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Report to Rapport au:

Community and Protective Services Committee Comité des services communautaires et de protection 20 May 2021 / 20 mai 2021

and Council et au Conseil 26 May 2021 / 26 mai 2021

Submitted on May 11, 2021 Soumis le 11 mai 2021

Submitted by Soumis par: Pierre Poirier, Chief, Service/chef, Service paramédic d’Ottawa

Contact Person Personne ressource: Manon Lavergne, Program Manager, Operational Support Services / gestionnaire de programme, Services de soutien opérationnel, / Service paramédic d’Ottawa 613-580-2424 ext. / poste 28988, [email protected]

Stacey Turnbull, Specialist, Strategic Programs & Project / Spécialiste, Programmes et projets, Ottawa Paramedic Service / Service paramédic d’Ottawa 613-580-2424 ext. / poste 44010, [email protected]

Ward: CITY WIDE / À L'ÉCHELLE DE LA File Number: ACS2021-EPS-OPS-0001 VILLE

SUBJECT: Ottawa Paramedic Service 2020 Annual Report

OBJET: Rapport Annuel de 2020 du Service paramédic d’Ottawa 2

REPORT RECOMMENDATIONS

That the Community and Protective Services Committee recommend Council receive this report for information.

RECOMMANDATIONS DU RAPPORT

Que le Comité des services communautaires et de protection recommande au Conseil municipal de prendre connaissance de ce rapport à titre d’information.

EXECUTIVE SUMMARY

The Ottawa Paramedic Service provides out-of-hospital patient care to residents and visitors of the nation's capital. The purpose of this report is to present an overview of the Ottawa Paramedic Service including the Ottawa Central Ambulance Communications Centre and provide information on the performance, programs and services delivered in 2020.

This report confirms that the Ottawa Paramedic Service met all Council approved response time performance targets in 2020 including the community percentile target set for the arrival of a person trained, qualified and equipped to provide defibrillation for Sudden Cardiac Arrest.

In 2020, the Ottawa Paramedic Service response volume decreased by 9.5 per cent over the previous year. This is the first time that the Service has experienced a decrease in response volume since 2013. Further, the OCACC answered 132,752 emergency calls, which required 166,890 emergency vehicle responses, a decrease of 7.2 per cent from 2019. The Service also experienced a slight reduction in the number of hours spent in off-load delay at Ottawa area adult hospitals: a positive correlation with an overall decrease in OCACC calls and response volume. These decreases are attributed to the ongoing novel coronavirus disease pandemic (COVID-19).

While response volume decreased, the Service experienced new, unanticipated challenges brought on by the pandemic. Unforeseen impacts of COVID-19 included supply chain interruptions, a shortage of personal protective equipment, changes in infection prevention and control measures, process changes for symptom screening and the need to continuously adapt to a rapidly evolving situation.

The Ottawa Paramedic Service’s community service delivery continues to be challenged by off-load delays. Off-load delay is a measure for the time 3

spend at area hospitals waiting to complete patient Transfer of Care. Off-load delay occurs when a patient arrives at an emergency department and is triaged but remains under the care of paramedics until the emergency department has staff and resources available to take responsibility for the care of the patient. In 2020, the Service expended 46,095 unit hours in off-load delay at Ottawa hospitals. This represents an average of 126 unit hours that were lost per day or five paramedic units continuously held in hospital over a 24-hour period. The off-load delay hours amount to a loss of 55 full time equivalents or approximately $6.6 million annually. Despite the decrease in response volume, if off-load delay continues at the rate described in this report, the Ottawa Paramedic Service will not be able to achieve the legislated response time performance standards and Council-approved targets in future years.

In 2020, the Service continued to mature off-load delay mitigation strategies including:

• A revised Patient Priority System Distribution Trial

• Continuing the Off-Load Nurse Pilot Program

• Maintaining the Paramedic Response Unit Program

• Expanding Community Paramedicine Programs

• Sustaining the Targeted Engagement Diversion Program

The Service also implemented service improvement initiatives including:

• Expanding the Heart Safe City Initiative

• Preserving the Neonatal Transport Team Program

• Strengthening the Ottawa Birth and Wellness Centre Partnership

• Advancing the Operational Stress Injury and Mental Health Strategy

• Continuing the Diversity Champion Program

Except for 2020, an unprecedented year, service demand has increased year-over- year. Since amalgamation of the , Council has made investments to address growth, response volume and to meet response time standards. Recently, Council approved 14 full time equivalents in the 2021 budget to address the increased demand for service which has been essential in supporting service delivery during COVID-19. 4

The Ottawa Paramedic Service continues to monitor performance indicators and evaluate new and innovative solutions in the interest of providing ongoing high-quality medical care to all patients.

