Background
Emergency Medical Services (EMS) is committed to promoting the safety and well being of citizens. No longer viewed as just transportation to health care facilities, ground ambulance services and ambulance crews serve as the front-line of our emergency health care system and play a critical role in the provision of emergency care and treatment of a patient's medical condition or traumatic injuries.
Hamilton EMS experiences over 55,000 emergency responses a year, and operates over 20 Transport Vehicles (Ambulances) and PRU's (Paramedic Response Units) during peak times of the day when call volumes are highest. On certain time-dependent life threatening calls, paramedics are assisted by the Hamilton Emergency Service - Fire first responders.
Fire and EMS are the two largest components that make up Hamilton Emergency Services and they work together in the field on a day to day basis. Other then cooperation on the street level they share administration and work together on strategic initiatives.
Dispatch for HES - EMS is operated by the Central Ambulance Communications Centre (C.A.C.C.), which is a part of the Ministry of Health and located on Fennell Avenue.
Hamilton Emergency Services (HES) - Emergency Medical Services (EMS)
Service Commitment as of Year 2007
TIME COMMITTMENT
The current MOHLTC response time standard for the City Of Hamilton is that an ambulance or emergency response vehicle ought to arrive on scene within 10.02 minutes at least 90% of the calls dispatched Code 4. All crews already on a roving assignment are to verify to dispatch that they are mobile in less than 1 minute of being notified by dispatch. The normal reaction time of the staffed ambulance from receipt of vital information to proceed on an emergency call (code 3, 4 & 8) will be a maximum of two (2) minutes from receipt of notification. Also, the normal reaction time of the staffed ambulance from receipt of call information to proceed on all calls other than emergency calls will be a maximum of three (3) minutes from receipt of notification.
COMMITMENT TO STAFFING AND EFFECTIVE STRATEGIES
In an effort to achieve the target response times HES EMS will ensure annually a minimum of 293,488 staffing hours is committed to street service and will encourage through policies with the MOHLTC Central Ambulance Communications Centre deployment of those resources that maximise the effectiveness and equity of responses throughout Hamilton.
HES EMS has 152.6 full time equivalent paramedic positions of which 42 positions are reserved for ACP. Currently the 39 positions are filled with ACP. A portion of positions are staffed with part time staff, currently 2 ACP and 30 PCP. In addition, there are 16 supervisor positions dedicated to Operations, 2 supervisors assigned to education, and 2 supervisors supporting both sectors. All but one supervisor hold their ACP designation. Support service includes 1 data clerk, 1 data coordinator, and 1 scheduler. HES EMS has 3 senior management team members including the Director, and two managers that oversee Operations and Continuous Quality Improvement that maintain their paramedic qualifications. Based on a shared service model HES EMS enjoys support from other divisions and departments for functions related to Shipping and Receiving, Mechanical, Labour Relations, Corporate Health, Human Relations, Purchasing, Finance, Payroll, Corporate Management Team, Information Technology, Risk Management, etc.
Click here for the HES - EMS Organization Structure
Click here for the HES - EMS Certification Document
On a weekly basis the EMS Master Schedule offers coverage of 12 ambulances staffed 24 hours, 7 days a week, and 2 ambulances staffed Monday to Thursday/Friday, and five (5) ambulances on duty 12 hours, 7days a week. Complementing this coverage there are three (3) Supervisor Emergency Response Vehicles (ERV) available 24 hours a day, seven (7) days a week, and (1) ERV 12 hours (day shift), 7 days a week.
HES EMS has 4 staggered start times for the 24h/7day units and all demand shifts have staggered start times. This strategy facilitates a consistent resource/demand ratio and the availability for multiple units to be dispatched for emergencies arising during shift changes. The shift starts times are based on historical data.
COMMITMENT TO THE RIGHT LEVEL OF CARE
HES EMS seeks to maintain a sufficient complement of Advance Care Paramedics (ACP) to maximize the number of patient that are confirmed to be the most critical (Canadian Triage Acuity Scale 1) are attended to by an ACP. The ACP resources are maximised by using various crew configurations and the full time ACPs and the ACP supervisors.
COMMITMENT TO CACC
Any daily adjustments to the HES EMS staffing is communicated no later than the start of each shift to the MOH CACC, and any adjustments during the shift are communicate as they occur. HES EMS has a call out process that is applied in the event during the shift HES EMS falls below our target staffing compliment.
Revised by B. Browett, March 27, 2007