9-1-1 Models of Care: Providing Care in the Right Place, at the Right Time

Published on May 07, 2021

Today, MPP Dave Smith announced our government's latest reform to Ontario's health care system, creating a more efficient, effective and patient-centred system.

Ontario Expanding Innovative Models to Deliver Better, Connected Care in Centre-East Ontario
9-1-1 Models of Care Will Provide the Right Care in the Right Place and Protect Hospital Capacity

Peterborough-Kawartha— The Ontario government is launching new 9-1-1 models of care to now cover 33 municipalities across the province, including Peterborough County. These new models of care will ensure paramedics have more options to provide safe and appropriate treatment for patients while helping to protect hospital capacity as the province continues to respond to the third wave of COVID-19.
MPP Dave Smith joined MPP’s David Piccini (Northumberland-Peterborough South), Lindsey Park (Durham), and Lorne Coe (Whitby) to provide details on the model of care today.

Currently, paramedics are required to bring 9-1-1 patients to overcrowded hospital emergency departments, even when there are other appropriate care and treatment options available in the community. Under the innovative patient care model pilots, eligible palliative care patients and those experiencing mental health and addictions challenges can receive appropriate care by the paramedic directly or in the community as appropriate. 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.

“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,” said Christine Elliott, Deputy Premier and Minister of Health. “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.”

“Since well before the COVID-19 pandemic our government has been committed to ensuring all Ontarians have access to an appropriate and effective level of care,” said MPP Dave Smith. “Today’s announcement is testimony to that commitment, and I am excited to see how this new model will enhance the quality of care available to Peterborough-Kawartha residents. As a community, we are truly blessed to have such an exceptional team of paramedics that work tirelessly to keep our community safe and healthy. I know I speak on behalf of all of Peterborough-Kawartha that we are thrilled to have our paramedics begin this pilot and expand their presence in the community,” added MPP Dave Smith.

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, after which it will be evaluated to assess outcomes, identify where program adjustments may be needed, and how to implement new models of care throughout the province.

 To date, 9-1-1 models of care pilots have been approved for implementation in regions across Ontario covering 33 municipalities, with additional details to become available in the coming weeks.

 Under the Alternate Destination model, specially trained paramedics assess the patient’s condition on-scene, per the Patient Assessment Standard of the Basic Life Support Patient Care Standards, followed by transport to a local hospice for palliative care patients, or to a local crisis centre for patients experiencing symptoms of mental health and addictions challenges. This model is currently available in select regions for both palliative care patients and patients experiencing symptoms of mental health and addictions challenges.

 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 and mental health and addictions 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.