BACKGROUND

The Ottawa Paramedic Service provides out-of-hospital patient care to residents and visitors of the nation’s capital. The Service is a leader in delivering paramedicine, continuously seeking new knowledge and applying innovation. When a member of the public requires immediate medical care, a team of dedicated, highly qualified professionals are available to deliver excellence in clinical care. This team includes Paramedics, Communications Officers, Equipment and Supply Technicians, Educators and Trainers, Quality Assurance staff and support staff.

The Ottawa Paramedic Service provides emergency medical coverage across the city of Ottawa (2,796 square kilometres), while the Ottawa Central Ambulance Communications Centre provides dispatching services to over 10,000 square kilometres of including Ottawa, the United Counties of Prescott-Russell, Cornwall and the United Counties of Stormont, Dundas and Glengarry. The Service provides an integrated advanced life support system delivering high quality medical services to more than one million residents and visitors.

On October 28, 2004, the Emergency and Protective Services Committee directed that staff report back annually to Committee and Council prior to budget on service delivery, performance trends, and associated financial impacts to ensure the Ottawa Paramedic Service can continue to meet performance targets. As well, the Service reports annually to the Ministry of Health on response time performance.

This report highlights the service demand (response volume), as well as the Ottawa Paramedic Service’s performance, programs and service delivery in 2020.

DISCUSSION

IMPACT OF COVID-19

COVID-19 has had a profound impact on all City of Ottawa services, including the Ottawa Paramedic Service. In 2020, the Service experienced significant challenges with staffing. In particular, at the onset of the pandemic, healthcare workers who had travelled outside of the country after March 13 were ordered by the Province to stay at home in self-isolation for 14 days, whether or not they were exhibiting COVID-19 5

symptoms (Ontario March break ran from March 16 to March 20, 2020). The Service continued to experience staffing pressures throughout the year as a result of provincial isolation and quarantine guidelines for healthcare workers who had been exposed to a probable case of COVID-19 in or outside of the workplace, or who were showing signs or symptoms consistent with COVID-19.

In 2020, the shortage of personal protective equipment, including N95 respirator masks, was a significant challenge for paramedics. N95 masks are the standard face mask used by paramedics for respiratory protection. They are portable, easy to use, and capable of filtering very small particulate matter, offering universal protection for all types of viruses. Due to a global shortage and difficulty procuring new medical grade N95 masks, the Service had no other option than to use expired N95 masks. The expired N95 mask performance was evaluated and was subsequently passed by a third-party testing facility. Further, the decision to use expired N95 masks was reviewed and approved by the Ministry of Labour. If required, the Service has alternate types of reusable respirators available, however, the N95 mask remains the preferred mask for reasons of portability, ease of use and safety. In 2020, the federal and provincial governments signed an agreement with the 3M Canada to produce N95 masks to meet provincial and private sector needs. In addition, the City has placed its own corporate order for N95 masks with 3M.

COVID-19 has impacted every area of the Ottawa Paramedic Service. Staff were required to physically report to work and have experienced significant adjustments in their everyday work roles and responsibilities. In addition to answering 9-1-1 calls and supporting the City’s COVID-19 assessment (swabbing) centres, the Service developed the Special Population Response Team and began working in long-term care centres. The SPRT was instrumental in helping to contain COVID-19 outbreaks and reduce the demands placed on local hospitals. This is one of many examples of how, through teamwork, collaboration and sheer dedication, staff have adapted to a rapidly changing situation in order to meet the needs of the community they serve.

