DUFFERIN COUNTY PARAMEDIC SERVICE

DUFFERIN COUNTY PARAMEDIC SERVICE 2015-2016 ANNUAL REPORT

Table of Contents Patient Stories... 2 Vision, Mission, Values... 3 Our Service... 4 Our People... 5 System Performance... 6 Program Development... 7 Strategic Direction... 10

Patient Stories This was the first time I have ever called an ambulance and the paramedics were very professional, knew exactly what to do and helped to calm my fears about what was happening to me. I feel very fortunate that we have such service so close to home. Our communities are extremely fortunate to have this extraordinary competent service. Best in the province. Thank you The paramedics were great. They took care of all my needs and helped me understand what was happening, I couldn t have received any better care. Thank you I have only high praise for the personnel who attended to my wife when she fell. Their care, concern and professional manners were all exceptional. I am so glad that such a caring system exists in the country for our benefit. The paramedics have saved my life before. I am very grateful to them. May God bless all of them with the strength they used to continue this service. This was a wonderful, competent, caring team. I would like to pass along many thanks. 2 P a g e

Vision, Mission, Values Our Vision Exceptional Experience Every Time Our Mission To provide high quality and compassionate care, in collaboration with our partners, to optimize the health of our community. Our Values To realize our Vision and Mission, we have three core values. These values are intended to be a message for all of our staff, volunteers and community about what is important for our continued success. They are the basis for performance evaluation, recruitment and our staff recognition program. CARE*CARE*CARE We are committed to caring in a sensitive, respectful and supportive way for those we serve and those we work with. BUILD BRIDGES We work collaboratively within our organization and with our external partners to ensure we provide the best standards of health care services. ASK*SEEK*EXPLORE We promote a culture of learning and innovation to effectively meet the evolving needs of our patients, staff and community. 3 P a g e

Our Service The Dufferin County Paramedic Service (DCPS) is responsible for the delivery of Paramedic Services as defined by the Ambulance Act of Ontario. Since the downloading of paramedic services in 2001, the Province of Ontario funds 50 per cent of land ambulance services. Since 2001, DCPS has strived to be a model for all other Paramedic Services within the Province of Ontario. Through the professionalism and dedication of the paramedics and administrative staff, we have created a dynamic organizational culture of service excellence. The Dufferin County Paramedic Service provides emergency medical coverage to over 56, 000 residents covering 1,486 square kilometres. Services we provide include Advanced Life Support, Community Paramedic Program and Public Access Defibrillator Program. Table 1: Dufferin County Paramedic Service Profile Area Served The County of Dufferin Geographic Coverage 1,486 km² Base Population (2011 Census) 56, 881 Percentage of Population over age 65 13% Advanced Life Support Services Provided Community Paramedic Program Public Access Defibrillator Program 4 P a g e

Our People Our people are the greatest asset within the Dufferin County Paramedic Service. The 54 members including front-line Paramedics, an Administrative Assistant, a Deputy Chief and a Chief work together to provide an Exceptional Experience Every Time to those requiring our services. Our team has a variety of backgrounds and skill sets that contribute to the successful delivery of paramedic services within Dufferin County. All Paramedics employed by DCPS are college graduates and are delegated by the Medical Director of the Regional Base Hospital Program to perform Medical interventions under the regulated Health Professions Act. As such, they are certified to administer numerous medications and perform an extensive list of controlled medical acts for patients requiring their services. In addition, approximately 49 per cent of DCPS Paramedics are certified as Advanced Care Paramedics, which means they are certified to administer an expanded list of medications, advanced airway management and cardiac interventions. This ensures that those requiring the services of DCPS receive the highest level of care. In 2015, an Advanced Care Paramedic attended 81.5 per cent of all responses. 5 P a g e

