2019 Business Plan

Department: Paramedic Services Strategic Priorities: 1. Find creative ways to engage our public. Make the county fully accessible to people through access to information. Engage in cross- departmental streamlining – specialize in the solution, not the department. 2. Explore alternate options to improve efficiency and service. Develop a system for measuring our processes and their successful desired outcome. Look for economy of scale or shared services among our departments and our communities. Coordinate working with other agencies. 3. Develop Key Performance Indicators (KPIs) that are meaningful and report on them. Set measurable goals and evaluate against them. Build in accountability and evaluation mechanisms. 4. Eliminate our own red tape. Focus on the internal and the external customer / client needs first and eliminate all duplications of services and data. 2019 Bruce County Business Plan - Key Performance Indicators: 2015 2016 2017 2018 2018 2019 2019 Indicator Actual Actual Actual Actual Budget Q3 Budget Total paramedic responses per 1,000 population 97 98 102 103 100 80 104 Average length of time from crew notification to P 13:25 P 13:45 P 13:31 P: 13:26 P 13:35 P: 14:00 P 13:35 arrival for Code 3 and 4 calls. L 9:28 L 9:48 L 9:28 L: 9:40 L 9:30 L: 10:00 L 9:30 I 9:07 I 8:46 I 8:37 I: 9:20 I 8:30 I: 9:28 I 8:30 C 10:47 C10:40 C 10:25 C: 10:36 C 10:30 C: 10:57 C 10:30 Length of time from crew notification to arrival for P 24:41 P 24:23 P: 25:20 P: 24:37 P: 24:30 P: 25:54 P 24:30 the highest priority calls – 90th percentile. L 16:39 L 17:20 L: 16:14 L: 16:51 L: 16:45 L: 17:01 L 16:45 I 16:43 I 17:55 I: 15:53 I: 17:59 I: 17:00 I: 17:10 I 17:00 A: 20:53 A: 20:28 C: 20:19 C: 20:13 C: 20:30 C: 20:58 A: 20:30 Cost to provide one hour of ambulance service. $188 $182 $166 $169 $169 $174 $174 Annual compliance with Council approved Meets or Meets or Met 3 of Met 3 of Met 4 of Meeting all Ambulance Response time criteria. Met 5 of 6 exceeds exceeds 6 criteria 6 criteria 6 criteria criteria criteria criteria criteria

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2019 Bruce County Business Plan

Combined Q3 Update 2019 Major Initiatives Operational Capital Total Budget Cost Budget Cost Budget Cost

(year) (year) (year) 1. Professional Development of $25,000 $25,000 Phase 1 Staff Paramedic Services Supervisory staff are enrolled in Lean and I Lean classes which are being delivered throughout Q-4 Phase 3 Mental Health First Aid cancelled Peer Support volunteers will be rescheduled for 2020 2. Facility Issues Port Elgin Station planning will be refocused in Q4 A) Port Elgin Station $25,000 $51,000 Data Transmission will be completed by B) PS Data Transmission $26,000 Q4 Equipment

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2019 Bruce County Business Plan

Program Estimated 2019 Major Initiatives Budget Project Description Budget Outcome (Operational & Owner) Pressure Cost (year) Category 1. The engagement of The design and implementation of unit-based Phase 1 Service Paramedic Services workflow and process improvement tools, which Tuition Q1 Initiative (PS) supervisory staff will promote staff engagement in the regular $3,000 Savings in the identification and identification of process issues and resolutions. Phase 2 resolution of workflow By using visible work tracking and Lean process Q1-Q2 problems within their review tools, conducting regular managerial work units using Lean Gemba walks and establishing regular staff Materials Phase 3 methodologies. huddles, unit improvement initiatives will be $1,000 Q2-Q3 paced and resources prioritized for the successful completion of activities in each unit. Owner: Paramedic Services Chiefs Phase 2- Kanban improvement flow boards Phase 2-3 have been installed to track initiatives and initiatives will see increase project and initiative completions in Paramedic staff each business unit. identify issues and solutions to daily work challenges and processes previously identified by staff as problematic in their providing of high-quality service, to patients.

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2019 Bruce County Business Plan

Estimated 2019 Major Initiatives Program Budget Project Description Budget Outcome (Capital) Pressure Category Cost (year) 1.Facility Issues The continued implementation Maintain Services of these initiatives have been (Policy and Directives) Owner: identified as Council priorities.

Paramedic Services Chief Project 1 The planning for the Planning Building DesignQ1 replacement of the Port Elgin Budget Tender: Q3 Paramedic Base. The lease $25,000 on the existing building has Internal Staff been extended for two years Time to allow for the planning and $3,000.00 tendering of the new facility.

Project 3 This process would allow PS Cost: Service Improvement vehicles to transmit $26,000 Ambulance Call Reports in a timelier manner to meet Internal Staff Provincial Regulations as well Time, as receive dispatch and $2,000 mapping information in real time, which is currently not available when paramedic units are responding to calls.

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2019 Bruce County Business Plan

Key Performance Indicators Index: Key Performance Indicators Description Total paramedic responses per 1,000 This is the number of responses completed per 1,000 population based on the latest population Statistics census of Bruce County total population of 68,000. This illustrates how many calls the service provider is receiving per capita. For 2015 there were 6,433 patient responding calls divided by 66 for a total of 97 responses per 1,000 population. Census data for 2016 shows a population of 68,000 therefore the 2016 and 2017 numbers are now reflecting this population count. Average length of time from crew This is the average length of time from when a call is received by a crew to when the notification to arrival for Code 3 and 4 ambulance arrives on scene for prompt and urgent calls (code 3 and 4). These calls statistics are obtained directly from the MOH<C ADRS database. These times are reported by the County (indicated with a C) as a whole and then by divisions (whereby P is the ‘Peninsula Hub’ consisting of North Bruce Peninsula, , and Cape Croker, L is the ‘Lakeshore Hub’ consisting of , Saugeen 29, Kincardine, and Huron-Kinloss, and I is the ‘Interior Hub’ consisting of Brockton, Arran-Elderslie, and South Bruce.) Length of time from crew notification to This indicates the 90th percentile of how long it takes from the time a call is received arrival for the highest priority calls – by a crew to when the ambulance arrives on scene for the highest priority calls (Code 90th percentile 4). These statistics are obtained directly from the MOH<C ADRS database. These times are reported by the County (indicated with a C) as a whole and then by divisions (whereby P is the ‘Peninsula Hub’ consisting of North Bruce Peninsula, South Bruce Peninsula, and Cape Croker, L is the ‘Lakeshore Hub’ consisting of Saugeen Shores, Saugeen 29, Kincardine, and Huron-Kinloss, and I is the ‘Interior Hub’ consisting of Brockton, Arran-Elderslie, and South Bruce.) Cost to provide one hour of ambulance This shows the cost per hour to have a Paramedic Service vehicle available to service respond to patient calls. Although the full cost of the service including administrative costs, medical supply costs, building operating costs, supervision and overhead are included only the hours that vehicles are available for service are used. As salaries and wages, fuel and other costs increase, this measure will also trend upward. In our case vehicles (including the Shift Superintendents) are available for 64,740 annual hours. As an example for 2018 you take the total expenditures of $10,978,073 divided 64,740 hours for a total cost per hour of $169. For 2019, the total expenditures are estimated in the budget at $11,300,881.

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2019 Bruce County Business Plan

Key Performance Indicators Description Annual compliance with Council These are the Canadian Triage and Acuity Scale (CTAS) response times that are approved Ambulance Response time required to be submitted by the service to the MOH<C annually based on each of criteria the six (6) CTAS level response time criteria.

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