Response Time Standards - Issue Report

Report To: Manitoulin-Sudbury District Services Board

From: Paul Myre, Chief of Paramedic Services

Date: April 18, 2024

Re: Response Time Standards

Background

Paramedic Services across Ontario are required by law to establish a performance plan for the following calendar year regarding overall response times to calls for service.  As per the Ambulance Act of Ontario, Regulation 257/00, the term “Response Time” is defined as the time a notice is received from a Paramedic Unit by a Central Ambulance Communications Centre (CACC) to the arrival on-scene of the Paramedic Unit. 

The plan must provide targets for Paramedic Service response times to 911 calls sequenced by acuity using the Canadian Triage and Acuity Scale (CTAS). This tool prioritizes patients based on their chief complaint on a scale from 1-5, 1 being the highest severity and 5 being the lowest. The plan must also include Paramedic Services’ target response times to all Sudden Cardiac Arrest (SCA) calls. The Ministry of Health (MOH) establishes the expected response times for all SCA (6 minutes or less) and CTAS 1 (8 minutes or less). 

The Paramedic Services sets the expected response time targets for all other calls. The legislation further mandates that Paramedic Services not only establish a plan but also must ensure that the plan is continuously maintained, enforced and evaluated.  By no later than October 31 in each year, Paramedic Services must submit a copy of the established plan for the following year including expected targets to the Ministry of Health. A complete copy of the previous year’s performance including the percentage of response times to Sudden Cardiac Arrests, CTAS 1,2,3,4 and 5 must be submitted to the MOH by no later than March 31st.

Current State

As reported to the board in February of 2023, our 2022 submission to the Ministry of Health (Figure 1) demonstrated that Paramedic Services achieved all but one of the target Response Time Standards. This was a significant improvement from our 2021 submission where the service had missed all but one of the six (6) response time targets. The Board may recall that the service implemented approved countermeasures in 2022 that were designed to address holes in our response capacity that were within Staff’s realm of control. As described in the April 2022 issue report, a second transporting unit was deployed in Wiikwemikoong along with a PRU in Little Current to mitigate unavoidable gaps in emergency coverage in our high-volume areas. The service also entered into a tiered response agreement with the municipality of French River which permitted Staff to cease the practice of moving the Hagar crew to standby in Noëlville whenever the Noëlville crew was transporting a patient to Sudbury or Sturgeon Falls. Staff are pleased to highlight that the recent addition of a tiered response agreement with the Municipality of Killarney Volunteer Fire Department has proven to be an effective and positive countermeasure to response gaps in Killarney.
 

Figure 1

Staff are proud to report that our 2023 Response Time Standards targets were achieved with the exception of our 6-minute response to Sudden Cardiac Arrests (SCA) (Figure 2). Given our geographical and sparse population challenges, an average 6-minute response 30% of the time for SCA is not a realistic target for our service.  However, staff are pleased to report that our average response time to SCA has improved in 2023 to 13 minutes from 17 minutes in 2022.

Figure 2

*Plan in minutes established by the Ministry of Health

Conclusion

Staff will be submitting our 2023 Response Time Standards performance to the Ministry of Health in draft by the March 31, 2024 deadline pending board approval on April 18, 2024.   By comparing our 2021 response times performance to our 2022 & 2023 results, our deployment plan and permanently implemented countermeasures continue to effectively address some of our previous gaps in our response capacity.