Code black, code red minutes trending down for 2024, EMS chief reports

The number of minutes when there are no ambulances available for service in Windsor-Essex is expected to trend dramatically downward this year, Essex-Windsor EMS says,following a sweeping effort to increase staffing and service levels.

In a mid-year update to Essex County council, the service reports that code black and code red minutes are trending downward as a result of adding more paramedics, ambulances and in-hospital resources to help combat the problem.

Essex-Windsor EMS chief Justin Lammers told councillors the service is anticipating a 71 per cent decrease in code black minutes this year over 2023.

In 2022, the region spent 2,272 minutes in code black. That number is expected to be about 492 minutes this year, according to EMS projections.

The number of minutes in code red is also expected to decrease by 21 per cent.

A code black indicates a time when there are no ambulances available. A code red indicates that there are only between oneand three ambulances available to respond to calls.

Overall call volumes are expected to rise this year, Lammers told councillors, as is the number of high-acuity calls. But the number of lower acuity calls (known as Code 3s) is expected to decrease, because of the community paramedicine program and efforts other health partners.

LISTEN: Essex-Windsor EMS declared a state of emergency over a shortage of ambulances in October 2023

Offload delay hours have trended downward this year, reaching below 2023 levels in March and April. Offload delays refer to the timeambulances spendwaiting at hospitals with patients. Use of the paramedic offload program is also down, EMS data shows: Used just 15 times in May and nine times in April, down from a high of 173 times in November 2023.

"These are both great indicators and we will continue to monitor the work, but itdoes not stop here," Lammers said.

'Best report I've read all year,' councillor says

May was the busiest month of 2024 for the service so far, Lammers noted. The service bucked the downward trend on code red and black minutes,though theresultwasstill improvedoverJanuary 2024.

Lammers noted that May was an unusually busy month and while data for June is not reflected in the report because of council timelines, it was more normal month.

It was a report councillors said they were happy to read.

"This might be the best report I've read all year," said Kingsville Coun. Dennis Rogers."There was money spent and people brought in, but the data shows the plan is correct and show you had a great vision for it. Ihave to commend you and your team."

According to the report, the county approved adding three 12-hour, seven day a week shifts as part of the 2024 budget.

The remaining three 12-hourshifts were added in June because of the need to hire paramedics, so the impact of those hires won't be felt in the data until the end of the year.

As of June 3, there are now two additional ambulances available 24 hours per day, seven days a week.

There are 20 net new paramedics onboarded to the service and deployed and two net new ambulances operational.

But they also looked at examples of hospitals where code black and code red minutes were decreasing such asNorth York General Hospital and London Health Sciences Centre. They visitedthose hospitals and invited a representative from North York to Windsor to share best practices.

The service is also reviewing high call volume times and scheduling to ensure they have more ambulances and paramedics available in peak times. They are also undergoing a master plan review, the results of which are expected to be presented to council in 2025.

Essex-Windsor EMS has a variety of programs that fall under community paramedicine, one of the things Lammers said helped to reduce the number of low acuity calls.

In 2023, the service introduced the community assessment triageteam, which provides care to low-acuity patients while reducing the number of unnecessary hospital trips. That has reduced emergency department transports through 911 by 69 per cent according to 2023-24 data.

The service also has a vulnerable patient navigator program, which connects frequent users of emergency services with support agencies and monitoring for follow-upcare to reduce emergency trips. That program decreased 911 responses for patients enrolled by 63 per cent.

They also have the Mental Health and Addictions Response Teamand a long-term care paramedicine program for patients who are eligible or on the wait list for long-term care.

The service also has more programs and initiatives in the work for the rest of 2024 and 2025.

Those measures, both ongoing and upcoming, include:

• A request in the 2024-25 budget for an increase to the nursing complement at all three area hospitals to facilitate flow.
• Paramedic aides on board and deployed at Windsor Regional Hospital campuses.
• 20 new net paramedics deployed.
• Two net new ambulances operational.
• Two net new district chiefs to provide support in the communications centre seven days a week, 12 hours per day.
• Daily "huddles" twice per day with hospital leadership to discuss operational demands and strategy.
• Sharing the EMS operational dashboard with hospital leadership.
• 24/7 notification to "all parities" on EMS code status changes.
• Upstaffing more ambulances in periods of high call volume.

Lammers took over as chief of the paramedic service in October 2023 from retiring chief Bruce Krauter, who left the job in February. He had previously been the service's deputy chief of planning and resources.