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Ottawa paramedics spending less time waiting to offload patients in ERs, report shows
Ottawa paramedics are spending less time waiting to offload patients in hospital emergency rooms and the service is at 'level zero' less often since the introduction of a new dispatch system a year ago, according to a new report.
The Ottawa Paramedic Service introduced a new 'medical priority dispatch system' in April 2024, which allows dispatchers to identify urgent patients who require an immediate paramedic response and non-life-threatening calls that may be deferred, delaying a paramedic response.
The 2024 Ottawa Paramedic Service Report says the introduction of the new dispatch system and the implementation of new mitigation measures in hospitals has resulted in a 'significant decrease to hospital offload delays and 'level zero' events.'
The paramedic service spent 11,373 minutes at 'level zero' in 2024, when there were no ambulances available to respond to a call. That's down from 52,995 minutes at 'level zero' in 2023 and 73,060 minutes in 2022.
Staff say offload delays at local hospital emergency rooms continue to be a 'significant contributor' to 'level zero' events for the paramedic service.
'The performance target for level zero is that there should never be a time when a paramedic crew is not available,' the report says.
According to the Ottawa Paramedic Service, offload delays improved at all five Ottawa hospital emergency rooms last year, but the paramedic service and hospitals are not meeting performance targets.
The industry accepted performance target to transfer patients to the care of a hospital is 30 minutes at the 90th percentile. Here is a look at the Ottawa hospital offload times in 2024:
Ottawa Hospital General Campus: 112.73 minutes (158.08 minutes in 2023)
Ottawa Hospital Civic Campus: 112.78 minutes (142.20 minutes in 2023)
Montfort Hospital: 159.01 minutes (234.40 minutes in 2023)
Queensway-Carleton Hospital: 144.18 minutes (171.81 minutes in 2023)
CHEO: 38.45 minutes (39.46 minutes in 2023)
The paramedic report says hospitals implemented several mitigations strategies last September aimed at reducing offload delays and improving service for the patient. Mitigation measures include:
Paramedic Response Unit : An emergency response vehicle staffed with a single paramedic can assess patients, initiate care and determine whether an ambulance is required.
: An emergency response vehicle staffed with a single paramedic can assess patients, initiate care and determine whether an ambulance is required. Dedicated Offload Nurse Program: Paramedics transfer care to a dedicated health professional within the hospital ER.
Paramedics transfer care to a dedicated health professional within the hospital ER. Vertical Patient 'Fit 2 Sit' Program: The program has seen almost 4,500 patients redirected to the emergency department waiting room, allowing paramedic crews back into the community.
The program has seen almost 4,500 patients redirected to the emergency department waiting room, allowing paramedic crews back into the community. Targeted Engagement Diversion: Paramedics may transport an individual experiencing homelessness to a specialized medical clinic operated by Ottawa Inner City Health. In 2024, almost 900 people were diverted away from the ER.
Paramedics may transport an individual experiencing homelessness to a specialized medical clinic operated by Ottawa Inner City Health. In 2024, almost 900 people were diverted away from the ER. Mobile Logistics Support Unit
Patient Flow Paramedic : The Ottawa Paramedic Service deploys a single flow paramedic to an ER to receive up to four patients, allowing four crews to return to service.
: The Ottawa Paramedic Service deploys a single flow paramedic to an ER to receive up to four patients, allowing four crews to return to service. Paramedic treatment on offload delay: Paramedics administer clinical treatment while in a hospital during an offload delay. A paramedic can consult with a physician on patient care and provide ongoing treatment.
Paramedics administer clinical treatment while in a hospital during an offload delay. A paramedic can consult with a physician on patient care and provide ongoing treatment. Physician assessment on stretchers: A physician will assess or treat a patient while in the care of a paramedic crew during an offload delay.
A physician will assess or treat a patient while in the care of a paramedic crew during an offload delay. Breakaway paramedic crew: Breakaway paramedic crews are identified at the start of the shift and deployed when there are high acuity calls waiting in the queue.
Ottawa paramedics
Ottawa Paramedic Service vehicles parked at a hospital in Ottawa. (Natalie van Rooy/CTV News Ottawa)
Response times
Ottawa paramedics received 121,461 calls for service in 2024, down from 127,107 calls for service in 2023. There were 173,053 responses by paramedics last year, down from 193,127 responses in 2023 and 184,113 responses in 2022.
The response volume is measured on how many paramedic resources are assigned to calls.
According to the report, paramedics met the Council-approved response time performance targets in 2024.
The Ottawa Paramedic Service responded to life-threatening calls within eight minutes 75 per cent of the time last year, up from 68 per cent of the time in 2023 and 61.8 per cent in 2022.
For urgent calls, paramedics responded to calls within 10 minutes 76 per cent of the time, up from 68.8 per cent in 2023.
Paramedics also met the response time target for sudden cardiac arrest, responding to calls within six minutes 70.2 per cent of the time. The target for sudden cardiac arrest is a response time within six minutes, 65 per cent of the time.
The City of Ottawa hired 14 new full-time paramedics in 2023 and 28 new full-time paramedics in 2024 to help improve response times. The 2025 budget included funding for 27 new full-time paramedic stations.