Brant Community Healthcare System investigating solutions to lower ambulance off load times and improve emergency room care

By Casandra Turnbull

The Administration and Operations Committee listened to an update on the state of healthcare in Brant County during Tuesday night’s meeting.

Delegates, Dr. Somaiah, ED Physician and Chief and Medical Director of Emergency Medicine and Brian Brennan Interim Director, Emergency Services, presented the healthcare update with a specific focus on ambulance off load times (AOT)

AOTs refer to how long it takes for an ambulance crew to leave a hospital once they have seen a triage nurse. With a significant number of patients are being held in the ED throughout their admission it’s greatly challenging the department’s ability to perform effectively. The BGH ED has 25 true care spots and over the past two fiscal years, on average, 22 patients/day, by 11:00 am are waiting in ED stretchers to be transitioned to inpatient hospital beds Over the last three fiscal years, the percentage of patients presenting at the ED via ambulance has increased to 30.5%, which equates to 41 patients per day, the report outlined. If you’ve heard the term Code Zero, or maybe you’ve saw a post on the Brant County Healthcare System social pages declaring Code Zero, it refers to when ambulance offload times are so high there’s no ambulances available to respond to community calls in a timely manner. It’s a frightening situation and has adverse effects in the community and for vulnerable patients who need emergency service

The Brantford General Emergency department is caring for 73 more patients per day compared to 2020. Over the last three years, the number of patients presenting at the ED via ambulance has increased to 30.5%, which equates to 41 patients per day.

Some recent increases in physician assistant hours since January have contributed to some better ambulance offload times in February, an improvement of 9 minutes. It may seem small, but in an emergency, every minute counts.

While these performance statistics are a symptom of the greater healthcare system pressures occurring across Ontario and Canada, the Brantford General Hospital is in dire restraints, caring for 73 more patients per day compared to 2020 and literally pushing the system to its limits. The report also noted that while ED volumes have been stable, patients are coming in sicker and with more complex health issues, where the rate of admission is climbing.

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BCHS is working in partnership with the Ministry of Health, Ontario Health, and BrantBrantford Emergency Medical Services (EMS) to find both short and long-term sustainable solutions.

BCHS’ corporate and departmental focus is on addressing the ED wait times and patient flow through the hospital.

Here are a few short-term wins outlined in the presentation:

*Brant-Brantford EMS investment for back hall nurse funding to support AOT has been used specifically for this need. Funds not used due to recruitment challenges have been returned, including

$152,000 of the $628,000 allocation received for the 20232024 fiscal We have had recent success in our recruitment efforts over the last 6 months, and 90% of the shifts are now covered.

• Trialed increase of physician assistant hours since January 2024 which has improved our physician assessment times and started to shift to lower ambulance offload times.

• Patients are seen quicker, beds become available sooner

• Significant improvement on our data collection to better understand root cause and generate solutions.

• Longer term plans include education to our front-line staff regarding corporate surge plans and the development code ambulance is underway to escalate the process to decrease ambulance off load times

The ED renovation improvement project will enhance the physical space to support health care professionals. Construction is estimated to take three and a half years, wrapping up in early 2027 if it remains on time. The full report, including statistics compared to other cities and municipalities, is available here

Also during this meeting, Bonnie Camm was introduced as the new President & CEO, BCHS.

Smile Cookies are back, April 29 th – May 5th

The Brant Community Healthcare System Foundation is once again thrilled to have been selected by the Paris Tim Hortons restaurant owners to be the 2024 Smile Cookie benefactor.

If you purchase a freshly baked chocolate chunk smile cookie at any of the three Paris Time Hortons, 151 Dundas St E, 304 Grand River St N or 1084 Rest Acres Road, 100 % of the proceeds will benefit The Willett, Paris and help support the purchase of patient equipment.

Brighten the day of a friend, family member or colleague with a smile cookie. They are only back from April 29th to May 5th .

You can pre-order your Smile Cookies, by simply filling in the form (available here) and delivering it to one of the locations listed above. Please place your orders at least 48 hours in advance.

It’s deliciously easy to make a difference!