As hospital backlogs grow, paramedics struggle to deliver timely care

Paramedics Colin Waterhouse and Josh Picknell are in their ambulance in Ottawa on a Friday afternoon when the call comes in: A Code 4, which means they need to get there fast. 

With lights flashing and sirens blaring, they race to the call's address and assess the patient; he needs to go to the hospital. Moving quickly, the drive to the Queensway Carleton Hospital, in Ottawa's west end, is fast. But as the paramedics arrive at the hospital, the rush of activity stops. 

There are six ambulances already parked outside and the emergency room is packed. 

The two paramedics will have to wait with their patient, monitoring him, until his care can be transferred to the hospital. "Essentially, we're stuck here," said Waterhouse. 

The experience is known as an "offload delay." It means their ambulance will stay parked at the hospital for now, rather than head back out on the road, where it can respond to other incoming 911 calls.

"While I'm here with this patient, I might be here for hours. I can't respond to a call. All of these paramedics are taken out of commission while we're waiting to get out of the hospital," said Waterhouse. "So you have a smaller amount of circulating ambulances in the city to respond to emergencies."

That waiting time adds up. Last year, the Ottawa Paramedic Service took 72,000 patients to hospitals and spent 49,000 hours waiting in offload delay. During the first five months of 2022, paramedics in Ottawa have spent 25,000 hours waiting at hospitals, with the 28,000 patients they have taken there.

At this rate, the service estimates they could lose more than 60,000 hours to offload delays by the end of the year. 

It's a situation that obviously affects patients and their families, too, said Waterhouse. 

"They're rightfully frustrated," he said. "Because they have a pretty reasonable expectation that they would call 911, they would promptly get an ambulance to them, and they would get to the hospital and get seen right away."

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According to the Ottawa Paramedic Service, the long waits at hospitals are a result of several reasons, including increased call volumes to 911, a lack of access to family physicians, and staffing shortages across the health-care system.

"All the weight is falling onto the hospital system to manage the entire health-care system — and it's just not capable of doing it," said Ben Ripley, a superintendent with the Ottawa Paramedic Service.

"Because of that, we're seeing backlogs in the emergency room … and because of that we're seeing our trucks sit there for hours on end."