De­lays at hos­pi­tals leav­ing too few am­bu­lances on the road

EMER­GENCY SER­VICES Paramedics raise alarm over long waits at ERs, fre­quent code zeros

The Hamilton Spectator - - FRONT PAGE - JOANNA FRKETICH

Hamil­ton Paramedic Ser­vice is rais­ing alarm that hospi­tal over­crowd­ing is in­creas­ingly leav­ing the city with too few am­bu­lances on the road to re­spond to emer­gen­cies.

“We end up hav­ing mul­ti­ple ve­hi­cles tied up at the hospi­tal longer than two hours,” Chief Michael San­der­son told the city’s emer­gency and com­mu­nity ser­vices com­mit­tee Thurs­day. “It’s not good for pa­tients, it’s not good for our staff and it’s not good for our ca­pac­ity to re­spond.”

Paramedics reg­u­larly wait more than two hours to hand off pa­tients to Hamil­ton emer­gency de­part­ments de­spite rec­om­men­da­tions that it take no longer than 30 min­utes, re­veals the ser­vice’s an­nual re­port.

In Oc­to­ber, it hap­pened 432 times, which trans­lates into 14 times a day.

On one day alone, Oct. 11, paramedics were stuck at the emer­gency room for more than two hours 44 times.

As a re­sult, there were one or no am­bu­lances left to re­spond to emer­gen­cies in Hamil­ton — known as a code zero — three times that day.

In that month, there were 18 code zero events.

“There is a sig­nif­i­cant cor­re­la­tion be­tween the num­ber of pa­tients we have on off-load de­lay at the hos­pi­tals longer than two hours and our fre­quency of code zero events,” said San­der­son. “If we keep the de­lays down, we don’t have the code zero events.”

The an­nual re­port shows Hamil­ton’s hos­pi­tals take more than three times longer to off-load 90 per cent of pa­tients than the rec­om­mended 30 min­utes. The worst de­lays are at Ju­ravin­ski

Hospi­tal and Cancer Cen­tre with 90 per cent of pa­tients off-loaded within 112 min­utes. Next was Hamil­ton Gen­eral at 107 min­utes and St. Joseph’s hospi­tal clocked in at 91 min­utes.

At times in Oc­to­ber, it es­ca­lated up to 140 min­utes.

“It’s cre­at­ing a lot of pres­sures for paramedics in the city,” said Ward 7 Coun. Donna Skelly. “Our off-load times are three times what the prov­ince is ask­ing.”

Hospi­tal over­crowd­ing was blamed for push­ing the num­ber of code zero events to 60 in 2016 from 44 the year be­fore. More than half were in the fi­nal quar­ter of the year when hos­pi­tals strug­gled with oc­cu­pancy rates as high as 120 per cent.

“I of­ten feel like EMS paramedic ser­vices are very much like the ca­nary in the mine shaft,” said San­der­son. “You can’t con­tinue to sus­tain 100 or 105 per cent oc­cu­pancy in hos­pi­tals. The tip­ping point has been ex­ceeded.”

NDP leader and Hamil­ton Cen­tre MPP An­drea Hor­wath says the an­nual re­port should be a “wake-up call” for the prov­ince. “You can get rushed to a hospi­tal in an am­bu­lance and than spend hours wait­ing be­cause there is no room in­side,” she said. “We have been on (the gov­ern­ment) about over­crowd­ing in the hos­pi­tals for years now. It’s reach­ing a cri­sis point. The thing that is re­ally wor­ri­some is that in this last bud­get the gov­ern­ment shorted the hos­pi­tals by $300 mil­lion to just keep ser­vices at the in­ad­e­quate level they are at now.”

Health Min­is­ter Dr. Eric Hoskins says he’s put mea­sures in place in­clud­ing in­cen­tive funding to emer­gency de­part­ments and cash for ded­i­cated off-load nurses to shorten the amount of time paramedics spend wait­ing.

“We rec­og­nize the chal­lenges as­so­ci­ated with off-load de­lays ex­pe­ri­enced by emer­gency med­i­cal ser­vices providers when trans­fer­ring pa­tients to hospi­tal emer­gency de­part­ments,” he said in a state­ment to The Spec­ta­tor.

Hamil­ton Health Sci­ences did not pro­vide com­ment Thurs­day about the de­lays.

St. Joseph’s Health­care said it has been slammed with 100 to 200 more pa­tients com­ing in by am­bu­lance some months. It is us­ing sev­eral strate­gies to try to get paramedics back on the road in­clud­ing open­ing up un­funded beds but the high vol­umes that started in the fall have con­tin­ued into the spring.

“The lack of bed ca­pac­ity is a pro­vin­cial prob­lem that they’re not ad­dress­ing,” said Mario Poster­aro, pres­i­dent of On­tario Pub­lic Ser­vice Em­ploy­ees Union Lo­cal 256. “It’s be­ing borne by the mu­nic­i­pal­ity and our am­bu­lance ser­vice, but it’s cre­ated by the pro­vin­cial gov­ern­ment.”

The an­nual re­port also raises flags about the steady growth in the num­ber of calls to 911 that re­quire an am­bu­lance.

Paramedics re­sponded to more than 79,000 calls in 2016, a jump of seven per cent over the prior year and a cu­mu­la­tive in­crease of 35 per cent over the past seven years.

If the growth con­tin­ues, it will mean an ad­di­tional 22,000 am­bu­lance calls over the next five years.

Ward 2 Coun. Jason Farr said he thinks the growth es­ti­mate is far too low con­sid­er­ing the ag­ing pop­u­la­tion.

The big­gest de­mand comes from those aged 80 and over who make about 16 per cent of am­bu­lance calls de­spite be­ing just over two per cent of the pop­u­la­tion.

“What we’re look­ing at is a cri­sis that’s loom­ing with re­spect to the in­crease in call vol­ume,” Poster­aro said. “The bot­tom line is we need more front-line am­bu­lances.”

Hamil­ton’s emer­gency med­i­cal ser­vices Chief Michael San­der­son.

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