Essex-Windsor EMS seeks provincial OK for ambulance dispatch takeover

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Essex-Windsor Emergency Medical Services and Emergency Management is asking the province to let it take control over local ambulance dispatching, arguing it would result in more efficient responses to calls with fewer resources

Switching to such a system has seen success in Niagara, Toronto and Ottawa and would lead to operational advantages given the need for extra ambulances and staff locally over the next few years, said Windsor-Essex EMS chief Justin Lammers.

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“The health-care system is strained, and we need to maximize all efficiencies to continue providing the level of service that we are,” Lammers told the Star. He said the local service has already made the pitch to the province for a five-year pilot project.

“We were asking the ministry to allow us to assume control operationally and essentially expedite the time it would take for us to make these changes.” 

Currently, 911 calls requiring paramedics and/or fire response are routed to Windsor-Essex EMS and Windsor Fire and Rescue Services through the Windsor Central Ambulance Communications Centre. 

The county is responsible for the EMS system covering Windsor-Essex, so taking over dispatch could improve patient outcomes and reduce visits to emergency rooms through a more agile dispatch system that is staffed with medical personnel, said Lammers. 

“Right now, when a call comes in, we send the cavalry,” said Lammers. “You call 911 — it’s a full response.  

“We don’t have to do that. We can get a little bit more granular on how we’re responding, and then we don’t need a $400,000 ambulance. We’re sending a Tahoe (SUV) and one paramedic.”

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The service can respond using community paramedics, for example, who have training to work with residents who call 911 more than three times per month.  

“Or the front-line paramedics identify them through an interaction. They might need more services. Community paramedics will follow up after the fact and assess them and see what services they’re eligible for.” 

Wrap-around services, which include a range of supports, could help keep some people out of the hospital and avoid the need to use 911, Lammers said. 

In other situations, such as an overdose of drugs, the EMS could send a response team that consists of a social worker, a mental health worker and a paramedic. 

The difference with the proposed takeover of ambulance dispatch is that you “have access to all this expertise, and whereas the communication centre as it is right now is a straightforward, strictly dispatch centre,” said Lammers. He said it can alter the care model for 911 callers and apply the most appropriate services for them, often steering them away from the hospital emergency room. 

The results in Niagara, for example, are impressive, said Lammers. “Niagara didn’t need to put another truck (ambulance) on the road for a number of years. We’re looking at a large amount of trucks because we’re measured against response times.” 

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Lammers presented the Windsor-Essex EMS 10-year master plan to Essex County council Feb. 5. It has some daunting numbers.  

Average annual call volumes for the EMS are expected to increase by 4.5 per cent from 2024 to 2030. Call volumes are expected to rise 5.1 per cent a year for the City of Windsor and 3.2 per cent a year for Essex County. 

That will require an increase of 44 full-time and 22 part-time staff, the plan says. Four more district chiefs will be needed by 2030. 

Maintaining the current levels of servicing to meet the anticipated growth in the region would require an extra $11.2 million, the report says.  

A consultant’s analysis says resources needed to achieve a 75 per cent response rate for Priority 4 (non-transport) calls within eight minutes could cost $15.3 million. 

An EMS report to the province’s health ministry presented at the Rural Ontario Municipality Association conference says it may be difficult to find the level of staffing required to achieve that level of service. 

“Even if we had unlimited funding to add the 13 ambulances required to improve service levels in the face of growing demand, where are we going to recruit the additional 104 full-time paramedics required to staff them when the province faces an annual shortage of 400 paramedics?” the report says. 

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The answer, the presentation to the ministry says, is to change the way the ambulance system is dispatched. 

Essex-Windsor EMS fielded about 68,000 calls in 2024, Lammers said, with a projected increase to between 84,000 to 90,000 by 2030, mostly because of an expected increase in the region’s population. 

“What’s required is not more and more resources but a reimagining of the way in which those resources are deployed in Windsor-Essex and the way in which those resources are optimized to leverage the success of groundbreaking community paramedicine programs and promote a wholistic approach to patient care,” the presentation says. 

“Allowing Essex-Windsor EMS to take responsibility for the day-to-day deployment and decision-making at the Windsor Central Ambulance Communications Centre is a low-cost step that would have an immediate and appreciable impact on ambulance response times and the quality of health care in Windsor-Essex.” 

In Niagara, where such a dispatch model has shown to be successful, nurses are in communication with the EMS dispatch centre, helping to screen the initial call. In some cases, rather than sending a transport unit, they can recommend alternate models of care, Lammers said. 

“We’ve got a large financial ask on the table … we can save money and provide better care to the patients,” Lammers said. 

 Bamacleod@postmedia.com 

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