Ottawa Emergency Medical Services

Ottawa Emergency Medical Services (EMS) Branch is responsible to provide all pre-hospital and inter-hospital care and transport of patients within the City of Ottawa in accordance with the Ambulance Act within Province of Ontario.

The Program Development Division of Ottawa Emergency Medical Services Branch has primary responsibility for quality assurance/improvement programs; training and development; and coordinating community programs such as the Ottawa Emergency Medical Services Public Access Defibrillation (PAD) program. In consultation with other EMS divisions (i.e. Operations, Support Services and Logistics), Program Development is developing the infrastructure (policies, processes, guidelines and standards) to ensure quality assurance / improvement of EMS clinical, equipment, fleet, and communication programs that are compliant with existing legislation. Program Development is also responsible for assessing and managing risk associated with service delivery and designing, implementing, and evaluating prevention and education/training programs for EMS staff.

Ottawa Base Hospital

The Ministry of Health and Long Term Care (MOHLTC) designates Base Hospital Programs. In Ottawa, the Ottawa Hospital - General Site serves as the Base Hospital for the paramedics who practice in accordance with medical direction provided by Dr. Justin Maloney. The role of the Ottawa Base Hospital is to provide medical direction, leadership and advice in the clinical provision of pre-hospital and inter-hospital care. This involves the Base Hospital acting as a resource and facilitator to assist Ottawa Emergency Medical Services in ensuring that pre-hospital and inter-hospital care and transportation is meeting the community’s needs. The Base Hospital is responsible for delivering services in accordance with the Ambulance Act, Regulations, and their Performance Agreement with the MOHLTC.

DISCUSSION

One of the essential measures of a performance-based system is the level of clinical capability and reliability. Ottawa EMS and the Base Hospital share the mutual goal of promoting efficient and effective use of resources to collectively produce the highest quality of pre-hospital patient care possible. Together, we are committed to continuous quality improvement based on progressive education and evaluation of all system components.

The impetus for the agreement was the mutual desire to avoid duplication of effort and to maximize the effectiveness of training programs and quality assurance/improvement programs with our combined resources.

The result is an agreement that reflects a very positive, productive and forward thinking partnership between the Ottawa Base Hospital and Ottawa EMS.

Process

Discussions between Ottawa EMS, Program Development staff and the staff of the Base Hospital Program have occurred during the first four months of this year. From the beginning, there was mutual interest and cooperation in creating and formalizing a performance agreement between the two parties.

Numerous existing performance agreements between other Base Hospitals and Operators across the province were reviewed and served as a template for this, the first “Letter of Agreement between The Ottawa Base Hospital Program and Ottawa Emergency Medical Services”, signed and dated April 2001. The agreement will be reviewed in December 2001.

Provisions

Both parties agree to meet, at a minimum, on a quarterly basis to address issues of common concern, and accept a shared reasonability to develop, implement and review formal business processes.

A provision of the agreement allows either party to propose new terms beyond the scope of the current agreement, which each party will evaluate in light of their budget/funding, mission / mandate and consistency with legislation and standards, as well as the current performance agreement the MOHLTC (Base Hospital).

Scope

The agreement sets out joint roles and responsibilities, as well as those specific to each party. The major roles and responsibilities include:

· Medical Direction

Medical direction will remain the primary responsibility of the Base Hospital Medical Director including: training and certification of Paramedics to deliver controlled medical acts; signing authority for the acquisition of required medically controlled devices and drugs; providing medical direction in all aspects of primary care and advanced care patient care services within the system design and for the Ottawa Emergency Medical Services Public Access Defibrillation Program.

· Continuing Medical Education

Both parties will work collaboratively to identify training needs, develop and deliver sessions and evaluate outcomes.

· Quality Assurance and Continuous Quality Improvement

Both parties will work collaboratively to monitor the performance of all Ottawa EMS paramedics through documentation audits, field observations, investigation of complaints, individual and aggregate evaluations, regular reporting and feedback to employees and EMS management.

· System Management and Development

Operational issues will continue to be the primary responsibility of Ottawa EMS.

CONSULTATION

There has been extensive consultation with the Ottawa Base Hospital Program, as well as Ottawa EMS Branch Management Team and Staff.

FINANCIAL IMPLICATIONS

There are no budget implication associated with this report.

BACKGROUND

Ottawa Emergency Medical Services

Ottawa Base Hospital

DISCUSSION

FINANCIAL IMPLICATIONS