Windsor-Essex sees steep drop in Code Black ambulance response delays

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The sharp drop in local code black incidents – when there was no immediate ambulance to deal with emergency calls – highlighting a range of improvements to the 2024 Windsor – ESSEX Emergency Medical Service.

According to EMS data, some key negative numbers have been falling.

The amount of time spent by local ambulance crew on code black fell 79% last year, from 1,701 in 2023 to 358. The 2022 figure was 2,272 minutes.

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Code red is reduced by 30% when only one to three ambulances are available to 6,231 minutes in 2024; code yellow is reduced to 231,843 minutes when four to 10 ambulances are available.

The service’s uninstall latency has dropped by 7.3%, from 19,319 hours in 2023 to 17,915 hours in 2024. These periods are when caregivers must remain on the patient until the hospital formally takes over the care. When the process takes more than 30 minutes, a delay occurs.

Justin Lammers, head of Windsor-Essex EMS, said partly because of the lack of code during the black period.

He said the Code is black for many reasons, including work from the Windsor Essex Ontario Health Team, frontline care workers, collaboration with local hospitals and the deployment of two other ambulances last year.

The province-mandated Windsor-ESSEX Ontario Health Team consists of more than 40 healthcare organizations including community support services, hospitals, and home and community care providers that jointly develop solutions to local healthcare needs.

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Lammers said the most important thing is that calls in black, red and yellow have increased significantly during the Covid-19-19 pandemic. Higher calling levels continued to decline during this period.

The service also improved response time for “sudden cardiac arrest”, four of the five categories in other service calls.

The provincial target for response to sudden cardiac arrest is six minutes. In Essex, health care workers are expected to reach 55% of the time. In 2024, the target reached 64%, up from 59% in 2023.

Other calls were graded in the Canadian Classification and Acute Scale (CTA), where Level 1 is the most severe, with 98% of the time required to be seen immediately by the doctor. Level 5 is when the patient needs to be seen 80% of the time within 120 minutes.

Windsor-Essex EMS has increased response time to these targets by 2% in levels 2, 3, 4 and 5 (the response ranges from 10–14 minutes for these categories), and 69% at level 1, with a response time of 8 minutes.

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These improvements were made at the same time as the number of EMS calls increased, with 65,707 such calls recorded in 2024. By 2030, the average call volume of local EMS is expected to increase by 4.5% per year.

When the service is processed There were 65,707 calls last year, with the actual response being 72,788, and additional resources needed to be deployed in some events. (The caregiver on site may also need a senior caregiver or a second crew member to help the patient.)

Lammers said the service has been at the caregiver patient navigator at Windsor Emergency 911 Center since 2022, which helps guide resources in a more effective way. Patient navigators directed the flow of resources throughout the region, but were not involved in the classification call.

“They are helping to work with all three hospitals (and) emergency departments to balance traffic across the region,” Lammers said. “The hospital’s emergency department and nursing staff, patient navigators, they’ve been in touch.

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“I’m talking about hundreds of messages every day, managing the process throughout the region to make sure there’s no over-the-top site.”

More than 99% of calls to EMS responses are code 3 and 4 events. Code 3 requires a timely response, during which time the vehicle has no lights or sirens (16.4%). Code 4 that requires emergency response, during which the vehicle uses lights and sirens, is 42% of the phone. Code 8, backup for emergency coverage, accounting for 41% of calls.

Code 4 calls increased by 5% last year.

Lammers said the Code 3 phone drop in 2024 was largely due to efforts in the nursing medical program of the mobile integrated healthcare community. The department actively works with residents who frequently use 911. Members identify services that residents can access, which helps reduce calls from emergency assistants and travel to hospital emergency rooms, thereby reducing unloading delays.

Lammers said lowering code 3 can affect ambulance deployment because they tend to be low-sharp calls, because triage systems need to address tall calls first, so it usually takes longer to uninstall in the hospital.

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The service will move to a new classification system in 2027, which will be called Medical Priority Dispatch in 2027.

“We can be very specific and start tailoring our resources,” Lammers said. “We will get the benefits from the MPD. There is no doubt that it will benefit.”

“It will immediately remove the response code because it will dig deeper.”

bumacleod@postmedia.com

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