On June 5, the Ontario government announced three substantial changes to the way emergency medical services will be delivered in the province.
These changes include:
- Updating the program 911 Dispatchers use to more accurately assess, or triage, patients in their time of need.
- Expanding and enhancing the use of Community Paramedic Programs, or CPPs, so patients may be able to avoid a hospital altogether.
- A proposed pilot project where local fire departments could hire paramedics to work on a fire truck, and provide “first response” care, while waiting for an ambulance to provide transportation to hospital.
Unifor believes the first two changes to emergency medical services in Ontario will prove very beneficial.
For quite some time, Unifor has called on the provincial government to update the current dispatch system. Under the current system, virtually all 911 calls end up labeled a “high priority”, or “lights and sirens response.”
Statistically, less than five per cent of ambulance calls turn out to be life-threatening. This mismatch between real and perceived emergencies ties up ambulance resources, leading some to conclude that Ontario has an “EMS problem.” In reality, the problem lies with faulty dispatch software. Upgrading to new software will give 911 dispatchers the tools they need to properly triage patients, and will result in patients getting the right care, at the right time.
Community Paramedic Programs (CPP)
CP Programs leverage the high skill-set of a paramedic to add efficiency to the health care system. Paramedics can perform early hospital-discharge care, and run clinics and check-ups in house, which results in fewer non-essential visits to emergency room departments by patients. In turn, the patients discharged early create room in the hospital for patients waiting to be admitted from ER. This makes space for the paramedics to then drop off any new emergency patients, instead of waiting in a hallway on “off-load delay.”
Unifor is concerned and disappointed with the third change proposed to emergency medical services delivery.
Unifor paramedics believe there is no additional role for local fire departments to play in the delivery of emergency medical services. Local fire departments and police officers are already equipped with defibrillators to treat patients in cardiac arrest. Science has shown that these patients are the most likely to benefit from a rapid response. Allowing fire department vehicles to speed to any additional calls creates a significant public safety hazard, while causing further strain on already tight municipal budgets through increased fuel, training and maintenance costs when compared to ambulances, and offers no measureable benefit to patient care.
Fire departments also cannot transport patients, meaning regardless of their arrival on an emergency scene, they will be tied up waiting for underfunded ambulance units to arrive; this does not improve patient care, and actually compromises the fire department’s ability to perform fire suppression and rescue duties in the community.
Staffing and running one ambulance costs approximately 1/4 as much as staffing and maintaining a fire truck. Cities have limited resources to spend on EMS. Any dollar spent on a duplication of services, cannot be spent on increasing real capacity to the existing ambulance services, which are facing call volume increases of six per cent annually.
Unifor believes the government must work quickly to implement the first two steps of their enhanced emergency medical services plan. The union also believes the third step will be expensive, inefficient and ineffective, and is calling on the government to remove this portion of their plan.