processes, resources and standards to assist volunteers to achieve the "grade" so to speak, rather than trying to do it inconsistently.

For the most part, first aid is not rocket science and still remains common sense. It is helping our volunteers to learn this knowledge and skills that remains important, and when they have trouble leaning we try again, until we mutually come to a decision that perhaps a different volunteer role in St. John might be for them. While developing our volunteers, we must remember to stay focused on why we do what we do - to service the public, in the best way possible!

The results of the 2003 Southern District MFR (Brigade) Pilot, which by the way was a mix of both mid-size urban and rural, have demonstrated the advantages of MFR over BTS and shown us possible solutions to making it work.

I hope this helps to understand our direction a bit and I (we) certainly welcome any input you or others wish to continue to provide throughout this evolution.

Sharon.
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Michael Lawrence, RN
Senior Member
Username: Spud

Post Number: 41
Registered: 10-2002
Posted on Tuesday, April 06, 2004 - 06:53 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I am personally glad to hear that this program is being rolled out. There will be challenges, there will be disappointments, and there will be those who quit over it (here's hoping that the seriously reconsider it however).

As with any change, there will be tensions amongst those who feel that the program is being forced on them and those who have a responsibility to administer it. I remember the early days of BTS and the people who said "I'll never do that!" After a few years, they recognized that there were inherent advantages to that system and grew to except it.

As far as the AMFR program, I too have concerns about administration of the program and recertification/maintenance of certification. Despite my few concerns, I know that there will be opportunities to voice my concerns and those of others and if there is true trouble across the board, they will be reviewed.

The advantages laid out by Sharon above, are among some of the things I have felt for years. We are no longer competetive with many fee-for-service organizations, yet we still deliver a higher quality product. If we can ensure that every independent patient care provider (brand new members and observers excluded) is an MFR, then we are offering better service to the public. The training time is not more than what we normally do, just more structured and comes with guides (thank you!!!). If you don't have the equipment... look to fundraise for a specific piece. You are only a better first aider if you have more knowledge, regardless of the equipment availability. You will be better able to assist EMS when boarding a spinal injury patient, won't be afraid of their defib when applied to your VSA patient, and if they ask you to get them a piece of equipment you will know what it looks like and how to use it.

Be patient, be open, and let the program settle a bit first before you make decisions about leaving the organization. This will only make us stronger.

Submitted respectfully,
Michael Lawrence
Div. Nursing Officer,
#504 Mississauga Division
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Alan Chan
Intermediate Member
Username: Achan

Post Number: 22
Registered: 01-2003
Posted on Tuesday, April 06, 2004 - 07:58 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Hmmm...

I think from all these postings, I, at least, can point one common theme: that we all want St. John to excel and be better.

There are bound to be logistical problems and challenges to any changes. I think we can all agree to this statement. However, I think, at least in my own opinion, is that this is not the issue where people have the most controversy about, it is actually how the whole organization is being run, and our direction ahead. The fundamentals need to be addressed and organizational issues need to be examined.

I agree that more FA knowledge will benefit us individually, as well as an organization being more recognized. MFR will potentially achieve that but BTS may also yield the same result. A potential reason why the stats posted previously suggest otherwise is due, possibly to the disarray of the system. The intentions have always been well for the BTS system, but we need a well founded structure and backbone. We need support from all levels of administration, be it, Federal, Provincial, Regional (District), and Divisional. Currently, there seems to be a some form of barrier separating them.

SJA all around the world is regarded as a leader in First Aid services. Some countries go beyond that, some countries have better disciplined/ well established services. Nevertheless, we should be asking ourselves, how do we make SJA Canada stand out as a leader in providing FA services in Canada. What makes us different from other services?

I am not against the implementation of the MFR program. However, I think we need to market our services better. Tell our clientele what options are available, Standard FA, Transport, MFR certified, or others. Let them know that these services are available for different amounts donation, and let them make their choices. Therefore, if people are willing to be MFR certified, they can be, and they can get duties which are potentially more exciting. People who may not have as much time in being MFR trained can cover less demanding duties.

