"Call for help botched by emergency services"

[mariomike]

Anways, the Paramedics would have their overflow patient in the "Code 7 Rooms" and wait around not allowed to take calls until their patient got a bed (this pissed them off royally), which caused an uproar amongst both Emerge medical staff and the Paramedics.

Based on experience and observation in a "Hi-performance" system, I believe it was T-EMS management who were the most royally pissed off because their crews had to "wait around not allowed to take calls". OLD costs significant loss in paramedic productivity, and millions of dollars in end-of-shift overtime. They also have to pay the crews a penalty for missed / delayed meal breaks.

T-EMS Offload Nurse Program:
http://www.toronto.ca/civic-engagement/council-briefing/pdf/1-3-38.pdf
"The ED Director for a Toronto hospital recently said “The hospitals have tried a lot of things to reduce ambulance wait times. The only thing that has had any effect is the Offload Nurse Program.” "

 

[Sheerin]

Hamilton we have offload nurses 12 hours a day at the 3 adult hospitals.  It's costing around $750,000 a year.  It hasn't made a significant dent in our offload delay issues, which we are told are statistically the worst in the province.  On a nearly daily basis we drop down to zero trucks available for calls due in large to offload delay.  It's actually pretty bad.  Forced overtime, missed meal breaks, cab fare for switching crews at the hospital at end of shift, are all costs that are rising fast. 
The offload issues were exacerbated by the LHIN's incredibly insightful decision under their "Access to Best Care" plan to turn McMaster hospital in a paediatric only facility.  This has resulted in the west end being without an ER, and increased the workload on the other emergs.  We all knew it would fail, everyone from city council, to the medics, to the emerg physicians all knew it would be a total CF, and we were right.

The main reason why the offload nurse doesn't make a huge dent is that they can only cover 4 patients and we typically bring in far more than 4 patients per hour so there can be a huge backlog.  True some of the patients we bring in can be offload straight to the waiting room, an option i full endorse, but even with that it doesn't always work. 

 

[mariomike]

Just to add to Sheerin's post.

Mar 17 2011
"Hamilton is on track to record its worst ambulance shortage ever,...":
http://www.thespec.com/news/local/article/502786--city-on-track-for-worst-ambulance-shortage-ever
"In the first two months of the year, the city’s paramedic service reported 39 “Code Zero” incidents..."

"That’s more than double 2010’s figures for the same two months and triple the year before."

"...the city is on pace for 241 Code Zero incidents this year."

Exactly as you said, Sheerin: "On a nearly daily basis we drop down to zero trucks available for calls..."

 

[BadEnoughDudeRescueRonny]

Once again LHINs screw up healthcare around the province. They are the best example of a bureaucratic pipe dream that I could ever think of. Seriously, who runs those things, certainly not anyone with an ounce of experience in or knowledge about the realities of healthcare. I'm convinced that they're run by pigeons and chickens that randomly peck at buttons that determine whatever a policy will consist of.

 

[Fishbone Jones]

Once again LHINs screw up healthcare around the province. They are the best example of a bureaucratic pipe dream that I could ever think of. Seriously, who runs those things, certainly not anyone with an ounce of experience in or knowledge about the realities of healthcare. I'm convinced that they're run by pigeons and chickens that randomly peck at buttons that determine whatever a policy will consist of.

I would bet that they are simply close friends and supporters of our super nanny McGuinty, being rewarded for their years of servitude to said emperor and party.

 

[BadEnoughDudeRescueRonny]

I would bet that they are simply close friends and supporters of our super nanny McGuinty, being rewarded for their years of servitude to said emperor and party.

I think you nailed it right there. I swear it's so typical of the Ontario government to give positions not based on skill or merit but to those who blindly follow McGuinty and see him as some sort of visionary. I wouldn't be surprised if these types had paintings of him on the walls of their homes.

Not to hijack the thread, but the bottom line is that the Liberals have completely FUBAR'ed all systems within the province. Hopefully a PC government can sort out the complete cluster$%^ the province has become. Just my  :2c: .

 

[mariomike]

Not to hijack the thread, but the bottom line is that the Liberals have completely FUBAR'ed all systems within the province. Hopefully a PC government can sort out the complete cluster$%^ the province has become. Just my  :2c: .

This goes beyond provincial party politics.

"Off-load delay is a problem that's happening in cities across Canada and the United States.":
http://www.cbc.ca/whitecoat/episode/2008/05/14/off-load-delays-highlight-paramedic-powerlessness/
"This week on White Coat Black Art, we show you the impact of off-load delay on emergency responsiveness in Halifax."

"Three years ago, Emergency Health Services Nova Scotia had a contractural guarantee to off-load their patients within 20 minutes of arrival in emerg. Now, it's not uncommon for medics there to complete an entire 12 hour shift alongside a patient in a hallway in the emergency department."

"I just listened to this and if I closed my eyes it could be Calgary."

Same problem in British Columbia, California and elsewhere.

2011 Memphis (Tenn.)
"Stories continue to pour in from across the country about emergency department (ED) wait times, which continue to be a problem for EMS."":
http://www.jems.com/article/administration-and-leadership/value-your-agency-s-best-asset-0
"The waiting game at the ED is only going to get worse as time goes on."