Grey-Bruce ambulance dispatch to better prioritize highest-need calls

Changes to 911 ambulance dispatch in Grey-Bruce will introduce a more specific patient classification system to better prioritize patients so paramedics get to life-threatening emergencies faster.

Grey County paramedics briefed county council on the new provincial Medical Priority Dispatch System Thursday.

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It is being introduced at dispatch centres in stages across Ontario. On Oct. 14, the London Central Ambulance Communications Centre, which services Grey-Bruce, will triage patients under an expanded prioritization system that identifies the highest needs first.

Currently there are two patient categories, Code 4 for “urgent” response and Code 3 for “prompt” response. This system lumps more and less serious cases under Code 4. Someone vomiting could be assigned the same code as someone experiencing cardiac arrest, Jessica Robb, the deputy chief of operations with the paramedic service, told county council.

Significantly, this means an ambulance is dispatched on a first come, first served basis to all Code 4 calls, and paramedics couldn’t leave or be redirected en route to a more urgent case. Ambulances could only be redirected from Code 3 calls.

The new system categorizes patient conditions into five colour-coded and ascending priorities, allowing cases to be separated out more carefully, based on questions posed to the caller by the ambulance dispatcher.

Council was told the new approach could lead to delayed responses for less serious cases, but it is intended to get help faster to life-threatening emergencies. Maximum wait times are being developed, according to a staff report about the new system.

Kevin McNab, the director of paramedic services in the county, said “there’s nothing more frustrating as a paramedic than you know that somebody, they may be vomiting and short of breath. Today, it’s a Code 4. And then a cardiac arrest happens around the corner. We can’t be taken off that call.”

Robb said the new system will divert an ambulance to the patient with the “greater need.” So an ambulance sent to a laceration, but which is closest to a cardiac arrest call that comes in, “will be diverted to the patient who has the greater need . . .”

Southgate Mayor Brian Milne asked at what point in responding to a call would an ambulance be committed and couldn’t be diverted. Robb said she understands that would be once the paramedics make contact with the patient.

“I can’t imagine seeing an ambulance pulling up my laneway and having them diverted because they haven’t actually made patient contact,” said Southgate Deputy Mayor Barbara Dobreen. She wondered if callers are told their level of priority by dispatch.

She asked for assurances that “diversion would be a last resort” or that there is communication with the patient “so they understand they’re not a priority.”

Robb said a dispatcher is in communication with the patient. McNab said he believes dispatchers check back with patients every 30 minutes. Patients are advised to call back if their condition changes, he noted.

Warden Andrea Matrosovs observed these diversions happen now, but also allowed they could happen more frequently under the new system.

“The likelihood of that happening is small,” McNab said. “But the thing is now, even better, with this new priority tool, we’re pulling somebody off for a cardiac arrest from somebody that isn’t imminently dying, it’s to help that other person.”

He said it’s done “with the best intent to do the most for the most critical.”

He said lower priority calls are still being responded to within 25 minutes, nine times out of 10 now.

In a separate report to council Thursday, McNab reported on response times to calls categorized using the Canadian Triage and Acuity Scale, referred to as CTAS. The latest full-year figures are for 2025.

In cases of sudden cardiac arrest in Grey County, the target response time is six minutes or less, 40 per cent of the time, where either a community defibrillator or a paramedic is involved.

In 2025, responses met that target 48.47 per cent of the time. In the first six months, that target was met 55.91 per cent of the time and 50.03 per cent of the time under the five-year average. This is a separate category from the CTAS classifications.

The county met all response time target criteria except for the most urgent, CTAS 1 (respond in eight minutes or less) and CTAS 2 (respond in 15 minutes or less) calls in 2025.

CTAS 1 response met the target 58.65 per cent of the time but the target was 60 per cent. CTAS 2 response met the target 88.78 per cent of the time but the target was 90 per cent in 2025.

However, the figures also show improvement in the first six months of this year for CTAS 1, which includes cardiac arrest. The target is to respond in eight minutes or less 60 per cent of the time and it did so 63.16 per cent to June 30.

The county is implementing recommendations and has made ongoing improvements to its deployment model and system performance to address this, a report to council says.