County without ambulances on multiple occasions
By Chad Ingram
August 2, 2016
Eight times in the first six months of 2016 there were zero ambulances available in Haliburton County, those incidents equating to a total of 12 hours.
EMS director and paramedic chief Craig Jones delivered that news to county council as he presented a report of call volumes for the first half of the year during a July 27 meeting.
“It’s difficult to call people in at night,” Jones said. “It’s a balancing act, it’s a struggle.”
Algonquin Highlands Reeve and Haliburton County Warden Carol Moffatt wondered where the tipping point was, how long it would be before the municipality would have to increase the number of manned ambulances available.
“In reality, how far away is that for us?” Moffatt asked.
Jones said it was difficult to provide an exact timeframe and that while obviously the ideal situation is to never be without an available ambulance, “that’s a perfect world, and no one can do that. It’s a balance of risk mitigation.”
The county has one 24-hour and one 12-hour ambulance stationed at its base in Haliburton village, one 24-hour ambulance at its Minden base and one 12-hour ambulance at its base in Tory Hill.
“Call volumes continue to rise,” Jones said, explaining they were up seven per cent over 2015 and have risen nearly 16 per cent since 2014.
Seventy-five per cent of patients are over the age of 60 and the most common type of call is for falls.
So far this year, the Haliburton base has handled more than twice as many calls as either the Minden or Tory Hill bases, which Jones pointed out is because the Haliburton base is equipped with twice as many ambulances.
During the first six months of 2016, the Haliburton base received 1,723 calls, the Minden base 781 and the Tory Hill base 535.
Meeting and exceeding response time targets is more easily achieved in Minden Hills and Dysart et al townships due to the presence of bases and that those townships are more densely populated than Highlands East and Algonquin Highlands.
In Algonquin Highlands, response times targets are not being met in any category.
“Geography and availability of resources to this area are the primary reasons,” Jones’s report read.
Moffatt asked what could be done to meet targets in Algonquin Highlands and Jones responded that having a 24-hour ambulance stationed in the township would really be the only way.
The average response time in Algonquin Highlands is 17 minutes and 34 seconds. The average for Highlands East is 16 minutes 32 seconds; for Minden Hills 10 minutes 32 seconds; and for Dysart et al, eight minutes and 48 seconds.
Overall for the county, 40 per cent of the time, paramedics are getting to patients within eight minutes.
Under the department’s deployment plan, Jones said the number of non-urgent transfers out of the county have been reduced.
“Some of those transfers can take three hours,” he said.
Due to the lack of certain services at the county’s hospitals, some patients must be transferred out of the county to locations such as Lindsay, Peterborough and sometimes Toronto.
While the number of calls Haliburton paramedics have responded to outside county borders has fallen to 124 versus 150 after the first six months of 2015, the number of calls inside the county being handled by other EMS providers has risen from 132 to 150.
An issue with call prioritization that Jones said many Ontario paramedic chiefs are advocating to have changed deals with the classification of Code 4 calls. Code 4 calls are life-threatening emergencies. Many of them don’t turn out to be life-threatening emergencies, however, but once an ambulance is assigned to a Code 4 call, it cannot be reassigned.
“Of our 1,131 patient-carrying calls, 56 per cent of them were dispatched as a life-threatening emergency Code 4,” Jones’s report reads. “In alarming contrast, we only returned on a Code 4 14 per cent of the time. The provincially developed dispatch tool ‘over prioritizes’ calls. This negatively affects the availability of resources to respond as once an ambulance is assigned to a Code 4, it cannot be reassigned. If the tool over prioritized less, it would allow for the more efficient and medically appropriate allocation of the county’s ambulances.”
Councillors resolved to send a correspondence to the province regarding the Code 4 issue.