Hospital delays ‘unacceptable’ for paramedics
Niagara paramedics are poised to wait for up to 13,000 hours this year delivering patients to emergency departments that are already too busy to take them.
Those offload delays are expected to cost Niagara Region the equivalent of $1.6 million in Niagara Emergency Medical Services resources.
“This is terrible, unacceptable,” said St. Catharines Coun. Brian Heit, referring to a report about the problem presented at Tuesday’s public health committee meeting at the Region. “We have to do something about this.”
The committee approved a motion to direct Niagara EMS Chief Kevin Smith to meet with Niagara Health System management to reinforce concerns, develop an action plan for immediate implementation, develop a schedule of performance targets, and report back to regional council later this year.
It’s not the first time Niagara paramedics have dealt with the problem.
The Region took steps to address offload delays in 2010 after paramedics spent 9,194 hours waiting to deliver patients that year. As a result of those initiatives, the number of hours waiting to drop off patients steadily decreased down to 2,107 in 2014 and 2,988 in 2015, despite steadily increasing call volumes for Niagara EMS.
“In that four-year period our call volume went up about 37 per cent, and yet we managed to bring down offload delays significantly,” said Niagara EMS Deputy Chief Richard Ferron.
But offload delays began to increase again in late 2016 for a total of 5,889 hours that year. So far this year, paramedics have already spent 6,082 hours waiting to drop off patients — a number that is expected to at least double by the end of 2017.
Ferron said the initiatives put in place to address the problem in 2010 have since been “enhanced and reinforced” as the offload delays started ramping up again last year.
Meanwhile, he said, paramedics continue to work with NHS administration “to understand why, despite those things that we still do, the offloads have continued to increase substantially.”
Niagara’s medical officer of health Val Jaeger said the volume of patients either being transported by ambulance or walking into emergency departments on their own has left health-care professionals questioning the validity of census data.
They’re asking: “How many people actually live here,” she said.
Jaeger said the problem is not unique to Niagara, but “that doesn’t negate the fact that we should try to find a Niagara solution.”
Although the report points to limited hospital resources such as a lack of beds as contributing to the offload delays, Jaeger said public health is not implying that NHS is “not trying.”
“All we are saying is that from our perspective, there is a mismatch between the needs of the people that we bring, the patients that are transported, and the ability to receive them and manage them,” she said.
Niagara Falls Coun. Selina Volpatti questioned if “anyone is listening” to the Region’s concerns.
“It’s a very scary report,” she said.
Jaeger said NHS administration has taken concerns extremely seriously, but added the report “carries a lot more oomph if council approves these kinds of things.”
“They are listening, and I think this is heightening our ability to work with them,” Jaeger said. “Working together last time had an impact.”
In an interview, Smith said significant changes would need to be implemented to address the underlying issues leading to the problem.
There are, however, some initiatives that could be implemented in the very near future. For instance, he said, not all people who call 911 actually require a trip to hospital.
“They’re seeking some kind of medical help and sometimes social help, the answer isn’t always the doors of the emergency department,” Smith said.
“We’d be able to refer people who call 911 in need of some sort of service, and it’s not apparent that they need emergency services, to what other resources are in the community to do that.”
A pilot project has also been in place since February allowing paramedics to bring less severely ill patients to urgent care centres in Fort Erie and Port Colborne, rather than to emergency departments. The project is currently under review.
“We’re at a point of having to make decisions about implementation,” Smith said. “That’s where it’s going to take partnerships with the province because of some of the legislative requirements.” ABenner@postmedia.com Twitter: @abenner1