Ottawa paramedics dispute damning dispatch report

The Ottawa Paramedic Service disputes a provincial report that found paramedics from neighbouring municipalities are spending more time responding to calls in the capital because of an "overall, ongoing and systemic [dispatching] problem."

In a letter to Mayor Jim Watson and city council sent late Monday night, Ottawa's chief of paramedics — currently on secondment as the city's acting general manager of emergency and protective services — said the paramedic service "strongly disagrees with several of the conclusions and findings of the report" and is currently "fact-checking" it.

Anthony Di Monte wrote that the ministry's report was triggered by a complaint from a neighbouring municipality about the overnight shift from Aug. 6 to 7. On Nov. 29, about two-and-a-half months later, Ottawa paramedics received the ministry's report on the matter and were given 10 days to review it and 40 days to come up with an action plan, if necessary.

But Di Monte said it's his understanding that the ministry "inadvertently shared" the report with neighbouring municipalities, one of which — the United Counties of Prescott and Russell — "chose to post the report on its website" on Monday, six days shy of the time Ottawa paramedics have to review it.

Di Monte did not say what is inaccurate about the report, only that acting paramedic Chief Peter Kelly has met with provincial officials "to clarify and challenge the validity of the findings," and that more meetings will occur "to seek to corroborate the findings and make necessary changes."

After that, the city will develop an action plan if required.

Report findings

The Ministry of Health and Long-Term Care report, released last week, points to several cases over the night shift where Ottawa paramedic dispatchers fell short of their own standards, including five cases where the closest ambulance was not assigned for life-threatening emergencies.

In one case, firefighters tried to resuscitate a patient on Stonehenge Crescent while waiting for an ambulance to arrive. The dispatcher assigned paramedics who were 17 minutes away instead of an ambulance five minutes away at the Children's Hospital of Eastern Ontario. 

The patient didn't survive.

The Ottawa paramedics were nearing the last 30 minutes of their shift, when they are not supposed to be assigned to new calls.

"This practice does not allow for a seamless ambulance service and negates Ottawa Paramedic Service's own mandate of sending the closest ambulance to all high priority calls," the report said.

But Di Monte challenged that conclusion during an interview Tuesday morning, pointing out the city's end-of-shift policy was approved by the province.  

"We have a finite fleet. That ambulance has to return in the half-hour at the end of the shift, because it has to be processed and ready for the next two crew that's ready to go out on the next shift. But we were never asked that question by investigators," said Di Monte.

Return to readiness policy questioned

The report also criticizes Ottawa's "return to readiness" policy, which requires dispatchers to wait 30 minutes after paramedics transfer a patient before they can assign paramedics to another call, and another that prevents dispatchers from assigning units in the last 30 minutes of their shift.

The report said the "return to readiness" and end-of-shift policies create a skewed inventory of what resources are available and contributes to more calls to paramedics in neighbouring municipalities.

And while the end-of-shift policy reduces the amount of overtime claims for Ottawa, it has the inverse effect on surrounding municipalities. Chrétien said, even without overtime, it costs Prescott-Russell $500,000 per year for paramedics to respond to Ottawa calls.

The report said in five of the 13 calls on Aug. 6, dispatchers did not assign the closest unit to respond to life-threatening calls, in violation of provincial standards and the Ottawa Paramedic Deployment Plan. 

Ottawa paramedics were assigned to non-life threatening calls when resources were low — instead of waiting for more ambulances to be available — twice on the night in question, which violated the deployment plan and requirements for minimum emergency coverage. 

The response to non-life threatening calls can be delayed by up to 60 minutes to make sure enough ambulances are available to respond to graver emergencies.

Di Monte again defended Ottawa paramedics, saying both policies were approved by the province, and explained that of the five cases cited on Aug. 6, only one was the result of a dispatcher not following proper protocol. 

5 neighbouring municipalities calling for action

Paramedics were also late in reporting that they had transferred a patient to the care of a hospital on several occasions, with the longest delay being 42 minutes. Those delays would mean dispatch wouldn't know they were available to deploy — and they would get another 30 minutes before their next call because of the "return to readiness" policy.

Five municipalities neighbouring Ottawa have already called for the province to step in and deal with the paramedic resource issue.

The municipalities include Renfrew County, Lanark County, the United Counties of Prescott and Russell, the United Counties of Leeds and Grenville and the United Counties of Stormont, Dundas and Glengarry.

The municipalities say Ottawa refuses to reimburse them for the service from their paramedics.

The province made it optional for municipalities to recover costs for emergency services delivered outside their jurisdiction in 2008, where before it had been mandatory.