Paul Raftis Chief Toronto Emergency Medical Services Headquarters 4330 Dufferin St.

Toronto, Ontario M3H 5R9 Phone: 416-397-9240 Cell: 416-895-0427 E-Mail:

November 30, 2012

To: From: Subject:


Recently, there have been a number of media stories critical of the management of Toronto EMS. The issues include paramedic staffing numbers, call volumes, response times, management overtime, new computer dispatch technology, and the use of EMS' fleet and service contractors. These reports represent a campaign by a group of employees with a specific agenda. I believe this campaign is unfortunate and a disservice to the City and Toronto EMS employees. We know we have a highly dedicated and skilled workforce. All of our staff, including Paramedics, Emergency Medical Dispatchers, Support and Management staff, are passionate about providing the best level of care possible for the residents and visitors to Toronto in the most efficient and effective way. It is correct that our call volumes continue to increase due to a growing and aging population. This is a serious issue and we have all been focused on and contributing to redesigning our service and making important improvements that will ease the pressure on the system. Some of the steps taken include: • Working with the expert consultant (Pomax) selected by the City Manager to review every aspect of Toronto EMS service, including our staffing requirements in the short and long term. This report is expected by the end of the year; In 2012, proceeding with the hiring of 64 paramedics; From 2010 to 2012, maximizing Federal infrastructure grants to modernize our facilities for staff and improve compliance with Ministry of Health requirements, e.g., addition of medical supply storage rooms; Modernizing EMS' fleet to address Paramedic health and safety concerns, meet recent Ministry of Health legislated changes and improve vehicle efficiency through the use of technology, e.g., greening the fleet. In January 2013, implementing a new Paramedic shift schedule that will now better match staffing levels to call demand and provide more options for staff; Tighter management of overtime, reduced budgeted expenditures by $1M in 2011;

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In 2011, when the renewed EMS senior management team took over, the annual management overtime costs were reduced by 50%; With expert advice from our Base Hospital physicians, we have based our dispatch priorities, tiered responses and deployment on analysis of ePCR data; Instituting community-based programs to reduce non-critical calls and repeat callers by assessing and referring certain patients to more appropriate community services rather than hospitals; With expert advice from our Base Hospital physicians, in 2013 we will move to a new model of care that will include a targeted response plan to improve our advanced life support capture of critical patients; In 2013, will implement part-time Paramedics to help reduce overtime; and Continue to work with the Ministry of Health and hospitals to improve the dedicated Offload Nurse Program to reduce ambulance in-hospital times.

Every organization can find room for improvement; Toronto EMS is no different. You need to know that we are continuously reviewing and making improvements to the organization in the most cost-effective manner to meet service level demands. The senior management team is committed to developing a culture of continuous improvement to meet the expectations of the community. Thank you for your ongoing dedication and commitment to our patients and the residents of our City. Your high level of professionalism and service excellence is very much appreciated. Sincerely,

(original signed by)

Chief, Toronto EMS

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