HomeMedicine By SpecialtyEmergency MedicineGetting ambulances back on the road

Getting ambulances back on the road

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When it comes to the challenge of off-load delays, and Peel Paramedics are partnering to find a solution.

Off-loading patients in a safe and timely manner is a high priority for all emergency departments so that ambulances can return to the road and be available to pick up the next person in need of emergent care. Unfortunately, is a common problem encountered in emergency departments.  The term refers to the time between when a patient arrives at hospital by ambulance to when the paramedic crew has transferred patient care to hospital staff, enabling paramedics to begin the process of returning to service. This delay significantly impacts patient care, emergency department congestion and operational costs.


A joint project between Trillium Health Partners and Peel Paramedics was initiated in the summer of 2013 with significant success.  “We wanted to address and reduce off-load hours because we know the importance of getting ambulances back on the road,” says Sonya Pak, Program Director of Emergency Department and Urgent Care Services at Trillium Health Partners. “We knew we absolutely had to do better.”

In order to do better, a new methodology was developed using a Kaizen – Six Sigma approach. This approach focuses on the flow of process, issues and their root causes, and the best way to implement solutions.

The first phase was introduced at the Credit Valley Hospital site’s emergency department in the summer of 2013 where the impact of this approach was felt immediately. In August 2013, there was a 50 per cent improvement in off-load times compared to the previous month. Prior to this project, Peel Region paramedics were losing 40,000 hours yearly to ambulance off-load delays, with the Credit Valley Hospital site accounting for 30 per cent of those hours. By working together to improve processes, the Credit Valley Hospital site decreased off-load times to roughly 33 minutes in early 2014, down from 50 minutes in 2012. The team is on the way to attaining its goal of 27 minutes by the end of 2014.


The project has sustained itself beyond the pilot phase, with the second phase currently underway at the Mississauga Hospital site. Since adopting the Kaizen – Six Sigma approach this past summer, the Mississauga Hospital site’s emergency department has experienced similar success. The key to the continuation of this project will be to sustain the goal targets, despite growing demand.

Trillium Health Partners and Peel Paramedics are pleased with the results of this project and the positive impact on health care delivery in the hospital and in the community.  With growing momentum, the partners hope to see the continuation of strong results for their region, and an opportunity for shared best practices elsewhere in the province.


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