New dispatch system to prioritize most serious medical emergencies in Perth County

A new emergency medical dispatch system coming to Perth County later this year will help ensure ambulances and other emergency resources are sent to the patients who need them most while reducing unnecessary emergency responses.

At its June 4 meeting, Perth County council received reports from paramedic chief Mike Adair and deputy chief of operations Tristan Barter outlining the implementation of the Medical Priority Dispatch System (MPDS) and new tiered-response agreements between Perth County Paramedic Services and local fire departments in Stratford, St. Marys, North Perth, Perth East and West Perth. The changes are scheduled to take effect when MPDS is rolled out through the London Central Ambulance Communications Centre in November.

“At it’s core, MPDS is a modernized, emergency medical dispatch system that is already widely used across Ontario and North America,” Barter said. “The goal of this system is really straightforward; making sure the rights resources get to the right patient at the right time.”

The new dispatch system replaces the current two-tiered ambulance dispatch model with a five-level priority framework designed to better match emergency responses to a patient's condition. Under the system, call-takers use a structured series of questions to determine the severity of an incident and assign the most appropriate response.

According to Adair's report, the internationally recognized, evidence-based system is intended to improve dispatch accuracy, enhance patient care and ensure life-threatening emergencies receive the fastest response possible.

One of the most significant changes residents may notice is that lower-acuity calls will no longer receive the same response priority as life-threatening emergencies.

“Life-threatening emergencies will continue to receive the fastest response possible, while lower-acuity calls may receive a response that is clinically appropriate based on a patient’s condition,” Barter said.

“… Another significant benefit of MPDS is it should reduce unnecessary lights-and-sirens responses within the county. Emergency driving carries a risk for not only paramedics but for the public. By reserving lights and sirens for truly timely, critical emergencies, we improve safety while ensuring patients receive appropriate care.”

The report notes that during periods when ambulance resources are limited – defined as three or fewer ambulances available in the system – some lower-acuity calls may be held for a defined period under guidance from base hospital physicians to ensure ambulances remain available for higher-priority emergencies. Those situations are expected to be rare and will be closely monitored.

The goal, according to the report, is to preserve resources for patients experiencing serious medical emergencies while ensuring lower-acuity patients continue to receive care within clinically appropriate timeframes.

“There really is no difference for the end user in terms of when you call 911,” Adair said. “It will feel exactly the same. They might ask you a few more questions, but if you’ve called 911 before, that system will remain the same. This is all the process behind the scenes that will change the way that we’re dispatched.

“What will feel different is in certain circumstances, we may be responding at a slower rate because it’s more appropriate to that call and we want to always have resources available for those higher-acuity calls.”

To support the transition, Perth County Paramedic Services is renewing tiered-response memorandums of understanding with the fire departments serving Stratford, St. Marys, North Perth, Perth East and West Perth. Adair told council the updated agreements have the support of all local fire chiefs.

The agreements establish when and how fire services may be dispatched to medical emergencies alongside paramedics. Under MPDS, fire departments will generally be sent to calls where their involvement provides clear clinical or operational value, such as cardiac arrests, unconscious or unresponsive patients, respiratory emergencies, motor-vehicle collisions, farm and industrial incidents and remote-access rescues.

The new agreements are intended to reduce fire-department responses to lower-acuity medical calls while ensuring firefighters remain available for serious emergencies and situations where additional personnel or specialized equipment may be required.

“This (memorandum of understanding) establishes a process for fire services to bring forward either any kind of concerns or requests to make changes in terms of how they’re responding to calls,” Adair said, noting the new agreements will be flexible in nature so changes and improvements can be made over time, when necessary.

Adair's report notes MPDS will not increase call volume. Instead, it is designed to ensure the right resources are dispatched at the right time based on real-time clinical information received through the 911 system.

Perth County Paramedic Services is working with the Ministry of Health, local fire departments and other emergency-service partners to prepare for the transition. A public-awareness campaign is also planned before the system goes live to help residents understand how calls will be prioritized and what they can expect when they call 911 for medical assistance.