Ambulance offload times have plummeted in the last several months at Guelph General Hospital.
But the head of the area's paramedic service is expressing "cautious optimism" as we head into a busy fall season.
Last October, the hospital was facing an average delay of 4.9 hours. It was down to 42 minutes in June.
"We've seen the impacts over the last couple of months in the reduction of offload incidents," said Stephen Dewar, the chief of Guelph-Wellington Paramedic Services. "It's a dramatic improvement for the conditions for our paramedics, for our ability to respond to emergency calls.
"(But) there's definitely some cautious optimism. In discussions with the hospital, we know that all of the problems of the world are not fixed, and there are still days when we are facing offload delays, but significant, I've seen dramatic improvement since May."
Melissa Skinner, the vice-president of patient services at GGH, admits the numbers are "a bit seasonal," with less viruses and less pressure on the healthcare system.
But she's also crediting strategies the hospital has been planning and trying out while things were alright for the success.
"The inpatient units have been incredible," Skinner said. "They have been working on their surge planning, and their fall preparedness plan now for many months. There's been some busy days, even in July, where we've been able to test out those plans."
She also credits the whole hospital and healthcare system working together to move people through quicker, allowing patients coming in ambulances to be admitted quicker.
In the hospital, the average time it takes to be assessed by a physician in the emergency room has trended down, from 5.6 hours in June 2022 to 4.4 hours as of this month.
The time it takes for patients being admitted to be taken to a bed has gone down significantly year-over-year.
The wait was an average of 26.7 hours in June 2022. It's gone down to 8.1 hours this past June.
Skinner said you can't fix offload issues, or other pressures in the ER, if you don't fix what's happening in the whole hospital.
"We did a lot of partnering with our Ontario Health Team partners, with home and community care, so that we can get patients moving through the system more quickly," she said.
Dewar said paramedics are working with the hospital on processes for when a patient is brought in by ambulance, to continue to improve the flow.
He said code reds still get declared, but as of late, they're "very short lived and sporadic," and a much improved situation now.
"In April, there were 587 hours that (local paramedics) spent in an offload delay. In July, that was 65 hours," Dewar said.
"The trend is really there, it's very clear that there's a dramatic change just after April, beginning of May, and it's continued to decrease."
And with call volumes only down "slightly," according to Dewar, they're able to service calls more efficiently.
Looking ahead, things are looking up. A room in the emergency department is being redeveloped, with a bay for three patients to wait with paramedics before being registered.
GGH is also hiring for offload nurses for support. Recruitment is underway for the role, who will be scheduled for 12 hour days, seven days a week. The provincial government provided the funding to create the role.
"We are looking for a full-time, permanent position, or a number of positions to fill that role," Skinner said.
"This person has to be highly skilled because patients that are being brought in by ambulance can have very different levels of acuity, so this person has to really be able to assess them, be able to triage them, make sure that they're moving through the system.
"It's going to be a challenge, but we're excited to get that recruitment going."
She said ideally, the roles will be filled as soon as possible, adding there's been quite a bit of interest already.
Perhaps just in time for the fall and winter, which brings along with it flu season and naturally, an increase in call volume.
"We all know that we're not unrealistic, and that there's a great potential for us to have problems again," Dewar said. "But we think that the systems and the strategies that have been put in place, and hopefully our working relationship in establishing different processes, and streamlining our processes, hopefully all of that works to maintain a better system than we had last year."
But as for the offload delay reductions in the present, there is plenty of celebration happening.
"No one can argue that the best place for our ambulances are out on the streets," Skinner said.
"We don't want those ambulances here as well, we want them out (in the community)."