In 2020, response volume decreased by 9.5% from 2019. This is the first volume decrease since 2013 and is directly due to COVID-19. As shown in Table 1, the decrease in response volume commenced in March, following the Province of Ontario’s declaration of a state of emergency on March 17, 2020, which included the implementation and enforcement of various emergency orders. These orders resulted in the closure of non-essential workplaces and the prohibition of events and gatherings. As a result, there was a significant reduction in indoor and outdoor activities, organized sports, and social gatherings. Further, the volume decrease is attributable to changes in 6 resident safety and security behaviours. It has been reported that residents avoided healthcare settings due to a perception that ambulances and hospitals were high-risk locations for the transmission of COVID-19. From March to July, response volume remained significantly lower compared to 2019, not returning to near pre-pandemic volumes until August.

Despite a difficult year and ongoing challenges brought on by COVID-19, the Service was still able to meet legislated and Council-directed response time performance standards.

2019 and 2020 Responses by Month 14,000 13,000 12,000 11,000 10,000 9,000 Responses 8,000 7,000 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2019 Responses 11,791 11,169 12,282 11,757 12,593 12,568 13,097 12,513 12,175 11,887 12,684 11,965 2020 Responses 12,263 11,487 10,924 8,938 10,598 10,862 12,055 12,177 11,423 11,055 10,358 10,390

Figure 1: 2019 and 2020 Responses by Month

PERFORMANCE TRENDS

The Ottawa Paramedic Service takes pride in providing the best possible clinical care to residents and visitors of Ottawa. The Service regularly reviews and analyzes patient outcomes, response times, response volumes, and OLD at hospitals. The Service then adjusts service delivery to improve service to the community. The primary measures that determine service demand and associated resource requirements are:

• The total number of 9-1-1 calls received

• A review of patient care documentation

• The total number of patients assessed, treated, and transported

• The total number of Paramedic resources required to respond

• The off-load delay measurements 7

Paramedic Response Volume

In 2020, the Ottawa Paramedic Service response volume was 132,530, representing a 9.5 per cent decrease over the previous year.

While response volume decreased, the Service experienced new, unanticipated challenges brought on by COVID-19. The extent to which the pandemic will continue to affect response volume is unknown. Despite ongoing uncertainty related to the pandemic, response volume will most likely rebound, and the Ottawa Paramedic Service will have difficulty achieving legislated response time performance standards and Council-approved targets in future years. The Service will require continued investment to address population growth and an aging patient demographic.

Table 1 represents the response volume and the annual percentage growth over the last five years.

Table 1: Response volume and annual percentage growth

Year Responses % Change

2016 137,995

2017 139,514 1.1%

2018 144,309 3.4%

2019 146,481 1.5%

2020 132,530 -9.5%

Paramedic Response Time Standards

The legislated response time reporting framework is defined as the elapsed time from when the first paramedic unit is notified of the call for service to the arrival of a Paramedic resource on scene (ambulance or single response unit). Response times across the province are measured and reported publicly on the Ministry of Health website.

Response time performance is based on the Canadian Triage Acuity Scale (CTAS), which sets a score for the patient acuity (severity of illness or injury). CTAS 1 is the 8

highest acuity and CTAS 5 is the lowest. The Ministry of Health determines the time target for CTAS 1 patients while the percentile rank is the Council-approved performance standard. The percentage represents how often a paramedic unit has arrived on scene to provide service to patients within the established targeted response time, categorized by the CTAS score.

The CTAS score can only be determined once a paramedic has arrived on scene and after a medical assessment has been performed.

Table 2 outlines the legislated response time standards and results from 2016 to 2020 by CTAS category. In 2020, the Ottawa Paramedic Service met the Council approved percentile rank in all CTAS categories for the fourth consecutive year.

Table 2: Response Time Performance 2016 to 2020

Council Category Target Time Approved 2016 2017 2018 2019 2020 (Acuity)* (minutes) Percentile

CTAS 1 (Life 8:001 75% 73.2% 77.3% 78.0% 75.1% 75.7% Threatening)

CTAS 2 10:00 75% 78.6% 79.6% 80.3% 77.2% 76.6% (Urgent)

CTAS 3 15:00 75% 90.9% 91.2% 91.5% 88.9% 89.1%

CTAS 4 20:00 75% 95.6% 94.8% 94.8% 93.5% 94.4%

CTAS 5 25:00 75% 97.5% 97.1% 96.6% 96.5% 96.6%

Community Performance Target for Cardiac Arrest

In cases of Sudden Cardiac Arrest response time is defined as the elapsed time from when the first paramedic unit is notified to the arrival of any person trained and equipped to provide defibrillation. The SCA response time is positively impacted if a

1 Mandated by provincial regulation 9

public access defibrillator is available at the scene or by the arrival of a paramedic, police officer, firefighter or OC Transpo Security, who are each equipped with an automatic external defibrillator in their vehicle.

