Long hospital drop offs an 'Achilles heel' for Ottawa paramedics

Ottawa had no ambulances available to respond to emergencies 322 times in 2017, 66 more times than the year before.

Number of 'level zeros' has risen even as response times improve

An ever-increasing number of calls to 911 and long wait times to offload patients at hospitals are making level zeros an ongoing problem for Ottawa paramedics. (Danny Globerman/CBC)

Ottawa had no ambulances available to respond to emergencies 322 times in 2017, 66 more times than the year before.

When it happens, the paramedic service calls it a "level zero."

For the first time in three years, the paramedic service met its standard for emergency response times in life-threatening situations. But the ever-increasing number of calls to 911 and long wait times to offload patients at hospitals are making level zeros an ongoing problem.

The city's emergency services manager, Anthony Di Monte, vented his frustration about the impact understaffed emergency rooms are having on Ottawa paramedics at a community and protective services committee meeting Thursday. 

"We're doing all the right things, but this is the Achilles heel that continues to remain in the system that's out of our control," Di Monte said.

Hospital emergency rooms a 'disaster'

Ottawa paramedics spent 37,423 hours in emergency rooms waiting to offload their patients in 2017. That's the equivalent of 1,559 days in a singe year.

Paramedics often feel anxious and held hostage as they wait for hospitals to accept their patients, he said. It also leaves them unavailable to respond to new emergencies, which could be contributing to the level zero problem.

"The emergency rooms are a disaster and there's no excuse," Di Monte said.
This chart shows the number of hours saved by the pilot project, and the number of hours paramedics are still waiting to offload patients into Ottawa emergency rooms. (City of Ottawa)

If he were the boss at Ottawa's hospitals, the people managing emergency rooms would be fired for handling ambulances so poorly, he said.

The province put $1.5 million toward a pilot project allowing paramedics to hand patients over to a designated nurse, which gets them back on the road and responding to more emergencies. The pilot project has been running for several years, but it's not a permanent fix, Di Monte said.

Even though it has saved paramedics thousands of hours in emergency rooms, the number of hours they spend there has continued to rise since 2014.

Ottawa has also hired 36 new paramedics in the last two years to keep up with the growth and improve response times.

17 ambulances waiting at once

At one point in the last few months, the city had as many as 17 ambulances waiting in hospital emergency rooms, said Coun. George Darouze.

"They shouldn't be there," he said.

Anthony Di Monte, the city's general manager of emergency and protective services, said Ottawa's emergency rooms are a disaster when it comes to dealing with ambulances. (CBC)

The worst offender is the Ottawa Hospital's Civic campus, according to city staff. They've been talking about it with hospital officials, who have promised to put an end to offload delays. 

Di Monte hopes that comes true.

"We've resolved our issues," he said. "Now it's time for them to act and to resolve this fundamental issue."

In a statement, Dr. Guy Hebert, head of emergency medicine at the Ottawa Hospital, said urgent patients are seen right away, but demand is also high.  

"The Civic Campus emergency department is the trauma centre for eastern Ontario, and has seen a steady increase over the last five years in the volume of patients seeking care. This pressure leads to higher ambulance offload times," he said.

Roughly 50 to 60 patients arrive at the Civic Campus via ambluance each day, Hebert said, approximately one-quarter of the total daily number of patients who seek care at the trauma centre.