Ending Paramedic Hallway Waiting

1. Paramedic Hallway Waiting – RGH Pilot Project
May 2017
Purpose:
The practice of Paramedics waiting in Hospital ER Hallways will end. This practice
is unsustainable for reasons discussed and the purpose of the RGH Pilot Project is
for EMS to assist Hospitals with developing strategies to cope with this eventuality.
Requirements:
A working group of Hospital and EMS staff committed to developing and
implementing, on a very short timeline, strategies that allow the immediate
acceptance of patients arriving by EMS into Hospital care. This RGH Pilot Project
would ideally begin testing before the end of June 2017.
Background:
For 15 years EMS has be asked to wait with patients as a temporary solution to
Hospital emergency overcrowding. Today inpatients sometimes fill the majority of
emergency department beds, often for several days, before moving to a ward.
As EMS call volume increases, our budget shrinks and we are finding it increasingly
difficult to cope with our own work. Adding resources is currently not possible.
Red Alerts, where there are no ambulances available to respond to calls, are
becoming a daily occurrence. On the afternoon of Wednesday May 31, 2017 we had
a typical Red Alert – NO AMBULANCES AVAILABLE - with 5 emergency calls stacked
waiting to be dispatched, while at the same time EMS had 27 of our Ambulances and
Paramedic Crews either waiting at triage or stuck in the Hospital hallway.
Patients who call 911 because they have a medical emergency are being punished
with delayed responses because of delays EMS faces returning crews into service
from Hospitals. Paramedic Crews are getting no rest, no training, missing meals and
incurring overtime on late trips as a direct result of the long hours EMS spends
waiting every day in the hallway. Safety issues for Paramedic crews are also arising.
There is now ample evidence that patients who are forced to wait to be seen in the
Hospital emergency hallway suffer harm. Paramedic care in the hallway is
suboptimal and demanding that we wait with patients is causing our core function
of Pre-Hospital Care to be eroded. Now there is evidence that we may actually be
PREVENTING the Hospitals from finding a sustainable solution to their problem.
Summary:
There are EMS and Hospital systems that do not suffer Paramedic Hospital waits as
we do. There are Hospital systems every bit as busy as ours that do not even
employ a Triage RN for EMS patients, where Paramedics are responsible for
delivering patients directly to the Hospital ER area where they will be treated.
I can only reiterate that there is no question that the current practice of Paramedics
waiting in Hospital hallways will end. It is only prudent for those of us who are
responsible and ultimately accountable for the health, safety and well-being of the
Albertans we serve to find solutions NOW, so that it ends in a praise worthy fashion.