Increased patient transfer times at Guelph General Hospital had a negative impact on the Guelph Wellington Paramedic Service (GWPS) last year, says a report by the region's paramedic service.
A report by GWPS chief Stephen Dewar going to the County of Wellington’s social services committee stated offload delays at Guelph General Hospital were historically rare and typically related to an identifiable cause such as a surge in patients or internal hospital issues like power failure.
The report explained upon entering a hospital, paramedics must provide a report to a hospital staff member who is assuming care for their patient, referred to as a transfer of care. A standard set by the province indicates this should occur within 30 minutes of arrival 90 per cent of the time.
Paramedics must stay with the patient and provide care until this transfer is complete and are unable to respond to further emergency calls.
Dewar wrote the incidence of offload delays have increased significantly beginning in August 2021 and for prolonged periods of time.
“By the end of October 2021, ambulance offload delays were occurring almost daily, with between three and eight ambulances in delay in some instances greater than four hours,” the report stated.
There was a slight reprieve in December but Dewar said it has ticked up again in 2022 with the Omicron wave.
Perry Hagerman, GGH spokesperson, said via email drop-off delays are related to how busy the hospital is as a whole.
"Throughout the pandemic, all hospitals in Ontario have experienced high demands and GGH is no exception," Hagerman said. "If all hospital beds are full, patients needing to be admitted have to wait in our emergency department."
Dewar said in an interview the service’s response time suffers as a result of these delays.
“When they’re tied up in the emergency department for hours at a time, we have fewer ambulances available to respond to emergency calls,” Dewar said.
“We’re still responding of course, it just takes longer. Our ambulances are further spread apart because there’s fewer of them and so it takes longer to get to an emergency.”
Dewar said there are normally seven ambulances in the county and eight in Guelph. In bad cases of delays at the hospital, Dewar said ambulances will have to be redirected from the county into Guelph which in turn increases response time.
Continued delays run the risk of the worst case scenario, which Dewar said is having no GWPS ambulances available to respond to emergencies and having to call on neighbouring municipal paramedics for assistance, again increasing the response time.
Another impact noted in Dewar’s report is burnout for paramedic staff who have little time to decompress after stressful and traumatic situations because their next call is almost immediate.
While only partially effective, there are mitigation strategies in place.
The report highlights GWPS’ community paramedicine program which aims to reduce the number of emergency calls through preventative services and transporting specific patients to alternative destinations when possible.
In the interview, Dewar said there is a joint proposal with the City of Guelph to fund an additional hospital staff member specifically to deal with offload.
He said this has been a success in other areas and would be very helpful for Guelph General Hospital.
This report will be presented to the social services committee on Wednesday at 3 p.m. at the county administration building’s council chambers.
Full report can be read here.
