'Hard work ahead' to alleviate ER delays, Ottawa Hospital says

The Ottawa Hospital says there's "a lot of hard work" to do to speed up the time it take to receive patients arriving at its emergency departments by ambulance, allowing paramedics to get back out on the road.

The acknowledgement comes after the city's emergency services manager scolded the hospital for holding up paramedics and potentially putting patients' lives at risk.

As CBC reported Monday, the Ottawa Paramedic Service was without a single available ambulance to respond to medical emergencies 329 times from January to August, a total of 138.4 hours.

The situation is referred to as "level zero," and it typically occurs when ambulances are tied up off-loading patients at the hospital. In one instance earlier this year, the city was at level zero for seven hours and 40 minutes.

Speaking to CBC, the city's emergency services manager, Anthony Di Monte, laid the blame squarely on The Ottawa Hospital, which he blamed for holding paramedics "hostage" and contributing to increasing morbidity and mortality rates.

New measures

The Ottawa Hospital did not directly address Di Monte's comments, but did acknowledge the city's report on the matter, also released Monday.

"We welcome this report as it shows that by working together, we can find better solutions to decrease ambulance offload times and provide the best care possible for patients in our community,"  said Dr. Guy Hebert, head of emergency medicine at The Ottawa Hospital, in a statement. 

While paramedics aim to transfer patients over to hospital staff within 30 minutes, it's typically taking closer to 90 minutes at The Ottawa Hospital's Civic and General campuses. 

Hebert referred to current pilot projects aimed at reducing the amount of time ambulances must wait to transfer patients. For example, dedicating emergency room nurses to that task could take the pressure off other staff.

"There remains a lot of hard work ahead even as we implement these new measures," Hebert wrote. "Transitioning patients into care in our Emergency Department is a top priority, and we will continue working with our partners to ensure the safe and efficient care of all who need it."

Long delays no surprise to paramedics

The Ottawa Paramedic Association agreed it's up to hospitals to fix the problem.

"We hear the level zero alarms going off every day in the city, and we're aware that that means that there are no longer any paramedics and ambulances available to respond to 911 calls," association president Darryl Wilton said.

The result, Wilton said, is that patients need to wait longer for care, and neighbouring communities are left without service while their own paramedics answer calls in Ottawa.

Wilton said emergency room staff aren't to blame.

"What we're seeing in the hospitals is that in the emergency department, the physicians and nurses are extremely overworked. They're very, very busy. They have far too many patients," Wilton said.

Health Minister Christine Elliott said the province has taken steps to minimize the impact on people who need critical care, including allowing paramedics to drop off patients at other institutions such as mental health crisis centres.

"This will help free up hospital beds for patients who need them most, and will get ambulances back on the road faster," Elliott said in a statement. 

The government also says it's spending more to grow land ambulance services in Ontario this year and next. 

Have you faced long waits for an ambulance, or been rushed to the hospital only to sit on a stretcher for a long period of time? CBC would like to hear about your experience. Email Laura.Osman@CBC.ca.