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Weekend ‘code zero’ has union boss calling for more paramedics in Hamilton

A local union boss in Hamilton is calling for municipal and provincial officials to address code zeroes in Hamilton's paramedic services. Lisa Polewski / 900 CHML

A local paramedics union boss is calling for local governments to hire more staff after a three-hour stretch on Oct. 20 in which only one or zero ambulances were available for calls.

OPSEU Local 256 president Mario Posteraro’s plea comes after paramedics from out of town were called in to Hamilton to respond to emergencies last Sunday because of long delays in transferring patients to the city’s emergency rooms.

“This is not a situation that we can allow to continue,” said Posteraro. “There’s been a lot of talks but insufficient commitment to follow through, and our words should mean something and commitments should be honoured even on the provincial level.”

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The Hamilton Paramedic Service (HPS) told Global News that for a period of three and a half hours on Oct. 20, the service experienced a “code zero,” meaning it had one or zero ambulances available for calls.

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Typically, paramedics transporting patients to a hospital expect to take no more than 30 minutes when transferring those patients to hospital staff. However, on the day in question, units were held up 53 times, taking more than an hour to transfer. Twenty-seven of those incidents involved delays of more than two hours.

The service has experienced similar delays two other times in October, with 21 one-hour delays on Oct. 18 and 28 offload delays of more than 30 minutes on Oct. 19.

Posteraro says he sees apathy from both the province and the city when it comes to investing further in the city’s ambulance service.

“We’re going to continue to experience code-zero events that have not ceased since 2006,” said Posteraro.

“Here we are, 13 years later, wondering why it’s happening. I think there’s been a malaise. I mean, the bottom line: code-zero events have become apathetic, administrative data-entry exercises.”

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Code-zero occurrences have fluctuated wildly over the last five years, with 242 instances in 2012, averaging about an hour and a half each time. The number of code-zero incidents dropped to just 44 in 2015 with an average duration of an hour.

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In 2018, there were 96 code zeros lasting about an hour each. January 2018 alone saw code-zero emergencies in the city rise to their highest monthly level in five years, with 34 instances, before dropping to 21 in February 2018.

There were just seven code zero incidents in October 2019, much lower than October 2017, when there were 20.

So far in 2019, there have been 74 code zeros.

But recent drops mean little to Posteraro, who says even one code zero is “unacceptable” in the grand scheme of things.

“You know, we need a reality check here. As I said, I think the code-zero term has lost its zing,” said Posteraro.

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“All metrics point to the fact that we are much below average as far as ambulance staffing.”

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Current data from the paramedic service says 25 per cent of all calls are Code 3 calls, or non-life-threatening injury calls. It goes on to show that at least 10 per cent of patients in those calls will wait in excess of an hour for an ambulance.

Global News reached out to the provincial Ministry of Health and the City of Hamilton for a response to Posteraro’s accusation of apathy. The city directed Global News to the provincial government for comment.

The ministry said it is aware of the issues with Hamilton’s code zeros and says it’s working on a modernization plan for ambulance services across the province.

Part of the plan includes a four per cent increase in funding for 2019-20 and giving paramedics the authority to transfer patients to relevant treatment facilities other than hospitals in order to offload patients sooner.

“As part of our plan to modernize emergency health services, we’re investing in upgrading the technology used by ambulance communication centres to reduce wait times for critical emergency services,” ministry spokesperson Hayley Chazan said.

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“At the same time, our government is empowering paramedics to safely and responsibly determine if there is a more appropriate care setting for patients to receive treatment other than an emergency department, such as a mental health crisis centre. This will help free up hospital beds for patients who need them most and will get ambulances back on the road faster.”

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Another variable could be the Doug Ford government’s plan to merge ambulance services across the province.

Posteraro says a shortage of hospital workers is another reason ambulances are delayed. Hospital staff spending long periods of time with patients means they are not available to take patients from paramedics, he says.

There’s a lack of capacity, unfortunately, within the units and in the wards, and patients get backed up.”

On Monday two NDP MPPs, Ottawa Centres Joel Harden and West-Ancaster-Dundas MPP Sandy Shaw, raised the issue of code zeros during question period at Queens Park calling for Doug Ford’s health care underfunding and hallway medicine to stop.

“First the Liberals’ and now the Ford Conservatives’ chronic underfunding of hospitals have created a scary hallway medicine crisis,” Shaw said. “Now the crisis is spinning out to include ambulances, and paramedics are saying things will only get worse as flu season hits.”

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