I agree with Mr. Lawrence that we may not be competitive enough, but I think as we change the way we organize we will achieve higher competitiveness. A better structured system where messages and opinions are relayed throughout the different levels.

Let's recognize what members have done, and it doesn't need to be in a form of medals or material rewards. A better way of communications, more pride in the organization is probably what most of us are asking for.

Therefore, in conclusion, I hope that MFR will work out if it does come into full inception (or else...) and hope that SJA future will be a bright one.

Looking forward into the future!
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David W. Schinbein EMCA
New member
Username: Schinbein

Post Number: 4
Registered: 12-2003
Posted on Wednesday, April 07, 2004 - 12:53 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I would like to wade into the issue of using the level of "Medical First Responder", as a replacement to the BAP/BTS level of certification. If I might ramble for a minute and give a little background. A few years back, I was the Manager of a Hospital based Ambulance Service in North-Western Ontario. (The McCausland Hospital, Terrace Bay, Ontario to be exact). At that time the service had one full-time(me!). As Manager I was to administer the service,prepare the budget, train and recruit ambulance volunteers (plus do calls!),(I had 25 volunteers when I left the service) At that time volunteers were use almost exclusively in the remote areas of Ontario due to the low population and resulting low call volume. As a demographic side bar very few people retire in the remote communities and as such there are not the number of calls to seniors as down south. Back to this issue at hand. As the training officer for that service, after I recruited a volunteer, it was a one year process before a volunteer was allowed to take call with a more senior volunteer. This meant that training had to be on going and cyclical in nature. The volunteers trained every second Tuesday. I had developed the training plan so that no matter when a recruit was "hired" they would begin training and within one year they were ready to roll. To make this work I broke my training down into moduals. Listed is a brief outline of the training:
-all applicable regulations as required by the Ontario Ambulance Act
-St. John Advanced First Aid as the basic introduction
-moduals on each piece of ambulance equipment
-Radio Operators Certificate
-class F drivers license
-Basic Rescue (road and high level)
After reviewing the Canadian Paramedic Association literature on the subject, it is apparent to me, that the level I developed, is roughly the standard to which today we call Medical First Responder. Which brings me to my point, an advance level can be achieved at the St. John if and only if we all accept a standard level of training. For one, I would like to see us pick one level, then pull out all the plugs to make it work. I find it hard to believe that St. John with all it's resources cannot come with a standard training manual for all community service units, that is applicable to the level of service to which we provide. At the time the training program I designed for Terrace Bay, was accepted by the Ontario Ministry of Health as an acceptable standard for those who "volunteer to do ambulance calls to the public". My question is that if this could be accomplished back in the "dark ages" and these volunteers did ALL ambulance calls, then I fail to see how we can not achieve the same level within St. John. I am always open for pro's and con's for what I have mentioned. I honestly believe that we can create a standard we call all live with. I know from personal and professional experience that a challenging training course is what keeps volunteers around.
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Paul W. J. Irwin
Senior Member
Username: Pirwin

Post Number: 57
Registered: 02-2003
Posted on Wednesday, April 07, 2004 - 02:40 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I must extend my apologies to any Member(s) who may have been offended by my recent posts to this thread. I posted information that I believed was generally fairly well know, as we are moving towards bettering our training and certification programs. I was aware of the pilot project over a year ago. I may have posted the added details sooner than some may have wished, or been prepared for.

I am a strong believer in open dialog. With Sharon being so kind as to lay out the facts for us all to peruse; thanks Sharon; it will only better Members for having the information with which to proceed and grow.

SJA Community Service Members are a hungry bunch. They crave information, involvement, insight, and recognition (feed us food too, that helps). I am happy to be a part of this great family, its past, and bright future in our own eyes, and those of the community we serve.

