Calls to Windsor-Essex paramedics expected to reach record highs in 2023, chief says

The number of calls for paramedic service in Windsor-Essex is expected to reach record highs this year, a new report going to Essex County council on Wednesday says, as the region grapples with ways to reduce code black minutes and offload delays. 

Essex-Windsor EMS chief Bruce Krauter writes that call volumes are projected to rise nearly 10 per cent by the end of the year, bringing the total projected call volume to 68,113 calls for service. 

Projections were generated using call response and dispatch data. 

Call volumes for Codes 3 and 4 — or calls that require a prompt or immediate response — are projected to rise 9.95 per cent this year. Calls for codes 1 and 2, or deferred or scheduled calls (like non-urgent patient transportation) are expected to go down, bringing the overall increase in call volumes to 9.87 per cent. 

"This is expected to be the highest volume in the EWEMS' history," Krauter wrote in his report.

Krauter wrote that the "hospital and health-care system continue to be strained."

"The future industrial development in the region, the expected completion of the international crossing, and the ongoing residential development in local municipalities will continue to contribute to the increased volume into the future," he wrote. 

Offload delays, code reds and blacks not isolated to Windsor: Chief

Krauter also noted the prevalence of offload delays, as well as code reds and code blacks, within the region. In 2022, paramedics spent just shy of 15,000 hours in offload delays. where a delay was 30 or more minutes. In 2023, paramedics had spend 9,900 hours in offload delays to Aug. 3. 

The region has also experienced both code blacks and code reds, which mean there are either none or fewer than two ambulances available to respond to incoming calls for service.

While those numbers hit highs in 2022 — around 1,200 minutes in code red in May and November 2022 and 630 code black minutes in October 2022 — those numbers had hit a peak of just 469 minutes in code red and 184 minutes in code black at their respective high points in 2023.

"It must be understood that the current issues with offload delays and hospital capacities are not isolated to the Windsor-Essex region," Krauter wrote. "There are multiple contributing factors that impact EWEMS and create offload delays such as decreased primary care access, the deferral of medical procedures, human resource fatigue and market capacity limitations in the health-care sector."

But there have been strategies implemented to help ease the issues, Krauter notes: funding for a dedicated offload nurse and paramedic offload program and offload to waiting room procedures, known as "fit to sit," Krauter noted.

He also noted communication between hospital staff and health-care partners and supporting applications for extended primary and urgent care in the community, among other strategies. 

The report is coming to council in advance of the county's 2024 budget process, and in light of the service's 10-year master plan, which was passed in 2019. 

Krauter wrote that several initiatives in the master plan are complete or near-complete, like a new paramedic station in Kingsville and re-rostering the schedule to match call volumes. The master plan recommends an increase to paramedic staff in 2024 and in 2026, Krauter noted. 

"In the upcoming budget development, consideration should be given to an increase in paramedic resources, support services, and a refresh of the 10-year master plan," Krauter wrote. "These considerations will prepare EWEMS and the County of Essex for the current, expected and anticipated pressures that paramedic delivery will face."

County council is expected to received and discuss the report at its meeting on Wednesday night at 6 p.m. Residents who choose to attend in person must register in advance online; the meeting is also livestreamed through the county's website.