Councillors vent frustration over 'level zero'

Coun. Matthew Luloff told the CEOs of three local hospitals Thursday that he knows what it feels like to be in a health emergency and have all of Ottawa's ambulances tied up at ERs, unable to respond to another 911 call.

When his daughter was born at the Ottawa Birth and Wellness Centre on Walkley Road in September 2019, she struggled to breathe. But the paramedic who responded arrived without an ambulance — those were all lined up waiting to transfer patients to city hospitals, a frighteningly frequent situation known as "level zero."

• Paramedics spent 53,000 hours delayed at hospitals in 2019
• 'People are dying': Life and death at level zero

"What was supposed to be one of the happiest nights of my life is always going to be scarred by an entirely preventable Level Zero," Luloff said during a virtual meeting of the city's community and protective services committee.

The heads of the Ottawa, Queensway Carleton and Montfort hospitals were on hand to answer questions from Luloff and his council colleagues about a problem that's been going on for years — one that seems only to be getting worse.

Last year alone, Ottawa's paramedics spent more than 50,000 hours waiting to transfer patients to hospital staff. The city hit level zero more than 500 times in 2019.

Councillors said residents will send them photos of two dozen ambulances waiting at the Civic campus of The Ottawa Hospital. "[That] keeps us up at night," said Pierre Poirier, the new chief of the city's paramedic service.

Symptom of a bigger problem

"All three of us feel that level zero is an unacceptable situation for our citizens," agreed Dr. Andrew Falconer, president and CEO of the Queensway Carleton Hospital.

The hospitals have asked the province to fund nurses who can take patients when an emergency bed is not yet available. A new pilot project is planned for the area's trauma centre at the Civic campus of The Ottawa Hospital, where paramedics will transfer patients directly to the nurses in a dedicated area.

But the CEOs said the situation is a symptom of an even more daunting problem: a shortage of beds, not only in hospitals but also in long-term care.

"Trying to do something to fix ambulance offloads without dealing with the system capacity issues is a patch in the short term without a solution in the long term," said Cameron Love, president and CEO of The Ottawa Hospital.

• Blocked beds costing Ottawa hospitals millions

Love said in the past month, there have been as many as 260 patients occupying beds at The Ottawa Hospital who didn't need that level of care. Five years ago, there were 140. 

To improve the flow, hospitals have established "surge" beds in other areas of the hospital, and even elsewhere: the Queensway Carleton currently has 28 patients in a former Kanata hotel, Falconer noted.

Dr. Bernard Leduc of the Montfort Hospital said the Ontario government has promised 30,000 more long-term care beds, as well as improvements to home care, but hospitals haven't seen that materialize.

Domino effect

Councillors acknowledged the domino effect taking place, but they're nevertheless frustrated the city keeps incurring costs for a problem not of its making.

"The capacity in the [health-care] system is not a municipal matter," said Coun. Catherine McKenney. 

"It's unacceptable that we have people waiting at home for an ambulance, and it's just a matter of time before somebody dies," said Coun. Carol Anne Meehan, echoing similar comments she made a year ago. "We're doing our part, now we're asking you to do yours."

But Love said bed capacity isn't a problem for hospitals alone to solve.

"We are moving in the right direction, it's just not fast enough, and I fully appreciate the frustration. Our [emergency room] docs, they're equally as frustrated because they're concerned for the people waiting to get access," said Love.

"I think we all share a common goal here, it's just trying to get some of these things in place and get them funded so we can make a dent in this."