Long hospital times still keeping ambulances off the road

Despite measures to prevent it, Hamilton ambulances are still staying at hospitals too long when they transport patients, and its part of the reason EMS will ask for more paramedics at budget time.

Councillors heard Monday that Hamilton still has the second slowest turnaround time in Ontario for paramedics offloading patients at hospitals.

And even though local hospitals have more nurses the past two years to decrease the turnaround time, its still putting a strain on local ambulances, said Michael Sanderson, chief of Hamilton EMS.

Our average is around 60 minutes, he said of hospital offloading times. Half the time, its longer.

Offload times are not a new issue for Hamilton ambulances. For the past two years, the province has funded more nurses to help with offload times. The province has also budgeted $1.343 million from April 2013 to March 2014 to provide 26,448 hours of nursing staffing, shared equally between Hamilton General, Juravinski and St. Josephs.

If the offload nurses werent there, itd be an awful lot worse, Sanderson said.

From their perspective, they feel that its working. Whats not working for us is it hasnt reduced our overall time.

Recent reports show that 23.8 per cent of every staffed transport ambulance hour is spent at the hospital. The provincial median is 17.8 per cent. Hamilton has the second highest reported measure in the province.

The city is studying how to reduce those times, particularly in light of the McMaster University Medical Centre closing to adult patients two years ago.

You often pass (hospitals) and theres three, four, five ambulances sitting there, Coun. Tom Jackson said. Reducing offload times is a work in progress.

Offload times contribute to the prevalence of code zero incidents, which is when one or less transport ambulances are available to help on emergency calls. On average, Hamilton paramedics have a code zero every day and a half, Sanderson said.

The city needs to convert seven of its emergency response vehicles into transport ambulances, Sanderson said. It also needs to work harder to reduce hospital offload times.

Hell also ask for more paramedics in his upcoming budget request for 2014.

There probably is some requirement to add some additional staff, he said.

Jackson wants to fix the offloading issue first, which will require working with the province and the hospitals.

We need cooperation to make the system more efficient so we dont necessarily have to spend more money to simply add on to a service, he said.