Niagara wants answers about offload delays
Idling ambulances began to skyrocket in August 2016
Something began to happened in August 2016 that was indicative of a systemic problem.
That’s when the hours ambulances spent parked outside hospital emergency departments waiting to deliver patients began to skyrocket in Niagara and across the province.
A year earlier, Niagara paramedics spent almost 3,000 hours on offload delay. But by the end of 2016, that number had almost doubled and continued increasing exponentially.
“Something happened in around that time, provincially across the LHINs (Local Health Integration Networks) where we started seeing these increases again,” Niagara Emergency Medical Services Chief Kevin Smith told members of Niagara’s public health committee, Tuesday.
“It’s odd timing.”
At first, Smith thought the increase was an anomaly, “but when it just kept on that trajectory, we knew that there was a crisis.”
By the end of 2017, Niagara paramedics set a record for offload delays, spending 15,438 hours idling at emergency departments.
Smith said he has pointed out the timing of the increase to Niagara Health System management, but they were just as perplexed.
“We have asked what happened in that time frame. The answer we received was, ‘Don’t know.’ There’s not one thing that changed.”
EMS has worked with hospital management to try to identify a reason, but Smith said they couldn’t come up with any change that could be to blame.
“It was almost mirrored across the province so it reinforced the fact that it wasn’t necessarily anything that Niagara Health had changed.”
Committee chair, West Lincoln Mayor Doug Joyner pointed out that sometimes numbers can be skewed by just reporting them differently.
Although Smith said there is now “better data” available to EMS, it isn’t enough to account for the increase. “All I need to do is go to the emergency department and lay eyes, and we have not seen anything like this before,” Smith said.
St. Catharines Coun. Bruce Timms, however, wasn’t convinced that no one had an explanation.
“It seems pretty clear in the evidence that something changed in the hospital system, maybe across the province,” he said.
Welland Coun. George Marshall agreed and directed regional staff to ask hospital administration for an explanation.
“The number is so spiked that there has to be something there,” he said.
“I think the question is necessary. It may be that they have no answer, but it’s so far out there that there has to be something that occurred. And I think somebody knows. That’s a question. It’s not an accusation. The spike is disproportionate to anything I can imagine statistically.”
St. Catharines Coun. Tim Rigby said there’s likely “a whole bunch of things” contributing to the problem.
“But I think the big magic bullet is money, and being able to open more beds and being able to look after people in their homes,” he said.
Meanwhile, the problem continues.
Asked about an unconfirmed report Tuesday that numerous ambulances were seen parked outside the Niagara Falls hospital, Smith said “there are times when we see eight or nine ambulances at one site stacked up there.”
“It’s a huge concern,” he said in an interview.
“We have about 30 ambulances at peak staffing, so when you’re losing almost a third of your fleet to the hospitals it’s a little difficult.”
Smith said EMS has been working with local hospitals for the past month to implement strategies in the hope of stemming the increase, but it will be 45 to 90 days before the impact of those strategies can be determined. Those strategies, which include streamlining information sharing, standardizing processes at hospitals and improving management of volume surges, were to be fully implemented this week.