Ottawa paramedics to use taxis to transport some patients to 'alternate destinations' for health care this fall

Ottawa paramedics will use taxis to transport some patients to "alternate destinations" instead of a hospital emergency department, as part of a new plan to reduce the number of paramedics waiting to offload patients in hospitals.

A report from Ottawa Paramedic Chief Pierre Poirier for the emergency preparedness and protective services committee outlines plans for a pilot project to use taxis instead of ambulances to transport select low acuity patients to "a destination that is best suited for meeting their immediate and individual health care needs."

Starting Nov. 1, the Ottawa Paramedic Service will begin piloting the use of local taxis to transport select low acuity, "less urgent (CTAS 4) and non-urgent (CTAS 5) patients to alternate destinations," according to the report.

When a paramedic crew responds to a call, the patient has the choice to either go to the hospital in an ambulance or the crew will not transport them.

"This adds to patient choice," Poirier tells CTV News Ottawa. "We have a third choice on occasion; a very, very specific set of patients that they may be able to have a taxi take them to the hospital."

The proposal comes as paramedics see an increase in calls, and spend longer times waiting to offload patients in the emergency department to hospital staff.

• FULL REPORT: Read the full report from Ottawa Paramedic Chief Pierre Poirier that outlines the pilot project

Paramedics responded to 140,772 calls for service between Jan. 1 and Sept. 30, up 3.6 per cent from the same period in 2022. The report says Ottawa paramedics spent 72,784 hours in offload delay in Ottawa hospitals in the first nine months of the year, up 7.2 per cent from the same period last year.

"The most likely patient population to be held for significant amounts of time in hospital offload delay is lower acuity patients," Poirier writes in the city report.

"This is also the most likely population to benefit from safe, alternate transportation via taxi. Taxi service will only be arranged after patients have been fully assessed by the Ottawa Paramedic Service and it is determined the individual does not require further treatment or transportation by a paramedic. All individuals transported safely by taxi will receive a follow-up call from a paramedic within 24 hours."

The use of local taxis to transport select low acuity patients is available to patients of the smart transportation program and the mental wellbeing response team, and they will be transported to alternate destinations.  A taxi will only be called after the patient has been fully assessed by paramedics and it is determined they do not need to be transported by a paramedic or require further treatment.

"We’re always trying to preserve our resource which is the paramedic crew so that we can attend to that next call for service," Poirier says.

"Hopefully, in the future we will be able to take this individual to a family physician, maybe to another clinic where a specific medical service is available."

The report says the safe alternate transporting pilot project aims to "further mitigate" the impacts of offload delay and reduce occurrences of level zero in hospitals.

"Offload delay at local hospitals continues to be a significant contributor to 'level zero' events in Ottawa," Poirier writes.

"In the first nine months of 2023, the Ottawa Paramedic Service was at level zero 1,088 times for a total of 32,697 minutes. In 2022, the Ottawa Paramedic Service was at level zero 1,313 times for a total of 53,885 minutes."

The Shepherds of Good Hope currently use taxis to transport patients to the emergency department if it is a non-urgent situation.

"We know that this is a service that can save the system money and provide care within the community," says Rob Boyd of Ottawa Inner City Health.