Ottawa Citizen

Hospital brass address ambulance delays

Backup putting service at risk of falling below city standard for response times

- J ON WILLING jwilling@postmedia.com

Freeing up and adding more beds is the only way to rid the misery of paramedics being held up at Ottawa hospitals, leading in some cases to zero ambulances being available to transport sick and injured residents to health facilities, city councillor­s heard Thursday.

Officials from The Ottawa Hospital, Queensway Carleton Hospital and Montfort Hospital were on the hot seats for more than two hours during a meeting of council's community and protective services committee as councillor­s repeatedly asked why the executives aren't acting on the lengthy patient off-load times from ambulances at the hospitals.

The answers from the executives were similarly repetitive: the problem is with the health-care system, not just the hospitals.

The amount of time Ottawa paramedics spent at hospitals waiting to off-load patients in 2019 was equal to $7.7 million.

Ambulances held up at hospitals have had an impact on response times, with paramedics responding to life-threatenin­g emergencie­s within eight minutes 75.1 per cent of the time.

The paramedic service is in danger of falling below the council standard of meeting that eight-minute response time 75 per cent of the time.

However, the most dangerous situation for the paramedic service is when it reaches “level zero,” when no ambulances are available for calls. It happened more than 500 times in 2019.

According to statistics provided by the hospitals, 85 per cent of ambulances are off-loaded within 60 minutes. The other 15 per cent of off-loads are taking longer, sometimes hours longer.

Cameron Love, president and CEO of The Ottawa Hospital, which runs the busy Civic and General campuses, provided most of the rationale for why hospitals can't magically make the patient off-load problem disappear overnight.

The overarchin­g problem is the growth of “alternate level of care” (ALC), where patients are taking up acute-care beds when they might not require hospital-specific care. ALC has increased about 50 per cent over the last five years, while ambulance volumes increased by nearly 10 per cent, the hospital executives said.

Trying to fix the off-load problem “is a patch in the short term without a solution for the long term,” Love said.

Bernard Leduc, president and CEO of Montfort Hospital, said the main challenge is getting the “right patients in the right bed at the right time.”

Andrew Falconer, president and CEO of Queensway Carleton Hospital, said hospitals are working closely with the paramedic service to distribute ambulance arrivals across the facilities so one emergency department isn't swamped.

Other initiative­s to get paramedics back on the road are equally straightfo­rward.

Falconer described a push for more “vertical off-load,” which simply means the patient can get up from an ambulance stretcher and walk to the emergency wait room so paramedics can get back on the road.

The hospital executives also highlighte­d plans to enhance a special off-load program using nurses, expand bed capacity in emergency department­s and launch a pilot program at the Civic campus that could use hospital-hired paramedics.

City managers have been hounding hospital executives for years to solve the patient off-load problem at emergency department­s. Mayor Jim Watson has brought it up with Premier Doug Ford.

Pierre Poirier, the new chief of the Ottawa Paramedic Service, said it has created a “dishearten­ing” situation for paramedics who are trying to serve residents. Looking at the statistics for 2020, Poirier hasn't seen an improvemen­t so far.

Anthony Di Monte, the city general manager that oversees the paramedic service and a former Ottawa paramedic chief, called the off-load delays a “crisis.”

“It affects us morally, ethically as providers of health care,” Di Monte said.

With the hospital executives agreeing to attend the video-conference committee meeting, councillor­s seized the opportunit­y to grill them.

Coun. Carol Anne Meehan accused the hospital executives of “dragging your feet for years” and she expressed worry that deaths will happen because paramedics can't get to patients in good time.

Coun. Matthew Luloff told a personal story about needing an ambulance for his newborn daughter when there was a level zero situation. On Thursday, he was upset that he didn't see the “concrete plan that's needed” to solve the off-load delays at hospitals.

Coun. Catherine McKenney accused the hospitals of downloadin­g health care and shifting responsibi­lity to the municipali­ty, which McKenney argued is doing its part through the paramedic service and public health programs.

“We cannot be held responsibl­e for it,” McKenney said.

Love dismissed McKenney's suggestion that hospitals are downloadin­g health care to the city. “I'd suggest we're trying to help as much as we can,” Love said.

Coun. Diane Deans reminded hospitals that the off-load problem has been around for 10 years and there needs to be an immediate solution.

“We can't take another decade,” Deans said. “This has been far too long.”

 ?? JEAN LEVAC ?? According to statistics from Ottawa hospitals, 85 per cent of ambulances are off-loaded within 60 minutes.
JEAN LEVAC According to statistics from Ottawa hospitals, 85 per cent of ambulances are off-loaded within 60 minutes.

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