Their mother died after an ambulance delay, but it's taken 20 years for change
Jury concluded in 2004 that Ottawa's tech was outdated and inadequate
The province says ambulance dispatchers in Ottawa will finally get software next year to triage the most urgent 911 calls with greater accuracy — 20 years after a coroner's inquest recommended it be immediately installed.
Alice Martin's children have been waiting for the province and the city to move to the "medical priority dispatch system" (MPDS) since the 2004 inquest into their mother's death.
Studies show the MPDS does a better job than the current system of prioritizing which people are truly in a life-threatening state.
That way, patients aren't getting an ambulance with flashing lights and siren when someone else needs it more urgently.
We thought by doing the inquest it was going to help, but obviously … 20 years later there's people still going through it.- Judy Gannon, Alice Martin's daughter
That it's taken so long — after they sat through days of inquest testimony that determined the dispatch technology was "outdated" even back in 2004 — has left Martin's family bitter and frustrated.
"I just don't understand why we invested so much time, effort and money into an inquest that's just … not implemented," said Tammy Yenson, Martin's youngest daughter.
Ambulance was diverted
Martin, 75, was suffering a heart attack on Oct. 14, 2003 and was struggling to breathe as she waited 20 minutes for an ambulance to arrive at her home in the rural village of Greely. Yenson was with her.
"When I was on the phone with the dispatch the second time, she was telling me that they were en route. And then I could hear sirens," remembers Yenson.
"And I said, 'Oh, I can hear them.' And she said, 'Yeah, they're on their way.' So we hung up. But it never came."
The inquest into her death revealed an ambulance sent Martin's way had been rerouted to a different high priority call, which was later downgraded as less serious.
A different ambulance had to be dispatched and took Martin. She arrived at hospital without vital signs.
"We didn't want anybody else to go through what we did," said Judy Gannon, Martin's eldest daughter.
"We thought by doing the inquest it was going to help, but obviously … 20 years later there's people still going through it."
Response times still an issue
Newspaper articles of 20 years ago sound remarkably like the news stories of today. The inquest jury concluded paramedics were short-staffed and underfunded.
It probed how rural areas were often underserved while ambulances were tied up in urban Ottawa.
The sisters have watched over the years as ambulance shortages have become the norm. Last year saw soaring call volumes, dispatchers had no ambulance to send a record-breaking 1,806 times and 60 staff per month were away with workplace injuries.
"We listen to the news and we hear the zero response times. We know exactly what that means for a family because we've lived it," said Yenson.
Most calls get lights and sirens
Ottawa paramedic Chief Pierre Poirier remembers when Martin died. He was a deputy paramedic chief then.
He can't say if Martin's death would have been prevented had the improved dispatch system been in place but says "We would have arrived quicker and maybe her chance of survival might have been better."
Even before the inquest, when several paramedic services were being amalgamated, Poirier said a consultant had recommended Ottawa move to MPDS. After that, mayor after mayor advocated through the years for the technology.
Poirier is convinced the dispatch system will be a game-changer for the dispatchers who serve not only Ottawa, but also Cornwall, Stormont, Dundas & Glengarry and the United Counties of Prescott & Russell.
WATCH | Ottawa's paramedic chief on the MPDS:
"Right now, sometimes we're chasing calls," he said. "When we have a number of calls held in the queue, we may be assigning and reassigning and reassigning paramedics to Code 4 calls that may not necessarily be Code 4."
Under the existing system, about 70 per cent of calls end up being deemed that highest Code 4, Poirier explained, so the system might treat cardiac arrest and abdominal pain equally.
"This new dispatch system will be much more discriminating. The highest priority calls will absolutely be given the highest priority."
Political delay
Poirier wouldn't weigh in on why the dispatch change took 20 years after a woman had died, instead saying how grateful he was the Ministry of Health had now finally given him the go-ahead and a date.
The president of the Ontario Association of Paramedic Chiefs, however, explained successive Ontario governments did not make ambulance dispatch a priority.
"Sometimes when you go from one government, one leader to another, it starts to lose steam. Other things become priorities and that's always a challenge," said Michael Sanderson.
Sanderson is also chief of Hamilton's paramedic service and saw firsthand the difference MPDS made when Vancouver paramedics implemented it more than a decade ago.
By not triaging patients as well as it could, Ontario has probably had longer ambulance response times, he said.
WATCH | Recent history of dispatch changes:
MPDS is standard in many jurisdictions worldwide and areas with it have been able to use it to identify and care for low-acuity patients without trips to the ER, thus improving the health-care system, Sanderson said.
Speeding up transfers of patients at ERs is the predominant issue causing the ongoing level zero problem, Sanderson said.
The new dispatch system could help, according to Poirier, if the triage for ambulance responses is more sophisticated.
PC government rollout
When Ottawa moves to the new system in 2024, Toronto will have had the system for decades. Niagara Region also received it in 2006 as a test project that never ended.
The Progressive Conservatives have now "picked up the project the Liberals left behind," wrote Health Minister Sylvia Jones's press secretary, Hannah Jensen, in an email.
She pointed out the former Liberal government moved only one of 21 dispatch centres (Niagara's) to the new software over 16 years. Ottawa had previously been told by the Liberals in 2017 that it would get the system.
- City seeks to triple new paramedic hires as ambulance demand soars
- 'Level zero' ambulance problem worsens dramatically in Ottawa in 2022
After some delays from COVID-19, the Mississauga centre made the switch last December, and the remaining 19 sites — including Ottawa's — should do the same over the next two years, Jensen wrote.
"Our government recognizes MPDS is the international standard and we will continue to work with our partners to complete the biggest change to pre-hospital care in the last two decades," she wrote.
Sanderson said the dispatch centres in Ottawa, Thunder Bay, and Dryden are among the next wave, but he intends to keep pressure on the PC government to speed up the extensive training and rollout to the rest of Ontario.
The Martin sisters often wonder if their mother would have lived, and how many others lost loved ones in the following years.
"I would like to know how many people ended up like us with these zero calls, zero response times," said Yenson. "How many people didn't make the wait?"
ABOUT THE AUTHOR