Table 3 shows the City of Ottawa’s performance against the legislated response time standard for Sudden Cardiac Arrest. The Ottawa Paramedic Service continues to meet the legislated response time.

Table 3: Response Time Performance

Target Council Category Time Approved 2016 2017 2018 2019 2020 (minutes) Percentile

Sudden Cardiac 6:002* 65% 69.3% 68.2% 73.2% 76.1% 77.3% Arrest

Ottawa Central Ambulance Communications Centre System Performance

The Ottawa Central Ambulance Communications Centre receives and triages 9-1-1 calls and dispatches paramedic resources across 10,000 square kilometres of eastern Ontario.

In 2020, the Ottawa Central Ambulance Communications Centre answered 132,752 emergency calls, which required 166,890 emergency vehicle responses, a decrease of 7.2 per cent from 2019. Note that some emergency calls require more than one resource depending on the complexity of the situation and the number of patients.

The Ministry of Health created response time standards (call processing times) for all ambulance communications centres in Ontario. The response time standards are a measure of the elapsed time from when a call is received at the communications centre to when a paramedic unit has been notified of the emergency call. Communications centres must report annually to the Ministry of Health on the percentage of time this process is completed within two minutes.

Table 4 demonstrates the Ottawa Central Ambulance Communications Centre call processing times for CTAS 1 and sudden cardiac arrest patients.

2 Mandated by provincial regulation 10

Table 4: OCACC Call Processing Times

Target Category Time Percentile 2016 2017 2018 2019 2020 (minutes)

CTAS 1 2:00 80% 84.8% 80.4% 84.6% 82.5% 80.2%

Sudden Cardiac 2:00 75% 87.5% 81.0% 86.0% 86.3% 81.9% Arrest

Impact of Hospital Off-Load Delay on the Community

Hospital off-load delay severely impacts the ability of the Ottawa Paramedic Service to respond to the next call, as well as the Service’s compliance with response time standards. The Service calculates the number of ambulances required to serve the community with an understanding that paramedic crews will not be held for an indeterminate time at a hospital in off-load delay. Excessive off-load delay creates periods where the Service is unable to transport the next patient to hospital since all ambulance crews are either on a call or in off-load delay and thus unavailable to respond to the next call in the community. The off-load delay creates unnecessary risk in the community. In 2020, the Service expended 46,095 unit hours in off-load delay at Ottawa hospitals. This represents an average of 126-unit hours that were lost per day or five paramedic units continuously held in hospital over a 24-hour period. The off-load delay hours amount to a loss of 55 full time equivalents or approximately $6.6 million annually.

The industry accepted performance target is Transfer of Care within 30 minutes at the 90th percentile. As reflected in Table 5, Ottawa Area Adult Emergency Departments Transfer of Care minutes at the 90th percentile are not meeting that performance target.

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Table 5: 90th Percentile off-load delay at Ottawa Area Adult Emergency Departments

Facility 90th Percentile 90th Percentile Transfer of Care Transfer of Care (minutes) (minutes)

2019 2020

The Ottawa 101.83 74.63 Hospital – General Campus

The Ottawa 102.43 72.32 Hospital – Civic Campus

Montfort Hospital 63.60 79.02

Queensway 82.98 70.48 Carleton Hospital

Figure 2: Relationship Between Monthly off-load delay at all Ottawa Hospitals per Month and the 90th Percentile Transfer of Care The Service recognizes that off-load delay is a challenge across Ontario and that the root causes may be related to broader issues within the healthcare system such as patient volumes, the availability of beds, alternate level of care patients that remain in 12 the hospital and human resource (staffing) pressures. All these issues reside with hospitals and remain outside the control of the City of Ottawa to resolve or mitigate. However, off-load delay impedes the Service’s ability to meet legislative requirements and Council-approved response time performance targets.

The Service’s objective is for the hospitals to immediately accept patient transfer of care from paramedics. Paramedics will then be available for the next call for service within the community. Residents expect and deserve to know that an ambulance will be available in their time of need. Of note, the Ottawa Paramedic Service will continue to engage with the hospitals in developing off-load delay measures with mutual benefit to each partner and the patient.

