Ottawa paramedics at 'Level Zero' 526 times in first five months of 2022

There have been no Ottawa paramedic units available to respond to calls an average of more than three times a day so far this year, as the service deals with an increase in calls and significant delays offloading patients in hospitals.

Between Jan. 1 and May 25, paramedics reported 526 "Level Zero” events compared to 45  during the same period in 2021, according to a report for the community and protective services committee.

Level Zero events occur when there are no ambulance crews available to respond to a call, often because they are stuck waiting to offload patients at the emergency department.

In the first five months of the year, paramedics transported 28,000 patients to hospital and spent 25,000 hours in offload delay.

Staff estimate paramedics could spend upwards of 60,000 hours in offload delay by the end of the year.

"Offload delay continues to be a significant contributor to level zero events in the city of Ottawa," staff said. "In addition, since the relaxation of COVID-19 restrictions within the community, the Ottawa Paramedic Service has experienced a 12 per cent increase in response volumes."

In January, Mayor Jim Watson and community and protective services committee chair Matthew Luloff sent a letter to Health Minister Christine Elliott asking for a "coordinated and innovated approach" to solving paramedic offload delay issues in Ottawa hospitals.

Luloff asked the Ottawa Paramedic Service what mitigation strategies have been implemented to address level zero in the city.

Staff say the Ottawa Paramedic Services have "implemented several strategies" to mitigate offload delays by reducing patient transports and diverting patients away from emergency departments.

Examples of mitigation strategies include "community paramedicine programs" where specially trained paramedics provide patient assessment, diagnostics and treatment in the community, a "mental wellbeing response team" and an "early discharge initiative". Paramedics have also established a "Patient Flow Paramedic" at the Queensway Carleton Hospital, where a paramedic is stationed in the emergency department to monitor up to three newly arrived patients while crews return to service.

A report on the outcomes of these initiatives will be presented to the community and protective services committee and council next year.

In 2021, paramedics reported 750 incidents of level zero, with paramedics spending 49,000 hours in offload delays at hospitals.

"The Ottawa Paramedic Service's service delivery to the community continues to be challenged by offload delay and level zero events," says the report. "The service continues to implement new and existing initiatives to provide individuals with alternate care options that are appropriate and safe to reduce transports to the emergency department."