System Performance Paramedic Call Volume Dufferin County Paramedic Service strives to provide the best possible care in a timely manner to the residents and visitors of Dufferin County and surrounding area. In order to achieve this, our administrative team continuously monitors response call volumes, response times and patient outcomes. Table 2: Paramedic Call Volume by Year shows that call volume has been increasing over the past five years. From 2011 to 2015, the number of emergency calls has increased by 18 per cent with no additional up-staffing. Table 2: Paramedic Call Volume by Year 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 7658 Call Volume 8532 8352 9367 9053 2011 2012 2013 2014 2015 Paramedic Response Time Standards DCPS continues to meet the legislated and council-approved response time standards. The current response time reporting framework is defined as the elapsed time from when the first Paramedic unit is notified to the arrival of a Paramedic unit on scene. Response times across the Province of Ontario are all measured and publicly reported in the same manner to the Ministry of Health and Long-Term Care. Table 3: outlines the legislated response time standards and results based on the Canadian Triage Acuity Scale (CTAS). The percent rank target represents the percent of time that a paramedic crew arrives on scene within the established target response time. Table 3: Response Time Standards Category Target Time (Minutes) Percent Rank Target 2015 Performance CTAS 1 8 minutes 60% 66.67% (most urgent) CTAS 2 15 minutes 90% 95.19% CTAS 3 30 minutes 90% 99.94% CTAS 4 30 minutes 90% 99.19% CTAS 5 (least urgent) 30 minutes 90% 99.66% Sudden Cardiac Arrest Response Time Standard In cases of sudden cardiac arrest, response time is defined as the elapsed time from when the first paramedic unit is notified to the arrival of any person trained and equipped to provide defibrillation. This response time is greatly impacted by the availability of a public access defibrillator, which can be found in various locations throughout Dufferin County including recreation facilities, schools, municipal buildings and fire departments. Table 4: outlines Dufferin County Paramedic Service s performance against the legislated response time standard for Sudden Cardiac Arrest. Table 4: Sudden Cardiac Arrest Response Time Standard Category Target Time (Minutes) Percent Rank Target 2015 Performance SCA 6 minutes 25% 25% 6 P a g e

Program Development The Dufferin County Paramedic Service remains committed to promoting and supporting improved clinical care, safety and quality. When a member of the public requires immediate medical care, an entire team of dedicated, highly qualified people come together to provide the highest level of care possible. The Paramedic Service uses the data collected from electronic Patient Care Reports (epcr s), Ambulance Communication Centre and various hospitals that receive patients from DCPS, to assist with the decisions that will impact the direction of the service in the future. All data collected during the course of a Paramedic s duties is protected under the Personal Health Information Protection Act and can never be shared outside of the circle of care. Table 5: outlines the Top 10 call types based on our Paramedics assessment of the patient once on scene. Table 5: Top 10 Call Types in 2015 Call Type # of Calls in 2015 General Illness/Weakness 579 Behaviour/Psychiatric 346 Abdominal Pain Not Yet Diagnosed 284 Respiratory Distress 280 No Complaints 245 Transfer (other) 197 Ischemic Chest Pain 192 Soft Tissue Trauma/Pain/Edema 163 Lift Assist Required 163 Quality Assurance As mandated by the Ambulance Act of Ontario, each Paramedic Service must have a vigorous Quality Assurance Program that oversees the daily activities of all Paramedics employed by the service. Dufferin County Paramedic Service currently exceeds all mandated requirements for a Quality Assurance Program by completing 7 P a g e

Program Development audits of 100 per cent of epcr s, on scene Paramedic evaluations, yearly performance appraisals and quarterly performance reports. This program leads to DCPS providing the best possible service to the residents and visitors of Dufferin County. been a 50 per cent reduction in the number of unnecessary 911 calls, ED visits and hospital admissions.the program has led to a larger network of community partners working together to improve the patient experience in our region, through the health links program. Education All Paramedics must complete various types of education on a yearly basis in order to maintain their Paramedic certification. Every year, our Paramedics undergo an Annual Practice Review conducted by the base hospital, and earn a predetermined number of Continuing Medical Education credits. In addition, Paramedics must complete service related training. Over the past year, this service-related training focused on new equipment, changing standards and an annual review of health and safety-related topics. Community Paramedic Program After securing funding from the Central West Local Health Integration Network (LHIN), Dufferin County Paramedic Service initiated our Community Paramedic Program in January of 2015. This program connects the most vulnerable patients to the most appropriate entry into the health care system. By using a number of strategies and approaches personalized to each patient s particular needs, the Community Paramedic Program reduces the number of unnecessary 911 calls and emergency department (ED) visits, decreases the number of hospital admissions, and shortens the length of stay for patients who need to be admitted to hospital. The Dufferin County Community Paramedic Program has been extremely successful in many areas. For patients enrolled in the program, there has Dedicated Nurse Funding Once again, Dufferin County Paramedic Service, in partnership with Headwaters Health Care Centre, secured funding for the Dedicated Nurse Funding Program. This program allows Paramedics to transfer the care of low priority patients to a nurse in the ED who is only responsible for taking care of patients at times when the emergency department is unable to accept responsibility of the patient due to patient volumes. This allows Paramedics to once again service emergency calls in the community. Ideally, a Paramedic crew should be able to transfer care of a patient to ED staff within 30 minutes of arriving at the hospital. Table 6: 90 th Percentile Patient Offload Time depicts the amount of time required to transfer care of a patient 90 per cent of the time. 8 P a g e

