Health

Offload Delays Emergency Declaration Moves to Monitoring Phase

The number and duration of Code Blacks has declined from crisis levels since the County of Essex declared a local emergency in response to escalating ambulance offload delays. We are continuing to work with our regional hospital partners and the Province on long-term solutions to address the systemic issues that contribute to these delays.

The County of Essex declared a local emergency on Oct. 17 in response to a sharp rise in Code Blacks, situations when there are no ambulances available. Code Blacks totalled 491 minutes through the first two weeks of October compared to 116 minutes in all of September, 77 minutes in August and 31 minutes in July.

On Oct. 12, Essex-Windsor EMS experienced 216 hours of offload delays and went into a Code Black for about three hours as all 26 rostered ambulances were experiencing offload delays outside area hospitals. That compared to the previous five-day average of 100 hours of offload delays. There have been just two Code Blacks since the emergency was declared, each lasting for a few minutes.

While there have been no systemic changes that would warrant rescinding this local emergency, the situation has stabilized to the point we can move to the monitoring phase. The monitoring phase requires the County to report biweekly to the Ministry of Health, Ontario Health, area hospitals, the Central Ambulance Communications Centre and other partners.

This does not mean the crisis is over. Nor does it mean we can stop working toward long-term, sustainable solutions to minimize offload delays and maximize the time ambulances spend on the road responding to emergency calls. The Community Control Group remains in a position to act should the situation again escalate to crisis levels.

It is important to note that offload delays are not the fault of our hospital partners. They have worked diligently and creatively to mitigate them and have worked with us to encourage residents to seek alternative forms of care for non-emergency issues.

The causes of offload delays are complex and connected to longstanding systemic issues related to hospital capacity, patient flow and a lack of local primary care providers, which causes increased usage of the 911 system.

We continue to work with the Ministry of Health and our regional partners on proposals to reduce offload delays. These include:

  • Provincial recognition of offload delays as a public health risk.
  • Implementing Fit-to-Sit programs at area hospitals for low acuity patients.
  • Having an Essex-Windsor EMS Navigator in the Central Ambulance Communications Centre.
  • A pilot project utilizing the Mobile Medical Unit at ERs.
  • Alternate destination and treat and refer protocols.
  • Additional Dedicated Paramedic Offload funding.

The stress on our local health care system is immense and there are real risks the situation could deteriorate as we enter flu season, which also brings with it the potential for escalating cases of COVID-19.

Windsor and Essex County residents can help relieve pressure on the local health-care system by taking some simple steps to avoid catching and spreading the flu to others. These steps include:

Residents should always phone 911 if they are experiencing an emergency. Examples of medical emergencies when you should call 911 include (but are not limited to):

  • Chest pain or tightness
  • Sudden severe pain
  • Shortness of breath or difficulty breathing
  • Choking
  • Possible broken bones
  • Uncontrollable bleeding
  • Sudden dizziness or vision problems
  • Sudden weakness, numbness and/or tingling in the face, arm or leg
  • Sudden difficulty speaking
  • Severe burns or allergic reactions
  • A child with diarrhea and vomiting who won’t eat or drink
  • A baby under six months with a fever over 38.5 C (101 F)

For non-emergency situations, residents are reminded they have multiple options available to them and that calling an ambulance does not get them to the front of the line at the emergency room, where patients are triaged based on the severity of their condition.

Those options include:

  • Contact your doctor or go to a walk-in clinic.
  • Set up a virtual appointment with a physician using the Urgent Care Ontario website, a service available to residents of Southwestern Ontario.
  • Visit Health Connect Ontario or call 811 to talk to a registered nurse 24 hours a day, 7 days a week. You do not need to provide your OHIP number and all information is confidential.
  • Call Telehealth Ontario at 1-866-797-0000.
  • Call 211 to find out about health-care services in Windsor and Essex County.
  • Use alternate transportation to go to a hospital emergency room.

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