In 2020, the Service continued to mature off-load delay mitigation strategies including:

• A revised Patient Priority System Distribution Trial

• Continuing the Off-Load Nurse Pilot Program

• Maintaining the Paramedic Response Unit Program

• Expanding Community Paramedicine Programs

• Sustaining the Targeted Engagement Diversion Program

Patient Priority System Trial

In November 2020, the Ottawa Paramedic Service, , the Queensway Carleton Hospital, and the began a trial of a revised capacity-based distribution model for patients within Ottawa.

The goals of the Patient Priority System trial are:

1. To ensure patients are transported to the most appropriate hospital emergency department based on health care need, specialty service, and minimal wait time.

2. To distribute patients based on the availability and capacity at local hospitals. Previously, most patients were distributed based on an allocation formula (two patients to either the Civic or General campus of The Ottawa Hospital for every one patient directed to the Queensway Carleton Hospital or Montfort Hospital).

3. To minimize off-load delay for paramedics at local hospitals. 13

4. To improve communication and information sharing between the Ottawa Paramedic Service and local hospitals.

In 2021, the Ottawa Paramedic Service and local hospitals will continue to work together to evaluate and refine the Patient Priority System.

Off-Load Nurse Pilot Program

The Ottawa Paramedic Service continues to oversee the Off-Load Nurse Pilot Program, which is fully funded by the Province. The program was implemented in 2008 and is a partnership between the Ministry of Health, local hospitals and the Ottawa Paramedic Service. This program permits paramedics to transfer patient care to a designated off- load nurse within the hospital’s emergency department. The Off-load Nurse Program expedites the transfer of care. Paramedics are then able to return to service in the community more quickly. In 2020, the Province provided $1.5 million for the fiscal year. The Off-load Nurse Program is effective, though the Ottawa Paramedic Service still experiences over 46,000 hours in OLD. The hospitals are responsible to develop other mitigation strategies to reduce OLD. Nonetheless, the Service continues to seek ways to improve the Off-load Nurse Program (expansion) and reduce off-load delay.

Paramedic Response Unit

The Paramedic Response Unit is a vehicle staffed with a single Primary Care Paramedic. The Paramedic Response Unit is strategically placed in the city to provide a rapid response to emergency calls and initiate patient care. Upon arrival, the Paramedic Response Unit paramedic will assess the patient and potentially downgrade or cancel the response to the call by an ambulance crew. The Paramedic Response Unit provides coverage in an assigned geographic area. The Paramedic Response Unit does not transport patients to hospital and are therefore immediately available for the next call for service in the community. The Paramedic Response Unit model is an industry best practice and has been in place for more than 14 years.

In 2020, Paramedic Response Units completed 16,109 responses. The Paramedic Response Unit program has an eight-minute response time performance of 76.7 per cent.

Community Paramedicine Program

The Community Paramedicine Programs utilize specialty trained paramedics who provide assessment, diagnostics and treatment in the community. The Community Paramedicine Program does not wait for a 9-1-1 call to respond. The Community 14

Paramedicine Program works with hospitals, the Local Health Integration Network, and health care teams to address health care needs long before an ‘emergency’ call for service. They provide service to vulnerable populations, individuals living with chronic health conditions, and seniors who prefer to receive health care services at their home or residence.

Partnership with the West Carleton Family Health Centre

Since 2014, the Ottawa Paramedic Service has been working with the West Carleton Family Health Team to deliver a Community Paramedicine Program funded by the Ministry of Health. In 2020, this program was staffed by two Community Paramedics who provided care to over 100 clients in the community.

Community Paramedics are an integral part of the Family Health Centre Team and are responsible for conducting home visits to clients with complex medical needs. The Community Paramedicine Program aims to improve or maintain patient quality of life and reduce the need and impact on health services. The Community Paramedicine Program is particularly useful to clients in rural areas who wish to remain healthy at home.

