Ambulances in short supply more often

‘It paints a grim picture,’ says president of OPSEU local

The number of times Hamilton has one or no ambulances left to respond to emergency calls is rapidly rising.

Known as a code zero, this alarming shortage has happened 71 times so far in 2017.

It means Hamilton has seen four times the number of code zero events compared with this time last year.

In fact, by June the number of code zero events in 2017 had already bypassed last year’s total.

It’s significant because it raises concern about Hamilton Paramedic Service’s capacity to respond to emergency calls.

“It paints a grim picture,” said Mario Posteraro, president of Ontario Public Service Employees Union Local 256.

Typically, busy months for code zero

events are in the last quarter of the year when flu season starts, so the worst shortages in 2017 might be still to come.

“At this point in the year, we have experienced 11 more code zero events than we did in the entire year of 2016,” said Michael Sanderson, chief of Hamilton Paramedic Service. “The frequency has increased over the past two years, which is concerning.”

Sanderson points to hospital overcrowding as the main culprit.

Hamilton Health Sciences was at 110 per cent occupancy on Tuesday and has averaged 105 per cent since October.

St. Joseph’s Healthcare is operating 25 unfunded beds a day on average while Juravinski and Hamilton General hospitals are at a combined 80 to 100.

“The frequency of code zero events is directly related to days where we experience a high number of long offload delays at hospital,” said Sanderson.

Off-load delays occur when ambulances are stuck at hospitals while paramedics wait — sometimes hours — for emergency department staff to take over care of the patient.

“There is a lack of bed capacity in the emergency department,” said Posteraro. “It is caused by a lack of bed capacity in the wards. That is caused by a lack of capacity in longterm care. It is a cascade.”

Nearly one in four beds was taken up by patients ready to be discharged at St. Joseph’s hospital during the week of July 10. But they were stuck waiting for other services such as home care and long-term care. Nearly one in five beds is currently blocked at HHS. There is a concern the situation will deteriorate further as HHS cuts $20 million and St. Joseph’s finds $7 million in savings to balance their budgets by the end of the fiscal year March 31.

At HHS, the cuts are expected to affect 69.37 full-time equivalent positions (FTEP) or 85 people.

That is on top of the 90.3 FTEP positions cut last year, which affected 122 people.

“It’s obviously going to make matters worse,” said Posteraro. “News of the cutbacks is bad news for the municipality, paramedics and patients.”

Code zero events are not yet near the peak of 242 in 2013. The number of times there were too few ambulances on the road dropped steadily to 44 in 2015, as a number of strategies were put in place.

But it is rising again. The first seven months of 2017 already had 60 per cent more code zero events than 2015’s year-long total.

The union predicts that will continue to climb with 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 7 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.

“Demographics point to an increasing call volume,” said Posteraro. “The bottom line is the demands for medical assistance are outpacing our ability.”

News of the cutbacks is bad news for the municipality, paramedics and patients. MARIO POSTERARO LOCAL 256 PRESIDENT