Ontario Expanding Innovative Models to Deliver Better, Connected Care

Currently, paramedics are required to bring 9-1-1 patients to overcrowded hospital emergency departments, even when there are other appropriate care and treatment options available in the community. Under the innovative patient care model pilots, eligible palliative care patients and those experiencing mental health and addictions challenges can receive appropriate care by the paramedic directly or in the community as appropriate. The patient will remain in ultimate control of the care they receive and can at any time request to be taken to the emergency department.

“Throughout the COVID-19 pandemic, we have seen more than ever how critical it is for patients to receive timely and effective care – when and where they need it,” said Christine Elliott, Deputy Premier and Minister of Health. “As Ontario’s hospitals face unprecedented capacity pressures during the third wave of the COVID-19 pandemic, these new models of care will enable our world-class paramedics to support our most vulnerable patients in the most appropriate setting, while avoiding unnecessary emergency department visits.”

In York Region’s model, palliative care patients dialing 9-1-1 will have the option to be treated on-scene for pain and symptom management by trained paramedics who may administer medications. If they agree, patients will be referred for follow-up care with their primary palliative care team. The Central Home and Community Care Support Services Palliative Care Network (under the Central Ontario Health region) and the Central East Prehospital Care Program are partnering with York Region on this initiative. This project will allow paramedics to be a part of a Community Palliative Care model within the municipality.

Each pilot project will be in place for one year, after which it will be evaluated to assess outcomes, identify where program adjustments may be needed, and how to implement new models of care throughout the province.

Quick Facts

• To date, 9-1-1 models of care pilots have been approved for implementation in regions across Ontario covering 33 municipalities, with additional details to become available in the coming weeks.

• Under the Alternate Destination model, specially trained paramedics assess the patient’s condition on-scene, per the Patient Assessment Standard of the Basic Life Support Patient Care Standards, followed by transport to a local hospice for palliative care patients, or to a local crisis centre for patients experiencing symptoms of mental health and addictions challenges. This model is currently available in select regions for both palliative care patients and patients experiencing symptoms of mental health and addictions challenges.

• Under the Treat and Refer model, specially trained paramedics treat palliative care patients on-site in their home, which can include administering medication for pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Once the patient has been treated, paramedics would directly coordinate follow-up care with a local hospice or the patient’s primary palliative care team to provide longer-term treatment options. This model is currently only available for palliative care patients in select regions.

• Patient eligibility criteria varies from model-to-model. Paramedics responding to 9-1-1 calls for select palliative care patients and mental health and addictions patients will conduct an assessment on-scene for eligibility to participate in new models of care. If patients are not registered, paramedics would ask the patients on-scene if they would like to be registered with their local centres in order to be eligible for the next time they dial 9-1-1.

Quotes

“By enabling patients to receive care outside of an emergency department setting, we’re helping relieve hospital capacity and respond to COVID-19. This is part of our government’s efforts to improve access to the right care at the right time.”

– Caroline Mulroney
MPP for York—Simcoe

“On behalf of York Regional Council and The Regional Municipality of York, I extend my greatest appreciation to the Government of Ontario for their ongoing commitment to the health and well-being of our residents. As our communities continue to grow, new and innovative models of patient care allows us to meet the changing needs of our communities, while allowing dignity and choice in end-of-life care.”

– Wayne Emmerson
Chairman and CEO of the Regional Municipality of York