Special Population Response Team

In 2020, a Paramedic Special Population Response Team was established. The Paramedic Special Population Response Team is a partnership between the Ottawa Paramedic Service, The Ottawa Hospital, and the Regional Paramedic Program for Eastern Ontario, providing health care services to long-term care and retirement home residents, clients living in congregate care homes, patients with complex medical conditions living in the community, and clients of the Akusivic Inuit Family Health Team. The Paramedic Special Population Response Team has been an integral part of the response to COVID-19 outbreaks in long-term care homes. In addition to providing care in the home, the Paramedic Special Population Response Team was able to reduce paramedic calls for service and transports to hospitals. The Paramedic Special Population Response Team cared for 2,406 patients, provided over 1,424 COVID-19 swabs, and responded to 13 long-term care and retirement residences with outbreaks.

Influenza Immunization Program

In late 2020, the Ottawa Paramedic Service renewed their annual Influenza Vaccination Peer Administration Clinic for members of the Emergency and Protective Services department and their families. The program, which has been in place for more than 10 15 years, was successful in providing over 1,000 immunizations, nearly double the volume from 2019. The vaccines were provided at no cost by the province’s Universal Influenza Immunization Program.

Targeted Engagement Diversion Program

The Targeted Engagement Diversion program is a successful partnership between the Ottawa Paramedic Service, Ottawa Inner-City Health, the Shepherds of Good Hope, the Ottawa Hospital and the . The Targeted Engagement Diversion Program has been in place since 2013 and works to identify and assist vulnerable individuals experiencing homelessness who suffer from substance use issues. Further, Targeted Engagement Diversion assists individuals with persistent mental health issues who frequently call 9-1-1. Through the Targeted Engagement Diversion Program, paramedics transport individuals experiencing homelessness to a specialized clinic as an alternative to a hospital emergency department. This is a unique initiative that aims to deliver enhanced and specialized care to a vulnerable patient demographic while reducing the demand for paramedic 9-1-1 service. In 2020, almost 900 individuals were transferred to the Shepherds of Good Hope rather than an emergency department.

SERVICE IMPROVEMENT INITIATIVES

In 2020, the Ottawa Paramedic Service delivered new and existing initiatives aimed at improving the service to the Ottawa community.

Heart Safe City

The Heart Safe City initiative is a partnership between the Ottawa Paramedic Service, Heart and Stroke Foundation, Advanced Coronary treatment Foundation, Maharaja’s Ball and private businesses. The Heart Safe City incorporates the Ottawa Paramedic Service Public Access Defibrillator Program which started in 2001 and has grown to include several City and business partners. This program has resulted in the placement and oversight of over 1,200 automatic external defibrillators (AED) in public and private buildings, which includes placement in police, fire, and OC Transpo vehicles and all O- Train stations.

Since its inception, the Public Access Defibrillator Program has directly contributed to bystanders saving 141 lives. In 2020, before and during COVID-19, the Service Public Education Team delivered 223 First Aid, CPR and AED courses to 2,459 people, mostly police, fire and City staff. 16

In addition, in 2020 an AED was deployed to 22 sudden cardiac arrests in the community and provided defibrillation on five occasions to save a life. The Public Access Defibrillator Program also deployed several AEDs to COVID-19 testing sites, respite centres and auxiliary shelters across the city.

Neonatal Transport Team Program

In 2019, the Ontario Health Minister announced $6.8 million in funding for five specially equipped ambulances and a team of paramedics in “key regions across the province” to support ambulance transport for Ontario newborns in need of specialized care. In 2020, the Ottawa Paramedic Service received $481,090 to fully fund and staff a dedicated ambulance equipped to care for critically ill newborn patients and provide a regional service to eastern Ontario. In 2020, the team responded to 325 calls resulting in over 1,100 hours of service.

The Ottawa Birth and Wellness Centre Partnership

The Ottawa Paramedic Service has been working with the midwife-led Ottawa Birth and Wellness Centre to improve the coordination of services to the community. The Service has shared protocols and operational procedures to ensure seamless quality care for ill newborn patients. In 2020, OPS and the Ottawa Birth and Wellness Centre worked together to implement a new piece of equipment called a NeoMate Pediatric Restraint System for the transport of all newborns under 10 lbs. The NeoMate Pediatric Restraint System is now a standard piece of equipment in all ambulances.

Operational Stress Injury and Mental Health Strategy

In response to 2017 changes in legislation which recognized post-traumatic stress disorder (PTSD) as a work-related illness for paramedics and communication officers, the Ottawa Paramedic Service developed a Mental Health Strategy, which focuses on prevention, awareness and support. To date, all front-line staff have been trained on the Road to Mental Health Readiness program which aims to improve paramedic mental wellbeing and resiliency.

