2015 Paramedic Service Annual Report
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1 Report to Rapport au: Community and Protective Services Committee Comité des services communautaires et de protection 20 October 2016 / 20 octobre 2016 and Council et au Conseil 26 October 2016 / 26 octobre 2016 Submitted on October 13, 2016 Soumis le 13 octobre 2016 Submitted by Soumis par: Anthony Di Monte, Acting General Manager / Directeur général par intérim, Emergency and Protective Services / Services d’urgence et de protection Contact Person Personne ressource: Peter Kelly, Acting Chief / Chef par intérim, Ottawa Paramedic Service / Service Paramédic d’Ottawa 613-580-2424, x22465, [email protected] Ward: CITY WIDE / À L'ÉCHELLE DE File Number: ACS2016-EPS-GEN-0006 LA VILLE SUBJECT: OTTAWA PARAMEDIC SERVICE 2015 ANNUAL REPORT OBJET: RAPPORT ANNUEL DE 2015 DU SERVICES PARAMÉDIC D’OTTAWA REPORT RECOMMENDATION That the Community and Protective Services Committee receive this report for information. 2 RECOMMANDATION DU RAPPORT Que le Comité des services communautaires et de protection prennent connaissance du présent rapport à titre d’information. EXECUTIVE SUMMARY The Ottawa Paramedic Service Branch provides progressive paramedic care and is dedicated to its community and patients throughout the Nation's Capital. In 2015, the Ottawa Paramedic Service response volume was 133,965 while the Ottawa Central Ambulance Communications Centre answered a total of 127,980 calls. This volume is a clear indicator that the demand for the Paramedic Service is increasing year-over-year and is outpacing staffing levels and vehicle availability. The purpose of this report is to present an overview of the Ottawa Paramedic Service, to highlight the performance of the Service over the previous year and to provide information on some of the successful programs and services delivered in 2015. Performance trends and growth impacts will be highlighted. In addition, mitigation strategies implemented by the Paramedic Service to help offset demand will be discussed. This report confirms that the Service fell short on meeting the legislated and Council approved response times for patients categorized as Level 1 under the Canadian Triage and Acuity Scale in 2015, which relate to the most critical patients (i.e. life threatening). The report also confirms that the City fell below the percentile target set for the community for the arrival of a person trained and qualified to provide defibrillation for sudden cardiac arrests for both 2014 and 2015. As staff have identified the trend in growth in paramedic call volumes over the past five years as the most significant factor impacting the Ottawa Paramedic Service’s ability to meet its targeted ambulance response time standards for the most critical patients (i.e. life threatening), staff is recommending in the Ottawa Paramedic Service Review Report (ACS2016-EPS-GEN-0005, Community and Protective Services Committee October 20, 2016), that Council approve the allocation of specific additional resources to the Ottawa Paramedic Service in 2016, 2017 and 2018 to address operational needs. The Paramedic Service continues to monitor performance indicators and to evaluate new and innovative solutions in the interest of providing the highest quality of medical care to all patients. 3 SOMMAIRE La Direction du service paramédic d’Ottawa fournit des soins paramédicaux adaptés et se dévoue pour la population et les patients de la capitale nationale. En 2015, le Service paramédic d’Ottawa a effectué 133 965 interventions, et le Centre intégré de répartition des ambulances d’Ottawa a répondu à un total de 127 980 appels. Ces chiffres montrent clairement que la demande en services paramédicaux, qui augmente d’année en année, est en train de dépasser les niveaux de dotation en personnel et le nombre de véhicules disponibles. Le présent rapport a pour but de donner un aperçu du Service paramédic d’Ottawa, de souligner son rendement au cours de l’année précédente ainsi que de fournir des renseignements sur certains des programmes et services offerts avec succès en 2015. Les tendances du rendement et les répercussions de la croissance seront également mises en évidence. Le rapport traitera aussi des stratégies d’atténuation mises en œuvre par le Service paramédic pour répondre à la demande. Le présent rapport confirme qu’en 2015, le Service n’a pas su respecter les délais d’intervention imposés par la loi et approuvés par le Conseil pour les patients classés au niveau I de l’échelle canadienne de triage et de gravité, c’est-à-dire les cas les plus urgents (danger de mort). Il confirme également qu’en 2014 et en 2015, la Ville n’a pas atteint le pourcentage cible qu’elle s’était fixé quant à l’arrivée d’une personne formée et qualifiée pour fournir des services de défibrillation en cas d’arrêt cardiaque subit. Puisque l’équipe a établi que la tendance à l’augmentation du nombre d’appels pour les services paramédicaux observée depuis cinq ans constitue le plus important facteur empêchant le Service paramédic d’Ottawa de respecter les normes en matière de délai d’intervention des ambulances pour les cas les plus critiques (c.