;-) "BE GOOD ALL DAY"
Paul
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Lana H
Senior Member
Username: Ldh

Post Number: 58
Registered: 11-2003
Posted on Wednesday, April 07, 2004 - 03:09 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Respectfully to all postees, I look forward to the opportunity to advance my skills but I would like to post a comment that was whispered in my ear (no not from voices in my head - I haven't completely lost my mind - yet!) "I only signed up for this to help out people when they need it not compete with the paramedics - besides they get paid a lot more than I do! If I wanted to be a paramedic I go back to school!" Submitted without bias on behalf of those that for whatever reason choose not to post on this forum. "$0.99 plus Service Charge"
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Kevin Morgan
Intermediate Member
Username: Kmorgan

Post Number: 24
Registered: 02-2003
Posted on Wednesday, April 07, 2004 - 09:04 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Lana:

As one of the instructors involved in the pilot project I had to hear a lot of the concerns and reasons people did not want to take the course. In fact I really had to sit and think myself if I felt this is the best thing. And I did think about the smaller divisions, possibly in the middle of no where, and other issues like that.

Also, I have constantly as a training officer had to face the issue of members who have been around much longer than I feeling like we are trying to be paramedics.

No matter how I break it down, I see benefits to these programs, and to me they still greatly outweigh the few small problems.

In our larger areas (major cities) we do have to be somewhat competitive for the organization to stay afloat. With all these Transfer companies and other places who are willing to do special event coverage these days, it's a competitive market. We need to offer our clients top notch service (both administratively and patient care wise) and we need to uphold a good reputation. A good reputation and relationship with local EMS helps. Don't think a patient doesn't notice if EMS shows up and clearly dislikes St. John Ambulance and has no respect for the organization (provided they're conscious and alert anyway). It can greatly hinder a smooth transition of patient care. It can even cause a few uncomfortable moments for everyone. I like to think its more than the fact that we are cheaper than everyone else that brings people our way.

In smaller areas what is the benefit? Well, first of all Ambulance service may be farther away. While in a major urban setting you should have it in 5-10 minutes, a rural area could be waiting 15 minutes, 20 minutes, or longer. While you can't learn good patient interaction in a 40 hour course (takes time, experience, and a knack for it), you can learn other skills that make that wait more productive and possibly more comfortable for the patient.

All I can say is the leadership of the division (district, council, whatever) needs to try to positively promote the change. Even if they don't necessarily agree with it, they need to positively promote it. Everybody has concerns, and there are always what-if's. We may lose some people in the process, but this should be minimal if the people in leadership positions work hard and make the best of it. Each person has their own opinions, but how the division takes it as a whole can be largely affected by how their leadership handles it.

(Just to be clear I'm not trying to suggest people should stop voicing their opinions in places such as this - an open forum for discussion, or that things can't be discussed and opinions brought out within our own divisions - what I am trying to say is the decision has been made and the program is coming , and if everyone gives it a try and tries to enter it with at least a neutral attitude, it may not be so bad. I am sure it will be looked at and re-evaluated as they start to roll it out across the various districts).
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Alex Kroeze
Senior Member
Username: Akroeze

Post Number: 154
Registered: 07-2003
Posted on Wednesday, April 07, 2004 - 11:12 pm:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Not to be a downer or anything Kevin, but if these divisions on larger communities want to compete than nothing has ever been stopping them from getting MFR to compete. It has been there in many forms and names throughout the years. I have asked around locally and there is nobody (some who are 12+ yr veterans) who can think of a time when they would have truly benefited from having MFR training above the current BTS-1 + extra stuff. There were a few stories about wishing they had O2 but that was before we carried it and is no longer an issue. Other than that, they could come up with none. That is why we view it as a lot of time spent on something that history has shown is rarely if ever used.

If larger centres want to, let them get MFR... that's great! Nothing wrong with more knowledge, I took the RC EFR for knowledge purposes. Just don't change everything when things can be changed at a local level to address issues. I think that is the real concern.
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Lana H
Senior Member
Username: Ldh

Post Number: 60
Registered: 11-2003
Posted on Thursday, April 08, 2004 - 12:58 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

