New dispatch system for Ottawa paramedics to come online next month

Ambulances are parked outside the Emergency Department at the Ottawa Hospital Civic Campus in Ottawa on Monday, May 16, 2022. (Justin Tang/THE CANADIAN PRESS)

A new dispatching system for the Ottawa Paramedic Service will be coming online next month, after numerous calls over the decades to improve how ambulance dispatchers triage calls.

Ottawa paramedics have been under increasing pressure in recent years, with high numbers of "level zero" events, where there isn't a single ambulance available to respond to an urgent call, often attributed to lengthy offload delays at local hospitals. Demand for 911 services has also been on the rise in recent years.

Paramedics in Ottawa have been using a triage tool called the Dispatch Priority Card Index (DPCI), which was developed in the 1980s.

Now, a report prepared for the City of Ottawa's Emergency Preparedness and Protective Services Committee says the new dispatching system, called the Medical Priority Dispatch System (MPDS) will finally come online.

"The Medical Priority Dispatch System is expected to launch in the Ottawa Central Ambulance Communications Centre on April 10, 2024 and will serve more than 1.2 million residents across 10,000 square kilometres of eastern Ontario, including Ottawa, the United Counties of Prescott and Russell, the United Counties of Stormont, Dundas, and Glengarry, and Cornwall," the report says.

What is the MPDS?

The MPDS system is considered a superior call triage tool to the Dispatch Priority Card Index tool currently in use by the Ottawa Paramedic Service. It's been in use in Toronto since 1992. Other communities in the province, including Niagara Region, Mississauga, Kenora and Thunder Bay also use it. There have been calls to install the MPDS in all communications centres in the province, and representatives from Ottawa have been asking for it since before amalgamation.

According to the report, studies have shown that the MPDS is exceptionally good at detecting high acuity of illness or injury. Its algorithm is more accurate at detecting patient severity of illness or injury and it is better at determining which calls require a paramedic response with lights and siren. DPCI, on the other hand, frequently over-triages 9-1-1 calls.

How will it improve service?

The main difference between the two systems is that the MPDS has five levels of severity for incoming calls and dispatchers, compared to DPCI's two, allowing dispatchers to better determine what resources are needed and when.

MPDS severity levels include emergent and immediate life-threatening conditions, emergent and potentially life-threatening conditions, urgent and potentially life-threatening conditions, non-urgent and potentially serious conditions with no immediate threat to life, and non-urgent and not serious conditions with no immediate threat to life that could be deferred without detriment to patient outcome.

DPCI has two levels: Code 3, which indicates an urgent but not life-threatening issue, and Code 4, which requires an immediate lights and siren response.

The report prepared for committee says that 77 per cent of 9-1-1 calls to the Ottawa Central Ambulance Communications Centre in 2023 were triaged as Code 4 responses, requiring immediate dispatch with lights and sirens but, upon paramedic arrival, only 12 per cent of those calls actually needed a lights-and-sirens transport to hospital.

Will the new system change what happens when you call 9-1-1?

Short answer: no.

"The implementation of MPDS does not impact how 9-1-1 calls are answered by the Ottawa Central Ambulance Communications Centre, rather MPDS will improve how calls are triaged," the report says. "Further, the implementation of MPDS will improve the Ottawa Paramedic Service’s ability to meet response time targets for life-threatening calls which will have a positive impact on these patients, including those with disabilities and older adults."

Poirier says transitioning to the new system will be an important step for Ottawa.

"After more than two decades of advocacy, MPDS will go-live on April 10, 2024. This is a significant milestone that will benefit the Ottawa community," the report by Paramedic Chief Pierre Poirier says. "The implementation of MPDS will have an impact on the Ottawa Paramedic Service's response time performance. As such, the Service is collecting data and reviewing its Response Time Performance Plan."

A report will be prepared for committee in June, he said, with recommendations to update the Response Time Performance Plan.

How is the city preparing?

Poirier said communications officers have each received approximately 100 hours of technical education and training on new regulations, policies, and local operating procedures to prepare for the new system's launch in April. All communications officers are also required to be certified as Emergency Medical Dispatchers (EMDs) under the International Academies of Emergency Dispatch (IAED), a non-profit standard-setting organization that promotes safe and effective emergency dispatch services worldwide. Certification must be renewed every two years.

"Post-implementation, the Ottawa Central Ambulance Communications Centre will participate in a quality assurance process, as required by both the Ministry of Health and the IAED. Third party auditors will be engaged to audit the performance of communications officers for ongoing accuracy and compliance with call triage and dispatch instructions," Poirier wrote.

Poirier added the paramedic service is working with hospitals, long-term care homes and retirement homes to inform them about the new system. The city's Tiered Response Agreement between paramedics, firefighters and police might also require modification, but the report doesn't outline what changes might be required.

The City of Ottawa's media and public relations teams are also expected to have a communications plan in place to inform residents about the new system when it launches, through the city's website, its social media channels, and other appropriate platforms.

The Ottawa Central Ambulance Communications Centre is 100 per cent funded by the Ontario Ministry of Health, while the Ontario Ministry of Health and the City of Ottawa equally fund land ambulance service.

The Emergency Preparedness and Protective Services Committee meets March 21.