Hamilton paramedics delayed in responding to life-threatening situations due to overcrowded ERs: union

The head of Hamilton’s paramedics’ union is urging for more provincial and municipal funding as paramedics are stuck waiting to transfer patients to hospitals, leading to delays in ambulances reaching those in life-threatening situations.

There were 457 cases between January and October of 2019 where it took paramedics more than 20 minutes to get to those suffering from serious emergencies — including heart attacks and drug overdoses.

OPSEU Local 256 president Mario Posteraro told Global News Radio 900 CHML’s Bill Kelly Show that those delays were due to paramedics being forced to wait with patients before they’re able to be admitted to Hamilton emergency rooms.

“The hospitals are working at above 100 per cent capacity virtually every day,” said Posteraro. “That puts a strain on our ambulance service in that we can’t off-load our patients — because there are no beds to put our patients in.”

“Pre-hospital care, which is our core role, has now become in-hospital care, and hallway health care is now the norm for us.”

While the province has pledged to add an additional 15,000 long-term care beds by 2024, Posteraro said the waiting list for beds is much longer than that.

In October, a report from the province’s financial accountability officer said the province’s aging population will outpace the growth rate of the new long-term care beds, effectively maintaining the status quo.

According to Posteraro, elderly patients make up about 30 per cent of the service’s overall call volume, which is increasing at an average rate of four per cent per year.

In 2019, that was an increase of 2,877, with an average of 238 calls per day.

“These patients have nowhere to go,” said Posteraro. “There’s no capacity within home care, long-term care, patients are being jammed up in the acute care hospitals, which is creating a downstream impact on the emergency departments, and as a consequence, on our ambulance service.”

“I just don’t see it getting any better.”

A spokesperson for the Ministry of Health has not yet replied to a request for comment on Posteraro’s remarks about provincial funding requirements.

Hamilton’s chief of emergency medical services Michael Sanderson said the increase in patient off-load delays did not lead to an increase in Code Zero events — which is when there are zero ambulances available in the city. In fact, the number of Code Zeros decreased to 80 in 2019 from 96 the year before, he said.

However, Sanderson said it did contribute to narrowed ambulance resources, which he said is an even bigger concern.

“When we have a small number of vehicles available, which is all about off-load delays, for the most part, those are the challenges in terms of our availability,” said Sanderson. “It’s hard on our staff, it’s certainly a challenge for the public.”

In 2019, Hamilton paramedics were delayed longer than two hours or more a total of 4,390 times, losing about 30,000 hours in time spent waiting to off-load patients to hospital staff.

“As patients are not able to get out of hospital into community care, they’re not able to get out into home care, not able to get out into long-term care homes, that backs up hospitals,” said Sanderson. “And that works its way down through the hospital, and of course, our paramedics get blocked up at the front door as a result of that.

“The reality is our paramedics and the people that we’re serving become the canary in the mineshaft. And that’s not something that we want to see happening.”

Sanderson added that the service’s overall response time was not negatively impacted, but he said that’s due to two factors — an additional ambulance approved by Hamilton city council in the 2019 budget, and a provincially funded ambulance for neonatal intensive care unit transfers, which was also used in some emergency situations.

The paramedic service will be requesting an additional ambulance as part of a staffing enhancement request during a budget presentation to city council on Jan. 30.

Posteraro said he’s hopeful that the request will be approved, but said the additional ambulance only helps to “scratch the surface” in dealing with the ever-increasing call volume.

“We’re trying to play catch-up, and we can’t keep up until we catch up,” said Posterara. “There’s been a staffing deficiency in years past. We’re trying to make some headway, but when you consider the increase in calls and demands on our service because of the demographic factors, we just need a hand up to try to deliver the care that I think we ought to deliver to our patients and our citizens.”