Ottawa Paramedic Service to launch new dispatch system April 10

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Ottawa is set to launch a new ambulance dispatch system on April 10 that will revolutionize the way paramedics in the region prioritize calls.

Under the Medical Priority Dispatch System, or MPDS, ambulances will be dispatched based on the answers to numerous detailed questions and according to five colour-based levels based on the “acuity” of the situation.

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The top priority will be “purple,” in which there are immediate life-threatening conditions. Time is critical in these situations. This is only about two per cent of calls.

Next on the priority list is “red,” which means emergent and potentially life-threatening, representing about 38 per cent of calls. Time is sensitive in these cases.

“Orange” is urgent and potentially life-threatening. Time may be a factor. This is 17 per cent of calls.

“Yellow” is non-urgent, but potentially serious. Time is sensitive. It’s about 19 per cent of calls.

“Green” is non-urgent and not serious, with no immediate threat to life, and it may be deferred without detriment to the patient’s outcome. This is about 24 per cent of calls.

Research on the protocol has found a strong link between what is reported to the dispatcher and the priority that should be placed on the call, said Pierre Poirier, the city’s paramedic chief.

Under the previous Dispatch Card Priority Index dispatch system, high priority was given to 77 per cent of calls, while only about two per cent of calls fit in “purple,” Poirier told city councillors on the emergency preparedness and protective services committee on Thursday.

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“Those individuals who may think their injury is significant may not be such. Therefore, we may not want to go to those calls immediately, so we can hold back a resource to make sure that we get to someone who is unconscious or someone in cardiac arrest.”

MPDS is considered best practice and is used in 45 countries, Poirier said.

Ottawa has been pressing Ontario to implement MPDS for more than 20 years. Soon after amalgamation in 2001, a consultant’s report recommended it for the city.

It has taken this long to implement MPDS because having it in place is at the discretion of the provincial health ministry, Poirier said.

“So 24, 23 years later, I’m excited to say that it’s happening.”

Poirier pointed to the 2003 death of Alice Martin, a 75-year-old Greely woman who was having a heart attack and was struggling to breathe when an ambulance was dispatched. However, that ambulance was rerouted to another high-priority call that was later downgraded, so a second ambulance had to be dispatched for Martin. She had no vital signs when she arrived at the hospital.

A 2004 coroner’s inquest probing the circumstances around Martin’s death recommended implementing MPDS immediately. That recommendation has stayed with the Ottawa Paramedic Service in terms of its belief that there was a better system for evaluating calls, Poirier said.

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“I’m not saying we could have changed the outcome of that event,” he told councillors. “But we may have been able to provide a better service in that scenario.”

MPDS was introduced in Toronto in 1992, in Niagara in 2007, in Mississauga in 2023, in Kenora in 2023 and in Thunder Bay earlier this year. The United Counties of Prescott and Russell, Stormont, Dundas and Glengarry and Cornwall will also be adopting MPDS.

“There was a fair bit of negotiation to ensure that the City of Ottawa was next on the list because, essentially, we were still three or four years down the road,” Poirier said.

One thing members of the public will notice when calling 911 and while being transferred through to paramedic dispatch is that dispatchers will ask for more information. That may be difficult for callers who are panicked about a medical issue, he noted.

There will also be follow-up calls every 30 to 60 minutes to see if a person’s condition has changed. If so, the call may be re-prioritized.

The goal is for the transition to be seamless, Poirier said. City communications officers are receiving 100 hours of training and certification. MPDS is subject to compliance audits and quality assurance reviews.

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Level Zero incidents — times when no ambulances are available to answer 911 calls — have attracted negative attention in recent years. In 2021, the Ottawa Paramedic Service recorded 750 Level Zero events. In 2022, there were no ambulances available 1,819 times. In November 2023, Level Zero levels spiked after a fire at The Ottawa Hospital’s General campus.

One of the problems is a logjam of ambulances waiting to offload patients at hospital emergency departments.

The paramedic service “did not do well” last year, Poirier told the committee. “This should help us do better by managing our resources.”

The new system will improve the paramedic service’s ability to meet the response-time target, which is a priority for this term of council, Poirier said. The paramedic service will be updating its response-time performance plan in June.

“The key element here is for us to manage our resources better as we go forward to get to the most important calls on a regular basis with a high degree of reliability,” Poirier said, “and this system helps us get there.”

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