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Essex County Council Rejects Changing EMS Response Times

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A Vote of 8 to 6 Opposed to Changing the Target.

Essex County Council is the delivery agent for Windsor Essex EMS, that means we are responsible for setting the response time targets for Land Ambulance. In providing performance reports to the Ministry, each municipality must
report on:
The percentage of times that sudden cardiac arrest patients received assistance from a person equipped to provide defibrillation within six (6) minutes from the notification of a call by an ambulance communication service.
The percentage of times that an ambulance crew has arrived on scene to provide ambulance services to sudden cardiac arrest patients or other patients categorized as CTAS 1 within eight (8) minutes of the time of notice is received respecting such services. The percentage of times that a paramedic arrived at a location of a patient determined to be CTAS 1, 2, 3, 4 or 5 within a period of time determined appropriate by the municipality.

CTAS 1 Resuscitation
Conditions that are a threat to Life or Limb (or imminent risk of deterioration) requiring immediate aggressive interventions. A typical CTAS 1 patient is non-responsive or vital signs absent/unstable.
CTAS 2 Emergent
Conditions that are a potential threat to life, limb or function, requiring rapid medical intervention or delegated acts. A typical
CTAS 2 patient may be non-responsive, with diminished vital signs and in an unstable condition.
CTAS 3 Urgent
Conditions that could potentially progress to a serious problem requiring emergency intervention. May be associated with
significant discomfort or affect the ability to function at work or activities of daily living. A typical CTAS 3 patient will be responsive, may be confused, and vital signs will be stable although may be out of normal parameters. This patient may deteriorate or have an underlying medical condition causing concern.

CTAS 4 Less Urgent
Conditions related to patient age, distress, or potential for deterioration or complications would benefit from intervention or
reassurance within 1-2 hours. A typical CTAS 4 patient is not in a life-threatening condition, vital signs are stable, maybe in slight distress, and requires medical attention but not of urgency. This patient may be best suited for an alternate level of medical care or service.
CTAS 5 Non-Urgent
Conditions that may be acute but non-urgent as well as conditions that may be part of a chronic problem with or without evidence of deterioration. The investigation or interventions for some of these illnesses or injuries could be delayed or even referred to other areas of the hospital or health care system.

Current Response Time Targets

The Proposed Change- Rejected on Sept 6th

Council voted NOT to change the response times proposed below in the chart and majority voted to remain status quo.

AM 800 Article by Meagan Delaurier-

A plan for how fast an ambulance responds in Windsor-Essex will remain the same for 2024. 

During the County Council meeting on Wednesday evening, Essex-Windsor EMS Chief, Bruce Krauter, presented a report to update the 2024 Land Ambulance Response Time Standard Performance Plan.

The plan, which was created in 2012, hasn’t been updated since its inception.

The plan follows a response time based on medical urgency, where Sudden Cardiac Arrest is the most urgent, and then it ranges on the Canadian Triage Acuity Scale (CTAS) also based on urgency, where CTAS 1 is extremely urgent, and CTAS 5 is considered non-urgent. 

Local health system pressures continue to impact response times and performance in 2023, including continued offload delays, decreased hospital capacity, increased backlog of health care follow-up and treatment, paramedic fatigue, an increase in EMS call volume, among many other local issues.

Krauter explains that recommended in the 2024 Plan is to alter the response times for CTAS 3, 4, and 5, which are considered non-life-threatening conditions, to increase speed and urgency based on patient conditions. 

Council decided to vote against the new 2024 Plan, and voted in favour of keeping next year’s plan the same as the current 2023 Plan. 

Krauter says there are benefits to altering the response time. 

“This can sound like I just want to change numbers to meet the performance plan, but it actually gives us the latitude of delaying calls reasonably so that we can keep the resources available for the right call, and at the right time.”

Sherry Bondy, Essex Mayor, says she feels this is a way to make the region look better on paper, and she’s not happy with that. 

“This is a big deal, and it’s a slippery slope. And what’s going to happen if we can’t meet targets, are we going to come back in one more year and say ‘let’s lower targets again, let’s lower targets again, let’s lower targets again, let’s lower targets again’. What used to be an A+ is now a D+ and hey, you’re fine, you’re passing, you’re doing great.”

Crystal Meloche, LaSalle Mayor, says she doesn’t want this to impact the region’s health care needs.

“I worry that if we lower them and we start hitting those targets all the time, is the province going to look at us and say ‘you guys are doing great, you’ve hit all your targets, you’ve hit all your marks, you don’t need funding, we’ve got other areas not even close to their targets and we’re going to focus on them’. I’d be afraid that by us making this drastic change, we may be looked at different down here as far as what our health care needs are, or will be in the future.”

There would not have been penalization or impacts from the Ministry if Essex-Windsor EMS didn’t meet the new response time requirements, they would be for reviewing and report purposes.

Krauter states that the plan can be altered at any time during the year, and if council wishes to update any times or other criteria that he can do that in 2024. 

County Council also approved the recommended creation of the Offload Assistant Program and to utilize the Safe Restart Funding in 2023 to address the unbudgeted amount of $67,000.

Administration will bring forward for consideration during the 2024 Budget deliberations a staffing enhancement of 24 paramedics and a review and refresh of the 2019 Essex-Windsor EMS Master Plan.

The Vote

The link to meeting agenda and video

https://coe-pub.escribemeetings.com/Meeting.aspx?Id=e5a49be6-01a2-4756-9d15-967b8ad0027b&Agenda=Agenda&lang=English&Item=27&Tab=attachments