So, Kevin et al, any suggestions on what we can tell these people that don't want to become MFR for whatever their personal reasons are? I don't think it's just about being afraid of change or being afraid to pass muster what I'm sensing (maybe it's just me but I'm usually pretty good at reading "vibes") is that perhaps they feel like their being pushed out by always being told that they have to keep going up, up, up with their standards. I know that this advanced training is valid has excellent merit and probably a good business decision to boot but I also can't help wondering, after 900 years plus isn't there also still room for the good old grass roots first aid that St. John is famous for? At least for the Patient Care end of things where, when most people don't really care when they are sick or injured how many advanced courses you've taken or how many stripes you wear on your shoulder. All they want from you is a little help to make them feel better until they can get to the hospital - they don't expect us to be the hospital. Will paramedics respect us more after this? I really can't say, since I've never had a problem with one before. I personally can't see how it would change much since they pretty much have to take pulse, BP etc again anyway so as long as you've done a professional and complete patient report on transfer, I'm not sure how much they'll care about the fact that now I could use a defib (if I'd had to and/or had one to use)even though I was just treating a sprained ankle. As for competing with other service providers - I'm not sure that that's what it should be about either. I truly believe that we're not out there because we're the cheapest. I think it's because people know we're community out there for community - whether it be for a $50 donation or a $1000 one. Not allowing a place for those that don't desire to "up the ante" almost seems like we're loosing touch with our heritage. Sad, I think, if we are....
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Brian Yau
Senior Member
Username: Bnb

Post Number: 60
Registered: 10-2002
Posted on Thursday, April 08, 2004 - 02:38 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Having 6+ years of brigade service, and also having taken the AEMR-I course, I have mixed thoughts on the new standard. Not once on a duty on in real life has the advanced skillsets come into play (KED, backboard, sager, etc), so it can be argued that the course doesn't accomplish much more than the current "full set" of training. However, the course not only builds on the advanced skills in case there would be a need one day, it builds HUGE amounts of confidence. After the course, I believe members would feel much more able to handle a situation with confidence and believe in their treatment decisions. This is due to the course going into detail about WHY something is done, rather than being mechanical ("when you see this, and this, but not this, then do this"). The first aider (responder) is capable in handling more complex injuries that are not "textbook", which is rather important in real life, since nothing really ever goes exactly the way it was taught.

An idea of how to implement the course is for members who have a certain amount of years of service (2? 3?) to take the course. This would allow newer members to familiarize themselves with the more basic procedures, as well as become more confident in themselves before tackling the AEMR course, which could concievably be tough if it is dropped on a recruit like a ton of bricks. It is important to realize this is pretty much the last certification step before getting an EMCA.

My $.02, thanks for reading!
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Lana H
Senior Member
Username: Ldh

Post Number: 61
Registered: 11-2003
Posted on Thursday, April 08, 2004 - 09:35 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Thanks Brian! There's a discussion point (or selling point) that can be used. I also like your idea on a delayed implementation, more like a "phasing in" or growing period. I think many would find this less intimidating and all round more comfortable so someone new doesn't feel like it's being pushed at them. Perhaps that will be taken under consideration as it sounds much more "user friendly".
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Alan Chan
Intermediate Member
Username: Achan

Post Number: 23
Registered: 01-2003
Posted on Thursday, April 08, 2004 - 09:45 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Lana said:
"Not allowing a place for those that don't desire to "up the ante" almost seems like we're loosing touch with our heritage."

I truly agree with that comment. I think we should emphasize to the community that we are community people who are VOLUNTEERING to service the community.

There are different needs in different areas. Regardless, I think Brian's idea is good where we should either phase in, or retain BTS-1 level. We don't have all to be Paramedics. Again, let the interested people in obtaining full MFR certs, and have others take modules to upgrade themselves one at a time.

Just like many other professional certification, you can take one module, slowly build up on the pre-requsistes until you attain full certification. For ex. in engineering, you dont need a full P.Eng title to do any engineering related jobs as long as you are a graduate from a recognized program. But for people who actually spend the time to acquire P.Eng, they are rewarded with more pay and more challenging roles and responsibility.

Similarly, keep BTS-1 as bare minimum for brigade members. OFfer structured upgrade modules such that people can upgrade themselves in a systematic manner. I am not against MFR, but I am discouraged by the way it is being implemented.

Don: Why is your comment edited? Does it contain profanity or any specific derogatory messages? I hope if we are telling the truth on how some members think, we are allow to speak freely and openly.

