Hamilton hospital cuts time to offload emergency ambulance patients from hours to minutes

A Hamilton hospital has made a "spectacular" turnaround — cutting the time it takes to transfer patients in ambulances to its emergency department from hours to minutes, says the local councillor. 

Juravinski Hospital has reduced its "offload time" from a high of 3.5 hours for 90 per cent of patients in September 2021 to below 17 minutes in July 2024, the city's chief paramedic Michael Sanderson told councillors earlier this month.

Coun. Tom Jackson, whose ward includes the Mountain-brow hospital, said it was common to see ambulances parked down the street as paramedics waited for a hospital bed to open up for patients in urgent need of care, and even surgery. 

"This is something we've been hammering away with tremendous concern, anguish, unhappiness and puzzlement as to why the offloads could be hours and hours," Jackson said at council Wednesday.

"This [change] is just tremendous, sensational, spectacular news." 

It has freed up ambulances and paramedics to respond to other calls, greatly reducing the number of "code zeros" — when there is only one or are no ambulances free to respond to emergency calls, Sanderson told CBC Hamilton.

There were over 300 code zero events in 2022, he said. So far this year, there have only been two and they were in January.

More staffing has also helped, with council approving the hiring of 35 additional paramedics in 2023 with plans to hire more, Sanderson said.

He called it a "significant investment to make sure we're right sized" to keep up with the needs of a population that's growing and aging.

Juravinski's offload time is now within Ministry of Health's standard of 30 minutes, 90 per cent of the time, and is one of the quickest hospitals in Ontario, Sanderson said. 

To address the slow offload times, the hospital hired two new nurses dedicated to bringing in patients from ambulances and created more space for them by reconfiguring the emergency department, said Liz Feres, director of emergency medicine and critical care in a statement.

Neil Johnson, a vice president at Juravinski, described the process at a committee meeting Sept. 19 as one that demanded "hard changes that take time and effort."

Juravinski has become a model, Sanderson said, for two other major emergency departments to follow. 

Hamilton General Hospital's offload time was about 50 minutes in July — the most recent monthly data available — compared to nearly three hours in January 2023, said Sanderson.