Ambulance system is stressed

Requires further investment to keep up with the rising demands: chief

WATERLOO REGION — More investments are needed in Waterloo Region’s paramedic services to keep up with the growing demand, the chief of paramedic services told regional councillors.

While there has been a slight improvement in response times this year, there has been more time when ambulances are tied up on calls, said Stephen Van Valkenburg.

“These indicators point to the need to continue to invest in paramedic services,” he said.

Van Valkenburg presented a supplementary performance report covering January to October at a regional committee meeting Tuesday to provide up-to-date data for 2018 budget deliberations.

“We’re hoping the resources that we’re asking for in the budget issue paper will start to move these statistics in the right direction,” he said.

The service’s unit utilization rate of 39.6 per cent continues to be higher than the 35 per cent recommended in the master plan and endorsed by council. Unit utilization is when ambulances are out on calls. When it is higher than the target, it becomes difficult to ensure an ambulance will be available for the next call in a reasonable time.

Code yellows and code reds are on the rise. Code yellow is when three or fewer local ambulances are available to respond, while code red is when there are no local ambulances and no out-of-town services immediately available to help.

There have been fewer code yellow occurrences, but in general they’ve lasted longer. Code reds have increased and also are longer in duration.

To date, 10.4 per cent of time has been spent in code yellow or about 2.5 hours a day, up from 9.9 per cent for the same period in 2016. Code reds account for 0.79 per cent of time or about 11.5 minutes per day on average, up from 0.52 per cent in 2016.

Call volume is expected to reach 52,000 vehicle responses by the end of the year, above the 49,000 forecasted. That represents an increase of nearly nine additional responses a day compared to last year.

“We have sustained growth in call volume,” Van Valkenburg said. “This is occurring at an even faster pace than predicted by the master plan.”

Average response times improved 17 seconds to nine minutes and 20 seconds, from nine minutes, 37 seconds during the same period in 2016.

By October, the average for ambulance days lost to off-load delays — when paramedics are waiting at a hospital to transfer patient care — increased 167.2 per cent compared to October 2016, resulting in the loss of 124 additional ambulance days.

“It continues to be a challenge for us,” Van Valkenburg said.

Provincial funding for the dedicated off-load nurse program has not kept pace with the increase in patient volumes and, in fact, has marginally decreased, the report said.

Cambridge Mayor Doug Craig asked if the budget issue paper, which will go to council on Wednesday, will address the issues.

Van Valkenburg said yes, with the exception of the off-load delays because that depends on provincial funding. He said the paramedic service is working closely with the region’s hospitals to ensure the funding provided is optimized.

Coun. Sean Strickland said that while call volume and offload delays are up, response times are down. “That indicates the resources that we’ve added have helped,” he said.

Two 12-hour ambulances were added in July 2016, followed by three this past July.

“With the upcoming budget issue papers, it should help some more.”

Strickland said he was concerned about rising call volumes and off-load delays, which are driving the challenges.

“We need to really address that bottleneck in the system,” Strickland said.

Education on when to call an ambulance could help stabilize call volumes, he said, and have “a positive ripple effect through the system.” He also proposed a motion from council requesting additional funding from the province for off-load nurses.