Thanks
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Johnson Lai
Senior Member
Username: Gundam

Post Number: 253
Registered: 11-2002
Posted on Thursday, April 08, 2004 - 09:45 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

One (long) point I'd like to add in is, "being competitive to keep afloat" in this new world of 3rd party business ran transport and first aid companies is real.

Remember what the purpose of the Brigade side of St John Ambulance is created for. I believe it was created for serving the community and not for revenue generation correct?

Revenue generation is mainly from the teaching public course side of the St John arm, and hence profits from that that is channelled back into the Brigade to perform its necessary community work. Why else are we called a "Not for Profit" organization?

From all the posts here, I gather that no one has treated a casualty that complained "Boy, your level of first aid skills isn't high enough to treat me." At least I haven't heard of it, in my 13 years of performing duties. Most of them were so very happy that I was there to help them.

As someone above pointed out all the "areas of opportunity" in our BTS/BAP system right now, I think it would have been better to continue to fix these problems that we have identified. ID'ing them is the first step, then we need to address them. Only then, can we achieve a standard of BTS-1 and above for the entire population. And given more time, I think we will get 100% BTS. As Don T. says, we just need some more official support from our District level, and more encouragement to move away from "wait and see" attitude, due to all these changes.

I see an endless loop here, we are yet again introducing another higher training system, that the entire thousands of Brigade members have to struggle to support. Need I add in that these members are non-paid "volunteers"? Volunteers are our most important asset. There are thousands of other organizations you can donate your time with.

Seriously, I think SJA members are the BEST acceptors (if that's a word) of change. We've been through soooo many changes, without any major damage to the image, quality and integrity of our service to the community. We are still around.

The only thing that volunteers ask for is to be fed. Fed with information, being offered to have a say, and a sense of belonging. And if we really are turning into a community service unit that needs to generate revenue, then that's fine too. Someone needs to communicate this new shift in purpose to us, and let the volunteers make their own choice.

I keep hearing that "yes, we will lose some members in new changes, and we are ready to accept that fact." Well I like to think out of the box and say, there is ALWAYS a way to make changes and lose NO ONE.

There are documented methods that we can employ, to show everyone why the change is needed. Besides, we are already starting with the BEST of humanity right here. All the volunteers are here because they BELIEVE in St John Ambulance. They have no money to gain from being here. So as long as you explain to them, this is the reality, and we need to change, and ask them, "how can we make this change so that everyone will be ok with it. Not 100% happy, but just okay." Then have a nice recognition system in place, its all a big happy family.

On the flip side, we are prepared to loose some members, but what if these members are all "great leaders" ? I think Toronto has seen enough of this happening, and thus, leading us into our current situation.

I say we can't afford to lose anyone.



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Kevin Morgan
Intermediate Member
Username: Kmorgan

Post Number: 25
Registered: 02-2003
Posted on Thursday, April 08, 2004 - 10:00 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Lana and Brian: Some more good points.

Brian, remember that this course they're taking is not the last stop before becoming an EMCA, the 80 course is the one that fully meets the PAC EMR Competency Profile. Also, I would not push that idea to reluctant members for two reasons - one is the ones that don't like the advanced training are going to dislike it more, and two, there's two years of college and provincial examinations between the EMR and the EMCA (to say it like that almost belittles the EMCA).

As for giving them time, they have up to a year as it stands today (if MFR replaces BAP completely as it is expected to).

Finally, I want to approach it from this perspective. It's a new one on the board, but another consideration we've had in implementing the program so far.

A new member joins. Comes to weekly training sessions. Tries to work hard. All of a sudden one week they're told "BAP is coming up" (as frightening music plays in the background and looks of horror creep along everyone's face).

Now the other perspective. When they join they're told "Well, you'll spend a few weeks in an intake session with the other new people. Then you'll start weekly training with us and in the next (3, 6, 8, 12) months you'll be able to take a 2 weekend comprehensive course. What's that, Is there a test at the end? Of course there is, but you'll be practicing for it through the whole course and be more than ready for it.".

To me the BAP process is much more intimidating to new members. The BAP process is much more intimidating to me (I've been a Level 2 evaluator for several years now and I still get so nervous when I do my BAP, sweaty palms and everything... real patient, no problem, bring it on). And what attracts new members more? Some internal certification that means nothing in the real world, or a defined standard that is recognized and accepted outside of the organization. I know we (and many other divisions) are really in need of new members.

