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How is hospital offloading hurting paramedic response times? County to explore the issue

While response times have improved in 2023, Simcoe County officials still looking for ways to get paramedics back on the road faster
Simcoe County paramedics respond to a call in Barrie in this file photo.

County of Simcoe Paramedic Services is working to better meet response times when dispatched to a potential emergency.

Members of Simcoe County council were provided with an update on local response times, as well as recommendations from officials for the 2024 Response Time Performance Targets, during the Oct. 24 committee of the whole meeting.

Local paramedics provide ambulance coverage in all 16 of the county's towns and townships, as well as the separated cities of Barrie and Orillia. 

Jane Sinclair, the county’s general manager of health and emergency services, noted the report is part of the paramedic service’s annual reporting to the province about performance standards. 

“There are six (performance standards) that are required by all paramedic services across the province," she explained at Tuesday's meeting. "Historically, paramedic services would look at their response data … and particular types of calls and set their targets accordingly, and that’s what we have done."

Sinclair noted members of the previous county council had significant discussion about being more progressive with the targets and, beginning in 2022, council requested staff go back and set new targets that were faster response times than the county had seen historically. 

“That was based on a number of new and innovative initiatives underway, such as the use of technology, looking at the application of drones, locator apps and knowing a new software program would be coming forward for paramedic services, called MPDS, which would really hone in on the most critical type of calls … and reduce the number of urgent responses,” Sinclair said.

In 2022, staff set new targets for a three-year transition period, with a goal to improve and increase response time, she added, with staff analyzing the data annually.

“When looking at 2022 response times, the service saw a reduction in most of the categories related to a number of reasons,” Sinclair said. “In 2021, paramedics saw a significant drop in their annual calls related to trending happening in health care. In 2022, we saw a huge rebound in calls and experienced an 11 per cent increase in calls.”

The service also saw a huge increase in offload delay times, she said.

“All of these factors impacted our ability to respond as we had historically," said Sinclair. 

Sinclair said the good news is that, after looking at the first half of this year, the service has seen a positive rebound.

“In all six categories, we have met the 2021 targets so far this year and we have met two of the six progressive targets so far and we are optimistic we will continue to see an improvement in the trending,” she said.

Staff is recommending the county “stay the course” according to the previous council’s direction and continue with the more “progressive metrics” for the three-year period set at the time, Sinclair added.

A big problem across the county, said Wasaga Beach Mayor Brian Smith, tends to occur after an ambulance arrives at the hospital while paramedics wait for a patient to be offloaded.

“Offload times mean one thing: We don’t have paramedics on the road that can respond to calls," he said. "I have heard they can spend half a shift or their whole shift … at the hospital sitting there waiting to do an offload. That unit is no longer on the road for that whole day.

“We really need to look, as we move forward, at those offload times. I don’t begrudge the hospitals … they are so busy … but I think we need to find more effective and affordable ways to assist at the hospital level to get those offloads," Smith added.

“I understand it’s a provincial issue, but at the end of the day our job is to make sure our citizens are getting the best quality care they can (and) if we can’t get paramedics back on the road we are going to be in big trouble,” he said.

Offload delay is currently a significant factor for paramedic services, acknowledged Sinclair, adding staff will be bringing forward what she called a “very fulsome report” to county council in November on the specifics surrounding the issue. 

She said paramedics are spending "significant time in emergency department’s across all of our hospitals."

Additional recommendations will also be brought forward as part of upcoming budget deliberations.

"But on a positive note, part of the report we will be bringing next month includes recent notification from the (Ontario) Ministry of Health of an increase in offload nurse funding," added Sinclair. 

For more than a decade, Simcoe County has been provided with about $132,000 in yearly funding to assist with offload delays, an amount that was recently increased to roughly $506,000. The county will soon see that funding nearly double, Sinclair said.

“We have just received notice we are getting an increase to $1.2 million annually, which we will be able to provide support to all of our area hospitals to assist in the offload delay issues," she said. "We are working very hard with hospital partners to try and address this.”