EMERGENCY

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EMERGENCY PROTECTIVE SERVICES COMMITTEE

• SYSTEM RESPONSE IN THE COMMUNITY
• January 29, 2009.

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Presentation

• Overview of system function how it works
• Deployment planning for system
• Demand Map where the calls are
• Performance results of the system

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• Overview of System Function

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The First Principles

• Seamlessness
• Deployment Strategy
• CACC
• Data

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1. Seamlessness

• Coverage having paramedics and response vehicles
  ready to respond
• Ontario principle of seamlessness allows Ontario
  coverage for all citizens regardless of
  location
• MOH controls CACC
• CACC sends closest vehicle regardless of
  originating region
• Paramedics are legislated to follow the direction
  of CACC
• Closest available ambulance is sent regardless of
  municipal borders Most available ambulance by
  time not distance will be responded to the
  emergency call
• Industry practice of mutual aid for major events

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2. Peel Deployment Strategy

• Legislated requirement
• Deployment Strategy balances coverage (cost),
  response times
• Coverage is service hours funded and approved by
  Council
• Coverage affected by approved service hours,
  growth in service demand, offload delay

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3. MOH Controls Vehicle Movement

• CACC is not controlled by us
• They are obliged to follow our deployment
  strategy
• They enable seamlessness and dispatch closest
  available unit
• We are not permitted to refuse a call from CACC

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4. Data is not our own

• Decisions we make about system are controlled by
  MOH
• Captured by CACC
• Quality is subject to change and inaccuracy
• PRPS uses best available data and uses detailed
  analysis to validate data and determine system
  values

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• Response CODE Definitions

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What are Code 1 and 2?

• Code 1 Non-urgent, unscheduled patient transfer
• Pt cannot ambulate and needs ongoing medical care
• Inter-facility transfer for treatments
• Code 2 Scheduled pt transfer
• Same as Code 1 except scheduled

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What are Code 3 and 4?

• Code 3 prompt, non life threatening
• Pain and suffering
• Broken bones, sprains, falls, minor bleeds/burns,
  nausea/vomiting, chronic abdominal pain
• Code 4 urgent, life threatening
• Cardiac arrests, unconscious, difficulty
  breathing, severe bleeding, child birth, major
  burns, trauma

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Dispatched Code vs. Return Code to Hospital
80 of all calls dispatched Code 4 64,000 sent
Code 4 7,000 returned Code 4 Nov 1 07 Oct 31
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• Peel Deployment Strategy

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Objective of Deployment Strategy

• Provide balanced coverage and response to
  citizens and visitors to Peel
• COVERAGE units available for the next call
  (next call follows highly predictable profile
  based on location of people)
• RESPONSE units responding to specific calls

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What is coverage?

• As resources are sent on calls, remaining
  vehicles are redistributed
• Redistribution based on highly predictable
  statistical work of where the next call will be
• Coverage is secondary to response
• First source of coverage are Peel units
• Second source are neighboring municipal units

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What is Response?

• Response for Code 4 as quickly as possible given
  resources (932)
• Response for Code 3s can be delayed if system
  strapped
• Code 4 responses are never sacrificed to maintain
  coverage
• First source is closest available ambulance
  (cross border options)

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How Deployment Works

• Crews report to a station
• Crew log onto CACC who control all activity in
  the system
• CACC uses the deployment strategy to maintain
  coverage as vehicles are sent on calls as well as
  return to system
• Throughout the day, the level of coverage expands
  and contracts
• CACC adjusts vehicle placement based on the
  number of remaining available vehicles in the
  system.
• Vehicles are placed in strategic predetermined
  positions

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How Deployment Strategy is Developed

• Call volumes and response times are literally
  mapped
• Vehicle positions are determined based on
  frequency of call volumes and ability to achieve
  response times
• Positions are defined as zones
• An algorithm is created to maintain as much
  coverage as possible given diminishing resources

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Reality vs. The Theory
Call growth caused by - Population growth
(34,000/yr) - Aging population - Social
Factors
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CITIZEN Impact Code Capacity (no units
available in Region)
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How we have distributed resources
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What you are about to see

• All calls serviced
• Call volume maps for Code 3 and 4 (98 of call
  volume)
• For Nov 1 2007 Oct 31 2008
• Light grey have calls lt every other week to only
  1 call in last year
• Grey scale have calls lt 1 per week
• Colour calls gt 1 6 calls per week
• Red calls every day
• You will see the posts as we move below 8
  vehicles in the system (8, 4, 2, 1) this
  happens every day in Peel

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• Response Times

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Peel Response Times 90th Percentile
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Call volume information by Pick Up Location
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Response Percentile by Municipality
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Histogram Time Distribution of Calls by
MunicipalityCaledon shown at 10x actual to
demonstrate curve
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• Municipal Experience

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Stations Serving Communities
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Unit Hour Activity by MunicipalityNote PRPS
UHA target is between .32 to .38
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Unit Hour Activity by MunicipalityNote PRPS
UHA target is between .32 to .38
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Summary

• 90th for 3 municipalities are very close in range
• PRPS has optimized coverage/response times given
  system and economic constraints
• Council continues to support program
• New response time framework will change program
  metrics