Should we lose the old ones in the process? I don't think so. Again this falls a lot on the leadership of the division. I think a lot of people will find it's not as hard as bad as they think.
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Alan Chan
Intermediate Member
Username: Achan

Post Number: 24
Registered: 01-2003
Posted on Thursday, April 08, 2004 - 10:05 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Kevin,

I think I can see it from your perspective.
However, what happens to the new member during the interim, can he/ she doe duties? (Assuming MFR course is >3 months)

But this perspective is interesting :-)
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Lana H
Senior Member
Username: Ldh

Post Number: 62
Registered: 11-2003
Posted on Thursday, April 08, 2004 - 10:16 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Here, here! Johnson & Alan. Both points articulated well. Now, on a purely personal note, I don't think we can AFFORD to loose members for any reason of our making and especially something like this. Yes in SJA we accept change well but at some point the question is going to come up - why should I have to? As has been said here many times before, there are many things you can volunteer your time to, if you are so inclined and many (if not most) require less personal costs (as in time and in some cases money). We've all seen it happen, not only here but in ALL areas of volunteerism. In this day and age of 24-7 shifts and having to be 10 places at the same time it's hard enough to slot in time for yourself, let alone volunteerism and sometimes, much as you love it, it's just not worth the effort. Not recognizing and accommodating this in order to increase profit margin or public recognition or whatever the motivation is sounds like a dangerous precidence. If one of the goals for SJA is to become more visible in the world of patient transport/first aid for hire I'm all for it but wouldn't it make more sense to create a new division of PCPs that are willing to take on this additional role? You could be a regular SJA member that goes and does the public duty thing or you could be a more highly trained PCP to fill this new job description or you could do both - your choice, this allowing retention of current members since I'm pretty confident that there would be plenty willing to "rise to the occassion" and (hopefully) opening up a new market which in turn (hopefully) would attract new people as well. The sad reality folks is that, once you lose 'em you rarely (if ever) get 'em back.
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Kevin Morgan
Intermediate Member
Username: Kmorgan

Post Number: 26
Registered: 02-2003
Posted on Thursday, April 08, 2004 - 10:21 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Can they do duties now if they don't BAP for > 3 months?

Sure, as an observer, third person, NON-BTS, or whatever each division calls them. They just have to be with someone who is MFR/BTS and cannot perform independent patient care.

It is replacing BAP. Rather than going to take your BAP one day you go to this course instead.

In terms of Policy I don't think much is changing. Replace the words BAP/BTS with MFR, and an IPCP will now be MFR certified instead of BTS certified.
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Lana H
Senior Member
Username: Ldh

Post Number: 64
Registered: 11-2003
Posted on Thursday, April 08, 2004 - 10:23 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Excellent food for thought Kevin - you were obviously posting at the same time as I otherwise I would have included that in my previous long winded (what else is new) post. Hey like I said before - here in SJA we're nothing if not passionate. Perhaps we should all consider new careers - motivational speakers, clergy, politicians? On second thought - nah! forgetaboutit!
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Brian Yau
Senior Member
Username: Bnb

Post Number: 61
Registered: 10-2002
Posted on Thursday, April 08, 2004 - 10:27 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Just to stir the pot some more... the AEMR cert is valid for three years (I think...)

BTS used to be for one year... is this going to change, or will there be a recert yearly?
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Kevin Morgan
Intermediate Member
Username: Kmorgan

Post Number: 27
Registered: 02-2003
Posted on Thursday, April 08, 2004 - 10:30 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Lana:

Sorry, I think I was typing at the same time as you there. I think you're using the initials PCP to mean Patient Care Provider (it's confusing, as PCP really stands for Primary Care Paramedic... unless this is what you are suggesting).

