Waterloo region paramedics to implement Fit 2 Sit this fall in order to speed up transfer times

The Region of Waterloo Paramedic Service plans to implement a new Fit 2 Sit program this fall that will speed up the process of transferring patients to hospital if those patients can safely wait for care in a hospital's waiting room.

The initiative is part of a series of efforts aimed at reducing the amount of time paramedics are delayed at the Grand River, St. Mary's General and Cambridge Memorial hospitals and increasing the availability of ambulances in the community, said John Riches, the chief of the region's paramedic service.

Paramedic services across the province have been struggling to respond to ballooning call volumes, an increase in the severity of patients' conditions and longer offload times at hospitals, according to a 2020 CUPE report — all of which have contributed to what the Region of Waterloo service calls "code reds," periods of time when there are no ambulances available to respond to calls. 

While the number of code reds dropped to 38 in the first half of 2023 from 59 during the same period last year, the number of hours spent in code red actually climbed to nearly 17 from just over 15. 

"The number of times that code reds or code yellows occur is still deeply concerning," Riches said, despite the drop in the number of incidents. 

"Nobody wants there to be no paramedics available to respond to calls in the community. Nobody wants that situation."

Paramedics already transfer some patients from ambulances into hospital waiting rooms, Riches said. 

Fit 2 Sit will establish a formal process for doing so, which will cut down the time involved, he added.

It will also clearly spell out the criteria for who can and cannot be left unattended to wait for care.

Fit 2 Sit programs commonly require patients to be alert and able to sit or stand, and to have vital signs in normal ranges. They exclude patients whose conditions rank high on the Canadian Triage Acuity Scale (CTAS).

The paramedic service plans to monitor the time it spends transferring patients to hospital waiting rooms before and after it implements Fit 2 Sit to assess how well the program works, Riches said. 

It will also look at patient outcomes.

"Us and our hospital partners are committed to changing the program if we need to," Riches said. 

"Maybe that change might be broadening who's eligible for Fit 2 Sit, or it might be narrowing it, depending on, you know, what the metrics are telling us."