The Ottawa Paramedic Service is involved in mental health research through participation in the First Responder Mental Health Network Collaboration Committee with and the Ottawa Police Service. As part of the First Responder Mental Health Network Collaboration, the Operational Stress Injury Health Clinic accepts paramedics identified by the Ottawa Paramedic Service Peer Support Team 17 who may require additional assistance. Paramedics can access a qualified psychiatrist in a timely manner. In 2020, the Clinic received 16 referrals from the Ottawa Paramedic Service.

The Ottawa Paramedic Service Peer Support Team consists of 45 members who provide staff with emotional support for work and life stressors. Team members provide training and support to all new staff within the Service and are critical to the maintenance of a healthy workplace. The pandemic has resulted in additional calls for assistance: mandated isolation and quarantines have been difficult for staff. During COVID-19, the Peer Support Team continued to provide face-to-face support (physically distanced and masked) and conducted isolation check-ins on staff.

In late 2020, the Ottawa Paramedic Service partnered with The Royal Ottawa to provide mental health support for members of the Peer Support Team. Additionally, in 2021, a national peer-to-peer mobile application (OnCall) will be launched for paramedics, firefighters, police officers, corrections workers, and public safety communicators.

Diversity Champion Program

The Ottawa Paramedic Service has a Diversity Champion Program with the aim to educate staff and encourage engagement amongst co-workers and patients. Through events and outreach activities, the Service continued to engage staff using three main objectives:

• Supporting the current diversity within the Ottawa Paramedic Service.

• Engaging and building relationships with diverse communities in Ottawa allowing The Service to learn how to better meet their unique needs.

• Improving diversity through recruitment and retention strategies so the Service can be more representative of the community it serves.

In 2020, Diversity Champion Program members participated in a wide range of activities and initiatives. The one-week PAW (Paramedic Awareness Week) Camp which allows young people to learn about being a paramedic moved to a virtual platform. A total of 19 youth participated in the virtual “camp”, with a waitlist of five additional participants. Diversity Champion Program members also participated in several online education and career presentations.

In 2020, the Ottawa Paramedic Service celebrated, participated and provided education to its employees on various initiatives including International Day of Persons with 18

Disabilities, Chinese New Year, Black History Month, Breast Cancer and Movember Awareness Campaigns, Pride celebrations, Mental Illness Awareness Week, Orange Shirt Day, World Suicide Prevention Day, the Sirens for Life campaign, Post-Traumatic Stress Disorder Awareness Day, National Indigenous People’s Day, National Public Safety Telecommunicators Week, World Day of Social Injustice, International Women’s Day, Day of Pink, Bell Let's Talk, Franco-Ontarian Day, Saint Jean Baptiste Day, and Trans Day of Remembrance.

LOOKING AHEAD

The Ottawa Paramedic Service remains committed to establishing an accountable, open and transparent relationship with the community and aims to continue to meet legislative performance standards.

The Service expects call volume to increase in 2021 and will continue to implement strategies to reduce call volume and maximize the distribution of patients to local hospitals.

The Service will also continue to work on the West Deployment Facility project to further address city-wide growth demands and legislative requirements for response times. As indicated in the Ottawa Paramedic Service 2019 Annual Report, the Paramedic Service Headquarters has reached its maximum capacity for vehicle deployments and staffing. As such, the Service is interested in procuring a secondary facility in the west end of the city.

In 2021, the Service will review submissions received through a Request for Expressions of Interest (REOI) to identify a preferred site location and delivery method. The REOI is the first step of a three-step procurement process and will be followed by a Request for Qualifications and a Request for Proposal. The Service is assessing the feasibility of a Public-Private Partnership (P3) for this project and will be undertaking a Strategic Assessment and Business Case Analysis in accordance with the City’s P3 Policy. The potential advantages of a P3 are that the City does not have to outlay upfront capital funds or increase its debt to finance the construction of the West Deployment Facility. Once constructed, the result is an operational-ready facility where payment will be made via a capital lease over a fixed time horizon (i.e. a 30-year period) where ownership of the facility will be transferred to the City at the completion of the capitalized period. The annual lease payments would be equally shared on a 50/50 basis with the Province. 19

The current Paramedic Headquarters, located at 2465 Don Reid Drive, was constructed utilizing a P3 and the Province currently provides 50% funding towards the annual lease payments.

