15 | durhamregion.com | This Week | Thursday, Octover 6, 2022 | When members of the new Durham Region council get down to business in the coming term, among the issues they'll be facing is the ongoing -- and worsening -- problem of regional paramedics being unable to respond to calls because of delays in admitting patients to hospitals. As the number of calls for service increases year to year, so do the off-load delays for paramedics as hospital emergency departments struggle to handle the flow of patients, according to the Region of Durham Paramedic Services. "This is a long-standing problem," said Durham Paramedic Services Chief Troy Cheseboro. Stephanie Taylor, president of CUPE Local 1764, which represents paramedics, agrees, adding, "Things have gotten worse. Off-load delay has been increasing for our paramedics." Hospital off-load delays mean paramedics who might otherwise be free to respond to incoming calls must instead remain at the hospital with patients awaiting admission, Cheseboro said. In effect, they are taken out of service because of their obligation to ensure patients are properly admitted. A delay is defined as an incident in which it takes longer than 30 minutes to transfer patient care to hospital staff. "All time greater than 30 minutes is a loss in ambulance availability to the residents of Durham Region and could be seen as the region augmenting the staffing the hospital emergency departments," the chief said. Data provided by the paramedic service indicates that in the first half of 2022, off-load delays ranged from a low of 1,718 hours in February to a high of 3,054 in May. The delays sometimes result in declarations of a "Code Zero," meaning no Durham ambulances are free to respond to incoming calls. In those cases, Durham relies on paramedics from neighbouring municipalities, with whom they have reciprocal mutual aid arrangements, to respond. Taylor said Code Zero situations are occurring with regularity, but the true frequency of such incidents is not known, because they're not officially tracked. She said that's an omission that ought to be corrected. "(Delays are) increasing our Code Zeros," she said. "That's a little scary in this day and age, but it is happening." In 2021, Durham paramedics responded to 90,822 calls ranging from Code 1 -- low-priority incidents, in which a response can be delayed by up to 30 minutes -- to Code 4, life-threatening situations that require an immediate response, according to data prepared by the service. In addition, paramedics responded to more than 30,000 Code 8 calls, requiring staff to stand by at scenes and provide "strategically deployed coverage." Cheseboro predicted that the demand for service will continue to increase during a presentation to members of the region's health committee on Sept. 8. "The number of calls and patient transfers is expected to continue to increase as the population increases, ages, and people live longer," he said. Taylor said the most effective immediate action regional officials can take is to hire more paramedics. "We need more funding for our paramedic services to increase staffing levels," she said. "That's the only way to address this." Cheseboro said the service has continued to work with partners, including Lakeridge Health staff and representatives of the provincial Ministry of Health, in search of solutions to the issue. Among the initiatives implemented are a community paramedic program that sees staff handling less urgent cases by providing consultation and treatment without transferring patients to hospital, Cheseboro said. Another new policy allows paramedics, in consultation with hospital staff, to leave some less urgent patients in hospital waiting areas until they can be admitted, freeing the paramedics to leave and respond to new incoming calls. These initiatives help, but until the core issue of hospital backlogs is more effectively addressed, delays will continue, Cheseboro said. "I think from a municipal perspective it's very hard to come up with a solution when we can't control so many aspects of this. The hospital solution literally has to be a hospital solution." Although more paramedics on the road would be welcome in Durham, they'll still be affected as long as off-load delays continue, he added. "If I put 10 more trucks on the road and they're stuck at the hospital, that doesn't help," he said. In a statement, Lakeridge Health acknowledged longer than usual wait times and higher patient volumes at its hospitals. "Ensuring timely access to care is a priority at Lakeridge Health. The organization continues to work on the capacity challenges in our Emergency Departments (EDs) as this can impact the speed at which our paramedic colleagues can offload ambulances," the statement said. "At Lakeridge Health, we recognize that reducing ambulance offload and ED wait times is complex and requires whole-system collaboration. Working together with our partners, including our paramedic colleagues, weaving the system together and addressing the pressure points all throughout a person's health-care journey, we will improve timely care and access." Anyone experiencing a medical emergency should still visit their closest hospital emergency department, the statement said. DELAYS AT HOSPITALS MEAN MORE CHALLENGES FOR PARAMEDICS JEFF MITCHELL jmitchell@ durhamregion.com MUNICIPAL ELECTION Ongoing delays in admitting patients at hospitals are placing pressure on Durham paramedics to respond to an ever increasing number of calls for service. Susie Kockerscheidt/Metroland