Program Development Table 6: 90 th Percentile Patient Offload Time Year Time 2013 01:09:00 2014 01:08:00 2015 01:04:00 Program Data In cooperation with various community partners, Dufferin County Paramedic Service participates in regional and provincial programs aimed at improving patient outcomes. Over the years these programs have continued to evolve and currently DCPS has five programs in operation including CVA Bypass, STEMI Bypass, Code STEMI, Sepsis Alert and Paramedic Referral. The CVA (commonly known as Stroke) Bypass program is a provincial program that transport specific patients suffering from an acute stroke to a hospital that specializes in the treatment of these patients. STEMI Bypass is a program within Dufferin County in which patients in the community who are suffering from ST Elevation Myocardial Infarction (STEMI) are transported directly to Southlake Regional Hospital for a life-saving procedure referred to as Primary Percutaneous Coronary Intervention (Primary PCI). Code STEMI occurs when patients present to HHCC ED suffering from a STEMI, these patients are also immediately transferred to Southlake Regional Hospital for Primary PCI. Sepsis Alert involves a highly integrated program involving advanced notice for the ED of patients suffering from life threatening infections that have high rates of mortality. Paramedic Referral involves referring those patients who are most vulnerable and consistently high users of the health care system to alternative sources of health care, so that they will receive the right care, at the right time in the right place. Table 7: Program Data shows the number of patients DCPS enrolled into these programs. Table 7: Program Data Program Patients Enrolled CVA Bypass 17 STEMI Bypass 15 Code STEMI 15 Sepsis Alert 32 Paramedic Referral 64 Public Access Defibrillation Program Dufferin County Paramedic Service manages the Public Access Defibrillation (PAD) Program within Dufferin County. Currently there are over 100 PAD s available throughout the county in various municipal buildings, recreation centers and public facilities. Since the start of the PAD Program in our county, there have been five saves directly attributed to PAD use. 9 P a g e

Strategic Direction The Province of Ontario is embarking on the province s first major health care reform in over a decade. These changes will ensure our health care delivery system is cohesive, responsive to local needs and provides equitable access across the province. In order to achieve this, the government is considering amending the current mandate of LHIN s to designate them as the bodies that will integrate primary care, home and community care, acute care, mental health and addiction services and public health across the entire health system. Currently, many of these organizations work independently which does not allow for an integrated approach to health care which has proven to be the most effective. Paramedics often act as a portal for patients accessing the health care system. As such, we experience first-hand many of the inequities in health care delivery and health outcomes the government is looking to address. With programs like the Community Paramedic Program and the Dedicated Nursing Program, DCPS has already proven its willingness to participate in these new initiatives by working with community partners to find a solution that works for Dufferin County. As always, Dufferin County Paramedic Service is committed to improving upon its core business objectives of providing the best care possible in a timely manner. When residents of and visitors to our county call 911, they expect to receive a professional, competent team member that will attend to their pre-hospital needs. We are proud to continue to provide these important services to Dufferin County. 10 P a g e

DUFFERIN COUNTY PARAMEDIC SERVICE 325 Blind Line Orangeville, ON L9W (519) 941-9608