Anyway, I don't think we should be looking to make a "new division" of SJA. We have a hard enough time with divisions we have now. We're not looking to move into the patient transport business (though it has been done). I was merely outlining some of the advantages and pointing out that yes, in some cases we do need to be competitive.
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Alan Chan
Intermediate Member
Username: Achan

Post Number: 25
Registered: 01-2003
Posted on Thursday, April 08, 2004 - 10:33 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

True, non BTS member would have to be the same, I agree. :-) My bad

I further agree with you Kevin, in stating that we need to be more competitive!

The policy won't change that much, but the level of committment and difficulty will. I, personally, wouldn't mind being MFR certified myself. However, I think we also need to afford some flexibility in the system.

On a general note, I think we all agree MFR is beneficial, but having MFR as a standard,for ALL volunteers, so quick, would that be beneficial? Should we keep some leadway and allow people to be more flex?

As Lana has stated, there are potentially other forms of volunteerism where people can approach.
Fundamentally though, members need to see a future and some form of security in order to elicit committment. Also, to gain trust from members, the members also need to trust the organization. Currently, our direction, or "way ahead" seem vague and we seem to be losing trust...unfortunately and there are examples :-(

Anyway, that's my most updated thoughts haha...

I though BTS is 2 Decembers, meaning that if I take it now, I would be certified until Dec. 2005.

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Kevin Morgan
Intermediate Member
Username: Kmorgan

Post Number: 28
Registered: 02-2003
Posted on Thursday, April 08, 2004 - 10:34 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Brian (sorry for the double post, I was typing when yours went up... unless another gets in between my last one and this one).

The cert is valid for three years. We were looking at the process of CME's (Continuing medical Education) to maintain your certification. Once every couple of months on your regular training night you would have to complete CME's and submit them to someone (we were saying the district training officer... who knows now). I don't know if this is becoming part of the official project or not, but I would expect to see something of this sort.

Essentially no, you recertify it in three years. You just have to "maintain" the certification.
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Kevin Morgan
Intermediate Member
Username: Kmorgan

Post Number: 29
Registered: 02-2003
Posted on Thursday, April 08, 2004 - 10:41 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

Well, you can "phase" it in to your own district (and I think it's rolling out one district at a time, not certain).

Think of it this way - the year you know you're starting MFR, run a BAP or two early in the year. Encourage everyone to BAP. Then start to phase MFR in by March. You have almost two years till those people who did their BAP in January/February actually expire (minus a few months). That is a significant amount of time to phase it in.

Problem with taking too long to phase it in is we want everyone at the same minimum standard across the province (country?) to maintain some uniformity.
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Johnson Lai
Senior Member
Username: Gundam

Post Number: 254
Registered: 11-2002
Posted on Thursday, April 08, 2004 - 11:22 am:   Edit Post Delete Post Print Post    Move Post (Moderator/Admin Only)

I think the concern here is not how this will work, because we know how it can work. Its just like any other new system that's being introduced. Just do it slowly and gradually. All members can adapt and given time, will work for sure.

The concern here is the treatment of the volunteers.

After years of trying to support the new change of BAP/BTS, with countless of thousands of hours for: training members to the BTS guideline, becoming an evaluator, convincing all my members that BTS is the best, holding BAP sessions, simulating casualties, paying for lunches, transportation, extra practice times for BAP..... only to hear a few years later that, "well, this didn't work, and we are now going to a brand new system."

There were minimal or no help or direction given to divisions on how to improve this during these years of BTS. Only message I heard was "how come there is only 50% BAP in Toronto?? That is really bad". So we go and push even harder to our volunteers.

Now we end up back again, we are going to implement a brand new system. To me, and a lot of leaders in the groups are simply frustrated.

Speaking of losing members, I can name off about 10 amazingly good leaders in Toronto that had done unimaginable positive things for St John, but only to get too frustrated and left. Because good leaders are the ones that do not complain, will always support their superiors' ideas. But the end point is when their frustrations overweighs the benefits, so they will just quietly leave.

Sadly, SJA suffers in the end.

SJA is not being competitive compared to other businesses out there, and is the level of training really the problem here? So will increasing the level of training solve the financial crisis that SJA is facing?

Or is there other avenues of SJA that actually needs more revamping and upgrading?

I urge everyone to remember to think of the human factor. This is not a business where people are paid like a job. Behave in more of an amiable behavior, rather than a driver.

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