Wednesday, April 30, 2008

"Off-Load Delays" Directly Effect Pelham

Have you heard about “Offload Delays” in our Regional Ambulance service? I have been deeply concerned about it and I am pleased that we are now taking action.

Emergency Medical Services (EMS) refers to an “Offload” as the time taken in an emergency department to transfer a patient from an ambulance stretcher to the care of the hospital. Generally, this interval takes 20-minutes in Niagara.

As you can guess, an “Offload Delay” describes a transfer that takes longer than the standard 20-minutes and any ambulance team stuck in offload delay is unavailable to respond to emergency calls!

While ambulance offload delays are common across Ontario, they are also a symptom of serious health care and community support systems problems. For example, when a community lacks general physicians and, therefore, access to comprehensive and effective primary care, people tend to visit emergency departments at hospitals. This overcrowds ERs and causes delays in triage and treatment.

Offload delays also occur when a community lacks adequate supportive housing, rehabilitation beds, and specialized at-home treatment programs. In these cases, patients who may be well-enough to leave a hospital cannot because they are too ill to be on their own. They require an “alternative level of care” (ALC) that is just not available.

In Niagara, we experience both types of challenges and, over the last two years, the frequency and duration offload delays at our hospitals have significantly increased.

At first, because of Niagara’s dynamic dispatch system, our EMS staff adapted well to these challenges. If an ambulance was stuck in an emergency department, the other ambulances in the system would move from their stations to other positions in the Region; in this way, when one, two, or three ambulances were delayed, EMS could still provide adequate coverage.

But, when seven (as happened 42 times thus far in 2008!) or eight (8) (25 times!) ambulances of the Region’s 22 vehicles get stuck on offload delay, the system starts to breakdown. The breakdown especially puts communities without hospitals – like Pelham, Thorold, and Fort Erie – at considerable risk.

In fact, Pelham’s EMS response times increased 33% from 10:27 in 2007 to 14:05 in 2008! It is now among the worst in the Region.

While the Province, the Niagara Health System, and Niagara EMS continue to work on solutions, I believe we cannot wait any longer.

That’s why I moved the motion in the Region’s finance committee to provide temporary (six-month) funding for two additional ambulances during peak times. I was also part of the Niagara Week team that met with Health Minister George Smitherman last week to persuade the Province to act.

Offload delays is a complex problem. By taking action now we can provide better EMS service while a solution is developed.