The current West Deployment Facility capital budget will fund the consultant costs for the design of the facility as well as the non-facility operational equipment and supplies.

In 2021, the Service will continue to implement existing service improvement initiatives as well as two new programs: The Community Paramedicine High Intensity Supports at Home Program and the Community Paramedicine for Long-Term Care Program. In late 2020, the Service was advised that both Community Paramedicine High Intensity Supports at Home Program and the Community Paramedicine for Long-Term Care Program would receive new Provincial funding for fiscal 2021 and beyond.

The Community Paramedicine High Intensity Supports at Home Program provides intensive supportive care in the community to patients with complex care needs. Many of these patients are in crisis and require a high level of care to stay in their homes. This program provides an enhanced coordination model with supports across the home and community care sector coming together to support the patient and their caregivers and allow them to remain safely in their homes. The Community Paramedic is an integral part of the team, providing home visits and assessments as well as rapid medical intervention when required.

The Community Paramedicine for Long-Term Care Program provide supports to older adults who are waiting for long-term care placement or who are soon to be eligible for long-term care placement so that they can stay in their home for as long as possible. The Community Paramedic will provide routine assessments and monitoring through home visits, remote patient monitoring, and urgent assessments and intervention for acute issues. The goals of this program are to stabilize the patient’s illness trajectory, reduce visits to the emergency department and improve patient quality of life.

Another possible initiative the Service is exploring is the establishment of a Mental Health Response Team. This initiative will aim to improve the City’s response to requests for service with a mental health complaint. A Mental Health Response Team comprised of a paramedic and another health professional will respond to 9-1-1 calls for service with an identified mental health complaint. The Mental Health Response Team provides a coordinated approach to mental health calls, wherein individuals receive the appropriate care and treatment. Staff will bring forward a report to Committee on the requirements of this initiative in late 2021. 20

The effects of the ongoing COVID-19 pandemic continue to emerge and evolve. In 2021, the Ottawa Paramedic Service, in collaboration with Ottawa Public Health, The Ottawa Hospital, and other health care partners will work together to vaccinate members of the community. Staff continue to demonstrate significant adaptability and resiliency in response to the ongoing and everchanging needs of the community.

The Ottawa Paramedic Service is a team of dedicated, highly qualified people who provide urgent and more recently non-urgent community care. The Paramedic Service will continue to monitor performance and trends and report back to Council as part of the 2021 Annual Report.

RURAL IMPLICATIONS

There are no rural implications associated with this report.

CONSULTATION

There were no consultations required as part of this information report.

LEGAL IMPLICATIONS

There is no legal impediment to receiving the information contained in this report.

RISK MANAGEMENT IMPLICATIONS

There are no risk implications associated with receiving this report for information.

ASSET MANAGEMENT IMPLICATIONS

There are no asset management implications associated with this report.

FINANCIAL IMPLICATIONS

There are no financial implications associated with this report. The West Deployment Facility is included in the 2021 Capital Budget and the total project authority is $3.5M, which is funded by 70% development charges.

ACCESSIBILITY IMPACTS

The Ottawa Paramedic Service provides care for patients with disabilities in line with the obligations of the Accessibility for Ontarians with Disabilities Act, 2005 and the Integrated Accessibility Standards Regulation, 191/11. The Service ensures that patients with disabilities have continued access to their support persons and support animals during transport and arrange for temporary care of service animals, when it is 21 not practicable to do so. The Ottawa Paramedic Service reports on its initiatives that enhance service to older adults and people with disabilities through the City’s Annual City of Ottawa Municipal Accessibility Plan (COMAP) annually. Although delayed due to the pandemic, there will be a communications strategy to highlight Ottawa Paramedic Service policy 1.8 (Transporting Passengers in Emergency Vehicles) and the inclusion of support persons and service animals as soon as possible.

ENVIRONMENTAL IMPLICATIONS

There are no environmental implications associated with this report.

TECHNOLOGY IMPLICATIONS

There are no technology implications associated with this report.

TERM OF COUNCIL PRIORITIES

There are no impacts on the Term of Council Priorities associated with this report.

DISPOSITION

The Ottawa Paramedic Service will action any direction received as part of consideration of this report.