Author Site Reviewresults

G.7.1 Emergency Department Closure or Delay in Transfer of Care


Paramedic Services Effective Date: April 30, 2019
Topic: Stakeholder Relations

Replaces: July 1, 2004

Subject: Emergency Department Closure or Delay in Transfer of Care Policy No. G.7.1.



To provide guidelines to Paramedics in the rare event that a hospital Emergency Department is closed, placed on diversion, or implements an ambulance offload delay (AOD) scenario for any reason.

  • Paramedics
  • Paramedic Superintendents
  • Senior Managers


  1. If any Emergency Department has been deemed closed to inbound Paramedic Services, for any reason, patients will be taken to the closest alternate hospital considered to be open to patients.  
  2. Notification of any Emergency Department closure should be communicated to Paramedic Services and the MOHLTC CACC in advance of such an action, and this information shall be shared with Paramedics through internal communications methods.  
  3. Where any Paramedics are required to transport a patient to an alternate receiving facility and that destination is not the closed most appropriate facility, Paramedics shall complete an Incident Report detailing the circumstances surrounding the event.  
  4. If a receiving Emergency Department is unable/unwilling to immediately accept the transfer of care for any patient, leading to an AOD event, Paramedics shall notify CACC of the AOD status and await ACO direction. Paramedics shall confirm with the CACC that the Paramedic Superintendent has been advised of the AOD event.  
  5. Paramedics shall continue to provide care for their patient within their scope of practice until transfer of care occurs.  
  6. If Paramedics have reason to suspect that a receiving facility may not immediately accept a patient being prepared for an interfacility transfer, the departure of this patient will be held until such time as the ACO can confirm immediate acceptance at the receiving facility. In such an event, Paramedics may be cleared for emergency coverage by the ACO.

MSDSB Paramedic Services Deployment Plan