Paramedics want to use taxis to take some patients to hospital
Program scheduled to launch Nov. 1; paramedics 'optimistic' about getting Ministry of Health approval
Ottawa paramedics are launching a pilot program to lean on taxis to help take some patients with less-urgent ailments to hospital, relieving some of the pressure on ambulances.
Pierre Poirier, the chief of Ottawa Paramedic Service, said the program is scheduled to begin Nov. 1. The service is "optimistic" it will get ministry of health approval within weeks.
"In a perfect world, we would not be doing this," Poirier told members of council's emergency and protective services committee on Wednesday.
But Poirier's world is far from perfect, as paramedics often wait hours to offload patients at overburdened emergency rooms. Those delays are primarily responsible for so-called "level zero" events, when there are no ambulances available to respond to new calls.
That's happened 1,088 times in the first nine months of this year.
'We're not getting to that other patient'
"What keeps me up at night is we're not getting to that other patient," Poirier said. "The other patient's waiting in the community, which has necessitated us to look at other options and try to do that as safely as we can."
Patients with what Poirier called "low-acuity" health conditions, like twisted ankles or cuts that require stitches, are most likely to face lengthy waits at emergency rooms.
"There's not a clinical imperative that there's a sense of urgency," he said.
When the pilot goes ahead, paramedics can call a taxi to move those patients, who could then simply walk into the emergency room and be triaged. Meanwhile, paramedics would be back on the road, heading to the next call.
Under the program, paramedics will conduct an assessment and consult with a doctor or mental health professional before calling a cab, according to Poirier. He said the pilot is expected to move about three to five patients each day.
'No silver bullet' for ambulance shortages
The pilot won't solve the ambulance crunch entirely, Poirier said, but it should help.
"Honestly, there is no silver bullet on the issue of level zeros," he said. "Anytime I can not take someone to the hospital and have that paramedic crew available for the next call, that's a bonus."
He said paramedics are looking for other options such as taking patients to alternate treatment options, including pharmacies or clinics with X-ray machines, instead of emergency rooms.
The taxi pilot is scheduled to run for six months, and paramedics will report the results back to committee next year. Poirier said they're now in final negotiations with taxi companies.
The paramedic service applied to the Ontario Ministry of Health about a year ago to seek approval for the pilot.
"We have been notified on several occasions that our approval was imminent," said spokesman Marc-Antoine Deschamps. "We are optimistic that the Ministry of Health approval is forthcoming in the next few weeks."
Councillor raises possible liability concerns
Even if it doesn't, the service will move forward with the taxi pilot under its Mental Wellbeing Response Team for some calls involving mental health or substance abuse issues.
Emergency and protective services committee chair Coun. Riley Brockington commended paramedics for developing the taxi program, though he raised concerns about liability.
"If I'm a taxi driver or a taxi company, I'm going to want assurances from the city that, should the patient's condition worsen, I'm not going to be held liable if something bad happens to that patient, because I'm not a medical professional," said Brockington.
Poirier said Niagara Emergency Medical Services has run a similar program since early last year, and hasn't faced any negative outcomes.
He said Ottawa's program will have additional levels of safety, including the assessments and consultations with doctors. There would also be a line for taxi companies to call paramedics if new issues arise.
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