The Ontario government is launching new 9-1-1 models of care to 33 municipalities across the province.
Currently, paramedics are required to bring 9-1-1 patients to hospital emergency departments, even when there are other appropriate care and treatment options available within the community.
A new model of care will be piloted in Central East Ontario including Kawartha Lakes, Haliburton County and Durham Region to ensure paramedics have more options to provide safe and appropriate treatment for patients while helping to protect hospital capacity during COVID-19. 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.
Description of Pilot Project
Central East Ontario (Kawartha Lakes Paramedic Service; Region of Durham Paramedic Services; Haliburton County Paramedic Service; Northumberland Paramedics; Peterborough County/City Paramedics).
Treat and Refer Model for Palliative Care Patients
Palliative care patients calling 9-1-1 will have the option to be treated on-scene for pain and symptom management, including pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Following treatment on-scene, patients have the option for paramedics to coordinate the patient’s follow-up care directly with the patient’s primary palliative care provider or with a local hospice for further treatment and wrap-around care.
Each pilot project will be in place for one year and evaluated to assess outcomes, identify where program adjustments may be needed, and how to implement new models of care throughout the province.
“Under this pilot, paramedics can provide direct care to palliative patients and refer them to alternative health care destinations. This is another example of how our government is continuing to find solutions to challenges COVID-19 presents while helping to shape our health care model for the future.”
Laurie Scott, MPP for Haliburton-Kawartha Lakes-Brock
“This is a unique program that will provide important additional care to residents in the community to help support palliative care patients and their families.”
Tim Waite, Chief/Director, Haliburton County Paramedic Service
“The Paramedic Services are pleased to have the opportunity to participate in the Treat and Refer Model for Palliative Care Patients pilot under the new 9-1-1 models of care. Many patients with life-limiting illnesses prefer to be cared for in their homes and communities. The ability to receive care in this setting has been associated with improved comfort of end stages of life for patients, families and caregivers. This patient-centered initiative will enhance the ability of paramedics, as part of a coordinated care team, to provide the option for patients receiving palliative care to have symptoms or changing care needs managed at the right place (in-home), the right time, and based on the needs of the individual.”
Randy Mellow, Chief of Paramedics, City of Kawartha Lakes
“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. 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.”
Christine Elliott, Deputy Premier and Minister of Health
- 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 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.
- Patient Care Model Standards
- Ontario Improving Access to the Right Care in the Right Place
- Ontario Unveils Plan to Build Mental Health and Addictions System
- Visit Ontario’s website to learn more about how the province continues to protect the people of Ontario from COVID-19.
Photo from March