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Hospital delays mean ambulances can't respond to emergency calls

Paramedic service chief raises concern with Guelph council, which called on province for more hospital funding

There were no ambulances available to respond to emergency calls anywhere throughout Guelph or Wellington County for a while on Monday morning. 

Known as a “code red,” it’s a situation that’s becoming more frequent as off-loading delays at Guelph General Hospital (GGH) keep paramedics occupied – ambulances lined up, forced to wait in order to turn over patient care to hospital staff so paramedics can answer the next call for help.

It’s a “crisis” requiring provincial intervention, Guelph Wellington Paramedic Services chief Stephen Dewar told city council on Monday afternoon when he presented a report on ambulance response times for 2021.

Last year, response times fell short in three of six categories of severity.

“This is definitely a provincial problem,” Dewar told council, which met as the committee of the whole, noting the local service is far from alone in experiencing offloading delays. “We are challenged to meet the targets set for us.”

Response times weren’t met in 2021 when it comes to “urgent care” such as mild shortness of breath, which saw a 15-minute or better response time in 89 per cent of cases (90 per cent targeted);  a 15-minute response time was reached in 87 per cent of “less serious urgent care” cases, such as minor trauma (90 per cent target); as well as 52 per cent of “sudden cardiac arrest” calls (65 per cent target).

Targets were met or bested in cases requiring resuscitation (65 per cent), major trauma (76 per cent) and non-urgent care (94 per cent).

While there are numerous factors at play, the largest contributor to longer response times is the patient off-loading delay at GGH, Dewar said, adding it’s been a “virtually daily” occurrence to varying degrees since last August.

There were two code red declarations in May, he noted, with the longest lasting about 16 minutes and Monday’s code red lasting for about 15 minutes.

Shortly before noon on Monday, GuelphToday observed no less than 10 ambulances parked at GGH and was told there had been more only minutes earlier.

Patient off-loading – the shifting of responsibility for medical care from paramedics to hospital staff – is expected to take about 30 minutes, Dewar said. It has taken as long as 12 hours.

Last year local paramedics spent more than 4,900 hours caring for patients during offload delays, the report notes. That includes a “dramatic increase” in delays lasting more than 90 minutes, which saw more than a 300 per cent jump from 2020.

Such delays are caused by a buildup of long-term care patients at the hospital rather than in community-based beds, Dewar said he’s been told by hospital officials.

“By the time we get to a code red, the hospital has already stretched themselves as far as they can,” he said.

With that in mind, the committee unanimously approved a motion in favour of advocating to the Minister of Health for “more funding and solutions to alleviate the delays.”

“We hear your pain,” Coun. June Hofland told Dewar as she moved the motion, seconded by Coun. Phil Allt.

Council will consider formalizing the committee's motion during its July 18 meeting.

While the paramedic service has taken some steps to lessen the impact on ambulance availability, such as bundling responsibility for multiple patients, that only serves to “normalize” the problem, Dewar said.

“The long-haul solution here is funding the hospital properly,” said CAO Scott Stewart. “Adding more equipment and staff (at the municipal level) doesn’t fix it.”

In addition to offloading delays, 2021 response times were impacted by a 14 per cent increase in calls over 2020, as well as extra time spent at scenes and after calls as a result of COVID-related requirements such as increased personal protective equipment and enhanced cleaning practices, the chief’s report notes.