By John McFadden
KAWARTHA LAKES-The man who oversees the paramedic service for both City of Kawartha Lakes and Peterborough Counties said he wants to assure the public, an increase in offload delays at the two hospitals in the Peterborough/Kawartha area is not putting peoples’ health and safety at risk.
Chief of Paramedics Randy Mellow added there have been some recent lengthy delays in transferring patients from paramedic care to hospital care inside the hospitals which is known as offloading.
“When we bring a patient to the hospital, they are triaged and then they are entered into the information system and then we transfer care from the paramedics to the hospital’s medical staff. Normally, in a typical situation, we expect that process to take about 20 minutes for a non-urgent transfer of care. If there’s a cardiac arrest or anything else life-threatening, we transfer them immediately,” Mellow said. “These offload delays are happening here, across Ontario and frankly across the country and there are any number of reasons for it. It tends to impact us more with smaller, regional hospitals than it does for instance in Hamilton where there are 40 ambulances. We only have six in the City of Kawartha Lakes and ten in Peterborough. We can’t afford to lose them to offload delays like big cities can.”
Mellow said the delays are the result of a perfect storm of conditions. They include obviously the global COVID 19 pandemic. He added that Ross Memorial Hospital in particular has been experiencing a higher than average percentage of patients requiring admission (not COVID related) rather than treatment and release, leading to a bed shortage. Mellow said changes to the electronic registration system known as EPIC has also contributed to patient flow pressures. He added there were some offload delays that lasted several hours. Mellow said paramedics and hospital staff have worked collaboratively to ensure the best interest and care of the patients.
“There’s always a domino effect. You can’t take them in the front door if you don’t get them out the back. The issues of long-term care space is also there. All of that is contributing to this.”
The issue of long term care space has been ongoing for years and means there are residents who could be in Long Term Care but due to lack of space in those facilities they are in hospital. They are called Alternate Level Of Care (ALC)patients.
Ross Memorial Hospital currently has 23 ALC patients. Of the 23, 18 are ALC-LTC which means they are waiting for a long-term care bed. That number is down from the average of 40 ALC-LTC patients at the hospital in January 2020 but it still a significant number of hospital beds being used for patients who could be cared for elsewhere, especially during a pandemic.
As of April 19th,2021 there were 4,419 ALC patients in hospitals across the province, of whom 1,912 are waiting for a space in a long-term care home. At that time the province said they were working to get those patients into LTC and open up beds for the pandemic response. We have emailed the Ministry of Health on December 7th, 2021 for an updated number of ALC patients but have not had a response.
Mellow added the issue of offloading has nothing to do with staff shortages caused by vaccine mandates.
“We are not hearing that it is due to a staff shortage at the hospitals,” Mellow said. “We are not down staffing paramedic staff because of people not being vaccinated. Anything you’ve heard otherwise is absolutely not true. What we do have is people who have been working for 23 straight months during a pandemic. If we try to put extra ambulances on the road, it’s not always easy to get people to come into work. Having said that, there are no staffing shortages in Kawartha Lakes or Peterborough. I would bet my paycheque that there are more health care workers off due to stress right now versus not being vaccinated. It’s not even close.”
In an emailed statement to Kawartha411, Kelly Isfan, President and Chief Executive Officer at Ross memorial stated that ambulance offload delays do occur from time to time.
“The emergency department saw high patient volumes and high patient acuity (earlier this month) both of which have been trending up in recent weeks,” Isfan stated. “Wait times can be further impacted by continued vigilance on the part of staff to ensure appropriate testing and isolation of patients who present with COVID-like symptoms as well as some expected delays as our staff and physicians adjust to new workflows related to the hospital’s new EPIC clinical information system.”
Mellow had one final message for the public. He said now is not the time to get frustrated and angry with health care workers including paramedics. He pointed out that when we send soldiers to war we restrict the length of their tours of duty and swap them out with other soldiers. He said that has not happened with front-line health care workers who are fighting their own battle against COVID for almost two years now.