Plan in place to stop EMS offload delays, but there's a hitch

The provincial government has put in place funding for an offload nurse at hospitals across the province in hopes of reducing paramedic offload delays, but a nursing shortage at Sault Area Hospital is proving to be bump in the road for the plan.

Offload delays are a problem across the country, said Katie Kirkham, chief of Sault Ste. Marie Paramedic Services. They occur when a paramedic crew arrives at the hospital’s Emergency Department (ED), but nursing staff are unable to take over care of the patient.

In response, the local Social Services administration board, through funding from the Ministry of Health, has been funding ED offload nurses to accept patients and allow paramedics to get back on the road more quickly.

The problem, said Kirkham, is Sault Area Hospital (SAH) does not always have the staffing resources to actually have an ED offload nurse in place.

“Unfortunately, they have a lot of staffing issues. We are filling in the gaps with paramedics,” said Kirkham of Sault Area Hospital’s staff shortage.

Brandy Sharp Young, manager of communications at SAH, said the hospital is experiencing the same nursing shortage as the rest of the province.

“We continue to experience staffing challenges in the Emergency Department, and we remain diligent in our recruitment efforts,” said Sharp Young. ”Currently, the ED offload nurse position is staffed when we have appropriate nursing resources in the Emergency Department.”

At times, said Sharp Young, the ED offload nurse has to be redeployed to provide patient care.

The provincial pilot project put in place to fund nurses dedicated to handling the intake of patients has been renewed for the next three years via $51 million in funding announced in the Ford government’s budget that was announced on Thursday.

In Sault Ste. Marie, that translates to $75,000 which Kirkham said will meet the needs of the service until the end of the fiscal year.

”We are hoping that we will receive a greater allocation for the next fiscal year, because we’ll be covering a greater time period,” she said.

Last month, the maximum number of hours a paramedic crew spent on a single offload delay was seven hours, 12 minutes. 

For February 2023, there was 79 fewer patients affected by offload delays versus the same month in 2022, but the total offload hours went from 335 hours up to 384 hours when comparing the same two months.

Offload delays affect the paramedic service by necessitating upstaffing (call in shifts), as well as having a negative affect on call times because paramedics who would otherwise be available to take a call are stuck in the ED with patients.

The offload delays also have an effect directly on the paramedics who are stuck in the Emergency Department with patients waiting to be seen, including missed meal breaks and forced overtime. 

Kirkham said compared to other northern Ontario communities, Sault Ste. Marie is faring worse than most. She plans to update the board next month with comparative statistics to other northern Ontario communities.

Offload delays have become such a problem that Kirkham has moved from reporting on them in a quarterly report to now presenting them to the local Social Services administration board on a monthly basis.