Hamilton Paramedic Service: Info and Updates

Chief Michael Sanderson and Deputy Chief Russell Crocker of the Hamilton Paramedic Service visited the Waterdown Library to provide updates and information about EMS service in Hamilton, along with key pieces of information regarding Ward 15.

Info at a glace:

• Half of all ambulance users are 65+

• In 2023, there were 88,345 calls to #911 across Hamilton asking for an ambulance.  Because some 911 calls required more than one ambulance, there were just under 102,000 responses. 

• In Ward 15, there were 2,187 calls from Ward 15

• Ambulances have a cross-coverage expectations legislated into their operations. Hamilton will cross into other municipalities when we are the closets available response unit, and we receive the same service from municipalities on which we border.

• At present, one ambulance and one rapid response unit are always stationed in Waterdown. In 2025, an additional 12-hour ambulance will be added to the current Waterdown Paramedic Response Station on Parkside Drive during times of high demand.

• The provincial government standard established in 2000 for response time is 10 minutes or less, 9 time out of 10. In Ward 15, that standard is met 72% of the time for all emergency calls.  For the smaller subset of emergency calls where the paramedic assesses the patient as having a life-threatening condition an ambulance is on scene in 10 minutes or less 78% of the time.  EMS tends not use ‘averages’ in its language, as an average time is the “half-way” measure, it is always lower but not as meaningful a statistic.

EMS Chief and Deputy Chief’s presentation:

Q & A with the audience, following the presentation:

Q – Will the ambulance at Station 24 stay in place after new joint police/fire station is built in Waterdown?

Yes, it will. If the City approves construction of the proposed 2 bay station at the planned police/fire campus our intent would be to add a 12- and 24-hour shift at the new campus.

Q – Do you keep lists of where migrant workers live along with how many people are inside a dwelling?

No, there is no list of migrant workers per se, as the Ministry of Health operates the dispatch centre. That said, they do have the ability to flag specific addresses and add special notes (such as accessibility concerns or key pieces of info), so what your suggestions can be documented and on file with dispatch.

Q – Do you keep stats on what causes longer response times?

Yes, we use a tool called First Watch to help us with that analysis. Most often, the answer to why is an ambulance ‘delayed’ is simply time and distance, both traffic and/or weather conditions could be factors as well.

Q – Do calls vary by season or by day of week?

Interestingly, no. At least, not by call volume, which remains relatively consistent throughout both days of the week and by months of the year. However, what is also clear is the variance in call style.  For example, in the summer, we receive a higher volume of calls associated with health impacts due to hot weather, especially after a few days within a heat alert. As you can imagine, slips, trips, and falls are more common in winter months. By day of the week, we see a similar trend, the number of calls stay consistent, but the style of call can change wherein traffic accidents are higher during weekdays. In the end, call volume remains very similar through the year. 

Q – What is the average response time for all calls in Waterdown?

The time value is 13 minutes and 12 seconds at 90th percentile. Which means 9 times out of 10, Hamilton EMS arrives in a little over 13 minutes.

Q – At present, Waterdown / Ward 15 uses EMS the second least often of wards in Hamilton. But as one of the fastest growing areas, what does the future hold?

Undoubtedly, Waterdown / Ward 15 will use EMS service more frequently going forward. We hope to have approval to include a new two bay satellite station at the forthcoming joint police/fire station, to be located at Parkside Dr. and highway 6. Once that happens, we believe that we’ll lower the 90th percentile response time to under 10 minutes.

Q – What are the mental health support programs in place for paramedics?

There is likely no such thing as enough mental health support for EMS personnel. We have an active mental health support team, though this is a conversation that can’t simply be viewed as a municipal problem, the province has a role to play. Presumptive legislation by the province has increased the number of paramedics on leave by 10% due to mental health challenges, but the issue is that there is a delay in reintegrating paramedics into active duty due to WSIB. Hamilton Paramedic Service currently has a very active Peer Support Team supported by a certified psychologist. Additionally, the service educates paramedics in how to recognize both their own mental health issues and others. Finally, we have developed an extensive vault of resources for staff to support their mental health issues.

Q – We had many code zeros years ago (which means no ambulance was available). Previous City Councils worked hard to reduce this from happening. Today, if an ambulance arrives at the ER, how long do they stay there until the patient is admitted to hospital? Years ago, the time delay was 3.5 - 4 hours.

At present, 90% of the time EMS responders are at a hospital for less than one hour. Hamilton EMS is funding multiple nurses and providing additional equipment (such as stretchers) with Hamilton hospitals to ensure effective off-loading of patients and dramatically reducing the time to return to patrol.

The leadership of Juravinski Hospital was particular transformative in shaping the path forward and has become a model for both Hamilton and other cities in the province. Juravinski went from being the worst for delays in EMS leaving the hospital to now being inside the top 10 in the province for timely hand-off of patients.

Q- What is the protocol for Fire vs EMS responding during a 911 call?

Our first responders have a tiered response agreement. This agreement sees the Ministry dispatch requesting Fire to respond to some emergency calls where they may be able to provide a life-saving intervention should they arrive ahead of the ambulance.  For example, Hamilton fire fighters are trained and equipped to handle issues of shortness of breath, cardiac arrest (boasting AEDs on their vehicles) and have advance first aid training. It’s not a competition as to who “gets there first”. It’s about getting effective help to patients as fast as possible. In ward 15, about 10% of calls are tiered to the Fire service which means that sometimes both fire and paramedics go to the same call to provide critical support to the patient. 

Q – What happened to the amalgamated services running together in the past?

I came in as EMS Chief in 2013. Since that time, we now have less management team members then we did at the time. The two services are coordinated, but they work much better as separate departments.