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www.oakvillebeaver.com The Oakville Beaver, Friday April 20, 2007 - 13 Software could reduce ambulance delays By Stephanie Thiessen SPECIAL TO THE BEAVER Halton EMS' track record of quick response times might be in jeopardy if a systemic healthcare issue that just recently hit Halton isn't resolved. Hospital offloading delays have affected Halton's surrounding areas -- as well as communities across Canada -- for several years, but weren't an issue here until December. Offloading delays occur when a hospital is at capacity and can't provide a bed for a patient brought in by ambulance. Paramedics must therefore continue providing care to the patient at the hospital, usually in Emergency hallways, preventing the ambulance from leaving and being used for another emergency. These delays and their impact on ambulance availability were discussed at Halton Region's Health and Social Services Committee recently, with a report submitted by staff and a presentation made by Greg Sage, manager of program development and quality improvement for Halton Emergency Medical Services (EMS). "Our response times haven't been affected negatively thus far," Sage said after the meeting. "The report's more to say the potential's there." A single offload delay can range anywhere from 30 minutes to four hours, Sage said, adding the average delay is just over an hour. On one or two occasions since December, no ambulances were available for emergency calls, Sage said. Last Friday, only one of 13 ambulances was ready for a call. Emergency plans are in place for such situations, and include sending out emergency response units staffed by supervisors and managers until an ambulance is available. Vehicles from surrounding areas are also deployed, but they're frequently unable to help because of their own offloading delays, the committee heard. Since 2001, Halton EMS' response time has been below the mandated standard. The potential for delayed response times is serious, Sage said. "We know from research that a "We know from research that a timely response has a significant impact on patient survival." Greg Sage, Emergency Medical Services (EMS) timely response has a significant impact on patient survival," Sage said. Sage said he is not sure why the delays started in December, and that it's probably a combination of factors including fuller hospitals due to the onset of flu season. In December, 825 hours of offload delay were recorded, with 812 hours in January, the report reads. "This amount of time is equivalent to more than two ambulances being out of service for an entire 12-hour shift every day during the months of December and January," it states. In January 2006, Health and Long-Term Care Minister George Smitherman announced an investment of $96 million to reduce such delays and wait times in emergency rooms. Regional Chair Gary Carr said the back-up at hospitals, which is affecting ambulances, is just one of the reasons why the Fairness for Halton campaign is so important. The initiative aims to raise awareness about the funds needed to make way for the 300,000-plus residents the Province's Places to Grow plan designates for Halton -- funds that will be particularly needed for area hospitals. "Unless the Province addresses our concerns with the Places to Grow Plan, offloading delays at hospitals will continue to get worse with our growing communities," Carr said. "We cannot have a strain on the system as it is not acceptable for our residents and these delays compromise the quality of life that Halton residents deserve and expect." Carr said the situation at Milton District Hospital is critical. He asked if offloading delays are worse at certain Halton hospitals, and Sage replied that the delays at Joseph Brant Hospital in Burlington are less frequent, but longer than at the others. Not only are offloading delays potentially dangerous to patients, they also create a stressful environment for Halton EMS staff, who find themselves on the go pretty much their entire 12-hour shift and who frequently miss meal breaks, Sage said. Regional council approved a motion Wednesday that calls for Carr to write to Smitherman asking for patient destination software to be implemented at the Mississauga Central Ambulance Communications Centre. The City of Toronto EMS developed the software in 2004. It lets paramedics know which hospital is best to offload patients, in turn avoiding many ambulances transporting patients to the same hospital. "This software would be available to the Province from the City of Toronto at no cost and would assist in alleviating some of the delay times," said Carr. "If this software assists us in improving our services to our residents, its implementation makes perfect sense."