-à-d. quand la vie des personnes est en jeu), elle recommande, dans le rapport d’examen du Service paramédic d’Ottawa (ACS2016-EPS-GEN-0005, Comité des services communautaires et de protection, 20 octobre 2016), que le Conseil approuve l’allocation de ressources additionnelles précises au Service paramédic d’Ottawa en 2016, en 2017 et en 2018 pour répondre aux besoins opérationnels. Le Service paramédic continue de faire le suivi des indicateurs de rendement et d’étudier de nouvelles solutions novatrices en vue de fournir des soins de santé de la plus grande qualité à tous les patients. 4 BACKGROUND The Ottawa Paramedic Service Branch is dedicated to its community and patients by providing progressive paramedic care throughout the Nation's Capital. The service strives to be a dynamic leader in delivering and improving paramedicine, continuously seeking new knowledge and applying innovation. When a member of the public requires immediate medical care, an entire team of dedicated, highly qualified people come together in the name of providing excellence in clinical care delivery. The Service consists of a team that includes Paramedics, Communications Officers, Equipment and Supply Technicians, Trainers, Quality Assurance Staff and critical Support Staff. The Ottawa Paramedic Service provides emergency medical coverage across the City of Ottawa (2,791 square kilometers), while the Ottawa Central Ambulance Communication Centre provides dispatching services to over 10,000 square kilometers of Eastern Ontario including the United Counties of Prescott Russell and the United Counties of Stormont, Dundas and Glengary. The Service provides a fully integrated advanced life support system delivering state of the art medical services to more than one million residents and visitors. The City of Ottawa operates the Paramedic Service on behalf of Ontario’s Ministry of Health and Long Term Care. The parameters of this responsibility are dictated through a Land Ambulance Agreement and the Ambulance Act of Ontario, whereby the Province of Ontario funds 50% of land ambulance services and 100% of the cost for the Ottawa Central Ambulance Communications Centre. On October 28, 2004, the Emergency and Protective Services Committee directed that annually, staff report back to Committee and Council prior to budget on performance trends, mitigation strategies and associated financial impacts to ensure the service can maintain its baseline performance targets. As well, the Ottawa Paramedic Service reports annually to the Ministry of Health and Long Term Care on performance. This report highlights the service demand (response volume), as well as the Service’s performance for 2015. DISCUSSION PERFORMANCE TRENDS The highest priority for the Ottawa Paramedic Service is to provide the best possible clinical care to the residents and visitors of Ottawa. The Service regularly analyzes response times, response volumes and patient outcomes in order to maximize the 5 deployment and usage of paramedic resources. The primary measures that determine service demand and associated resource requirements are: Total number of 9-1-1 calls received, total number of patients assessed and treated, and total number of Paramedic resources required to respond, also known as response volume. PARAMEDIC RESPONSE VOLUME The greatest indicator of system utilization is the response volume. In 2015, the Paramedic Service response volume was 133,965, representing a 4.7% increase over the previous year. The five year trend demonstrates a 23.7% overall increase. Table 1 represents the response volume and the annual percentage growth over the last five years. Table 1: Response Volumes Year Responses % 2011 108,331 N/A 2012 120,898 11.6% 2013 119,292 -1.3% 2014 127,883 7.2% 2015 133,965 4.7% Total Increase 25,634 23.7% 2015 CITY OF OTTAWA PARAMEDIC RESPONSE VOLUME BY WARD Table 2 below shows the Ottawa Paramedic Service response volume by ward. In general, the more densely populated a ward, the higher the response volume. Note that the Ottawa Paramedic Service also responds to calls outside of the City boundaries and as such, the total response volume is greater than the total ward responses. 6 Table 2: Response Volume by Ward Ward Ward Number Response Volume Rideau-Vanier 12 12,533 Alta Vista 18 11,950 College 8 11,411 Somerset 14 9,512 Rideau-Rockcliffe 13 9,352 Kitchissippi 15 9,113 Bay 7 9,109 River 16 7,472 Capital 17 6,551 Gloucester-Southgate 10 5,175 Orleans 1 5,041 Beacon Hill-Cyrville 11 4,589 Knoxdale-Merivale 9 4,193 Barrhaven 3 3,860 Kanata South 23 3,834 Innes 2 3,268 Kanata North 4 3,196 Rideau-Goulbourn 21 2,542 Cumberland 19 2,480 Stittsville 6 2,296 Gloucester-South Nepean 22 2,228 Osgoode 20 2,005 West Carleton-March 5 1,605 PARAMEDIC RESPONSE TIME STANDARDS The current 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 7 Paramedic Unit on scene.