New program at Montfort Hospital aims to reduce paramedic offload delays

The Montfort Hospital and Ottawa paramedics are teaming up for a new pilot program to help ease pressures at the emergency department and reduce offload delays. (Leah Larocque/CTV News Ottawa)

The Montfort Hospital and Ottawa paramedics are teaming up for a new pilot program to help ease pressures at the emergency department and reduce offload delays.

This comes as the city of Ottawa is experiencing “unprecedented” numbers of Level Zeros—events when there are no ambulances available—often because crews are waiting to offload patients at the emergency department.

“We are over 15,000 events, resulting in 64,000 minutes at this point. The problem is chronic, it is unprecedented and it is continuing,” says Ottawa Paramedic Chief Pierre Poirier.

According to the city, Ottawa experienced 1,549 “Level Zero” events from January to Nov. 7, when there are no paramedics available to respond to emergency calls, compared to 750 in all of 2021.

Normally, when a paramedic arrives at a hospital, they must stay with the patient until care is officially handed over to the hospital.

Under the new program, which started in June, four primary care paramedics are working inside the emergency department at the Montfort Hospital on Montreal Road. When an ambulance arrives, the patient can be transferred from the crew to the paramedics working in the ER. This allows the ambulance to get back on the road more quickly and be available for the next call.

Similar programs exists at other area hospitals, where a paramedic monitors up to three newly arrived patients. But Poirier says the pilot program at the Montfort goes a step further because the paramedic is allowed to continue care inside the emergency room.

“The paramedic is actually able to treat, whereas with the initiatives we already have in place at the other hospitals the paramedics are only receiving patients, they aren’t actually providing any other treatment," he said. "So it becomes more of a holding patterns, as oppose to here it is a full disposition of the patient, where the paramedic is also part of the emergency room team, the health care team.

"There is a significant difference and there is a greater benefit in this model.”

Each paramedic can monitor and care for up to four patients at once. Poirier says the paramedic will be able to work “within their professional scope of practice” with the medical direction of an ER doctor. The paramedic will be perform various medical procedures and diagnostic tests.

Genevieve Gregoire is one of the paramedics in the Montfort program.

“When I start, usually I can see the first four patients, and sometimes they have already been waiting for four or five hours.  So I see a big difference, and in my 12-hour shift I can see between six and eight different patients.”

“The doctor does the initial assessment and from there I am making sure the patient is comfortable, taking vitals and if the doctor orders any tests I can do them, so if it blood work, X-Ray, any type of intervention.”

The hospital says they have seen a reduction in offloading delay. For example, over the course of one day in September, one paramedic eliminated over 30 hours of offload delays by caring for seven patients during their shift.

Four paramedics will work 12-hour shifts in Montfort’s Emergency Department, providing 12-hour coverage, seven days a week.

Montfort covers the staffing costs of the paramedics. The program will run until September 2023.