Funding targets ambulance offload delays

In 2011, at least one ambulance was stuck at Health Sciences North's emergency department the majority of the time, according to the City of Greater Sudbury's deputy chief of emergency services.

That's because the paramedics were dealing with what's called an “offload delay” — an all-too-common situation where paramedics are forced to care for patients on stretchers in the emergency room hallway, Joseph Nicholls said.

This occurs when there's too many patients in the emergency department, and staff have trouble caring for new patients coming in by ambulance.

Last year, paramedics spent 4,070 hours caring for patients at the hospital because of offload delays, he said. When they're at the hospital instead of going out on calls, it decreases response time, Nicholls said.

Offload delays also cost the city $353,805 in extra costs, such as overtime. More difficult to quantify is the frustration that paramedics experienced, he said.

“It's harder to get them meal breaks, which creates frustration, and they hear calls going on in areas they cover,” Nicholls said.

For the past four years, though, the city has received provincial funding, which it in turn gives to Health Sciences North to hire what are known as ambulance offload delay nurses.

These nurses care for patients on stretchers in the emergency room hallway while they wait for treatment, thus freeing up the paramedics to go out on other calls.
The very sickest patients receive immediate treatment from doctors, but the ambulance offload delay nurses are able to care for the rest until they can be seen.

Right now, ambulance offload delay nurses work Monday to Friday from 10 a.m. to 10 p.m. However, the province announced Aug. 8 that it's providing another $219,191 to provide the same level of service on weekends.

A press release from MPP Rick Bartolucci said the funding will mean up to 3,368 extra hours of nursing — a 37 per cent increase over last year, which ultimately means better emergency care.

“This means patients will get the care they need, while allowing paramedics and ambulances to respond to other emergency calls,” Bartolucci said, in the press release.

Nicholls said the funding is excellent news.

“This is a great partnership between the provinces and the municipalities and the hospitals,” he said. “We all benefit from it.”

Representatives of Health Sciences North were not immediately available to comment on the new funding.

When asked if he'd like to see 24 hour ambulance offload nurse coverage, Nicholls said the hours between 10 a.m. and 10 p.m. capture about 80 to 90 per cent of offload delays.

“We do sometimes see offload delays occurring throughout the night, but there are often times when there's not,” Nicholls said.

“We've got to balance the reality of the fiscal situation of the province and spend the money wisely.”

Because the ambulance offload nurses are just regular emergency room nurses rotated through the position, staffing shortages in the emergency room sometimes cause them to be pulled away, he said.

“They may have to pull that offload delay nurse and have her do a regular nursing position,” Nicholls said. “In that case we don't pay for that. the hospital pays that just as a regular nurse.”

On the whole, though, ambulance offload nurses are “absolutely beneficial and essential,” he said.

“It's very hard to say 'What would it look like without them?'” he said. “We don't know, because we have them. Certainly we know based on some of the stuff, that if we did not have them, there would be times we'd be in a lot deeper trouble.”