Report To: Manitoulin-Sudbury District Services Board
From: Paul Myre, Chief of Paramedic Services
Date: October 19, 2023
Re: Response Time Standards (RTS)
Purpose
The purpose of this report is to provide the Manitoulin-Sudbury DSB Board with a Response Time Standard (RTS) for calendar year 2024, and to obtain approval for submission of the plan to the Ministry of Health (MOH) by October 31st, 2023. Additionally, this report will provide the DSB Board of Directors with specific information related to response capacity in order that future strategic planning can be informed.
Background
Paramedic Services across Ontario are required by law to establish a performance plan for the following calendar year regarding overall response times to calls for service. As per the Ambulance Act of Ontario, Regulation 257/00, the term “Response Time” is defined as the time a notice is received from a Paramedic Unit by a Central Ambulance Communications Centre (CACC) to the arrival on-scene of the Paramedic Unit.
The plan must provide targets for Paramedic Service response times to 911 calls sequenced by acuity using the Canadian Triage and Acuity Scale (CTAS). This tool prioritizes patients based on their chief complaint on a scale from 1-5, 1 being the highest severity and 5 being the lowest. The plan must also include Paramedic Services’ target response times to all Sudden Cardiac Arrest calls. The MOH establishes the expected response times for all SCA (6 minutes or less) and CTAS 1 (8 minutes or less).
The Paramedic Services sets the expected response time targets for all other calls. The legislation further mandates that Paramedic Services not only establish a plan but also must ensure that the plan is continuously maintained, enforced and evaluated. By no later than October 31st in each year, Paramedic Services must submit a copy of the established plan for the following year including expected targets to the Ministry of Health. A complete copy of the previous year’s performance including the percentage of response times to Sudden Cardiac Arrests, CTAS 1,2,3,4 and 5 must be submitted to the MOH by no later than March 31st.
Current State
Since 2017, our service has submitted the following response times and performance expectation as targets by October 31st of each year:
| Patient Type | Plan in Minutes | Plan in Percentage | Performance in Percentage |
| CTAS 1 | 8 mins* | 30% | Due March 31 |
| CTAS 2 | 15 mins | 65% | Due March 31 |
| CTAS 3 | 20 mins | 75% | Due March 31 |
| CTAS 4 | 25 mins | 85% | Due March 31 |
| CTAS 5 | 25 mins | 85% | Due March 31 |
| SCA | 6 mins* | 30% | Due March 31 |
*Plan in minutes established by the Ministry of Health
During the February 2023 Board Meeting, the Board heard through the 2022 Response Time Standards Issue Report that thanks to the implementation of approved countermeasures, our service was able to achieve all but one of the set response time targets. This was in contrast to our performance in 2021 where we had failed to achieve our targets in all but one set response time standard. The only exception was the 6-minute response target to Sudden Cardiac Arrests (SCA) that is set by the Ministry of Health and not the Paramedic Service. While this is an important target and one that has an emotional component attached to it, our average response time for SCA in 2022 was just under 17 minutes. This means our crews either travelled an average of 15 kilometers per SCA call or were possibly “on-call” when the call was received making a 6-minute response practically impossible to achieve.
Paramedic Services will be submitting the exact same response time targets to the Ministry of Health as 2023 to continue to assess if our Deployment Plan effectively manages our emergency response capabilities while continuing to explore other means to stabilize and improve our response times.
Conclusion
The Manitoulin-Sudbury DSB will submit the 2024 response time standard plan to the Ministry of Health as outlined above.