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Central Ontario paramedics can direct 911 palliative calls to care other than ER in pilot project

Click to play video: 'Provincial government expands the 9-1-1 emergency call model' Provincial government expands the 9-1-1 emergency call model
Ontario has expanded its 911 Models of Care pilot program to cover 33 municipalities across the province. This program allows paramedics more options when responding to a 911 call, including more individualized care on-location and the ability to bring patients to mental health clinics or addiction centres – May 7, 2021

A year-long pilot project in central Ontario will allow paramedics to deliver 911 palliative patients to other treatment options than a hospital emergency department, the province announced Friday.

Dubbed the new “911 model of care,” the projects cover 33 municipalities across Ontario. The Central East pilot project “Treat and Refer Model for Palliative Care Patients,” encompasses Peterborough, Peterborough County, City of Kawartha Lakes, Northumberland County, Haliburton County and Durham Region.

The province says currently paramedics are required to bring 911 patients to hospital emergency departments, even when there are other appropriate care and treatment options available in the community.

Read more: Union representing Ontario’s Ornge paramedics in favour of strike if necessary

Under the Central East pilot project, eligible palliative care 911 patients, and those experiencing mental health and addiction challenges, can receive on-scene care for pain and symptom management by a paramedic directly.

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Following treatment on-scene, patients have the option for paramedics to coordinate follow-up care directly with the patient’s primary palliative care provider or with a local hospice for further treatment and wrap-around care. The province said:

“The patient will remain in ultimate control of the care they receive and can at any time request to be taken to the emergency department.”

Randy Mellow, chief for both the Peterborough County/City Paramedics and Kawartha Lakes Paramedic Service, says many patients with life-limiting illnesses prefer to be cared for in their homes and communities, which the pilot project could allow.

“The ability to receive care in this setting has been associated with improved comfort of end stages of life for patients, families and caregivers,” he said.

“This patient-centred initiative will enhance the ability of paramedics, as part of a coordinated care team, to provide the option for patients receiving palliative care to have symptoms or changing care needs managed at the right place (in-home), the right time, and based on the needs of the individual.”

Tim Waite, chief and director for the Haliburton County Paramedic Service, says the pilot offers additional care options for residents.

“This is a unique program that will provide important additional care to residents in the community to help support palliative care patients and their families,” he said.

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Northumberland Paramedic chief Susan Brown said the pilot will leverage the skills and training of paramedics to deliver “enhanced” health care services.

“By enabling in-home care and symptom relief supports for palliative patients, the pilot announced today is another opportunity to improve patient and caregiver experience with the health care system while decreasing pressure on our local hospitals,” Brown said Friday.

“We are proud to be working with neighbouring paramedic services as well as local health and community care providers to make this service accessible in Northumberland and throughout the region.”

Area MPPs held a virtual media conference Friday to outline details of the project in their ridings.

“Since well before the COVID-19 pandemic our government has been committed to ensuring all Ontarians have access to an appropriate and effective level of care,” said Peterborough-Kawartha MPP Dave Smith on Friday.

“Today’s announcement is testimony to that commitment, and I am excited to see how this new model will enhance the quality of care available to Peterborough-Kawartha residents. As a community, we are truly blessed to have such an exceptional team of paramedics that work tirelessly to keep our community safe and healthy.”

“I know I speak on behalf of all of Peterborough-Kawartha that we are thrilled to have our paramedics begin this pilot and expand their presence in the community.”

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Peterborough-Northumberland South MPP David Piccini said the model will avoid unnecessary emergency department visits.

“Our Northumberland Paramedics do remarkable work, and this pilot will allow them to expand their scope of practice and deliver enhanced palliative care services in our communities,” he said.

Haliburton-Kawartha Lakes-Brock MPP Laurie Scott echoed the sentiment.

“This is another example of how our government is continuing to find solutions to challenges COVID-19 presents while helping to shape our health care model for the future,” she said.

Read more: Ontario provides $3.25M to expand Haliburton County community paramedicine long-term care program

The pilot projects aim to reduce emergency department visits which are currently under strain from the third wave of the COVID-19 pandemic, said Ontario health minister and Deputy Premier Christine Elliott.

“Throughout the COVID-19 pandemic, we have seen more than ever how critical it is for patients to receive timely and effective care — when and where they need it,” Elliott said.

“As Ontario’s hospitals face unprecedented capacity pressures during the third wave of the COVID-19 pandemic, these new models of care will enable our world-class paramedics to support our most vulnerable patients in the most appropriate setting, while avoiding unnecessary emergency department visits.”

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Each pilot project will be in place for one year, after which it will be evaluated to assess outcomes, identify where program adjustments may be needed, and how to implement new models of care throughout the province.

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