New model of care for select 9-1-1 medical emergency patients

Ontario is improving patient access to the right care in the right place by launching new 9-1-1 models of care so that paramedics have more options to provide safe and appropriate treatment for patients, as part of the province's comprehensive plan to end hallway health care.

On February 10, 2020, Christine Elliott, Deputy Premier and Minister of Health, announced the first new model in Ottawa. Starting in April, eligible palliative care patients who call 9-1-1 in the Ottawa region will have the option to be treated on-scene for pain and symptom management by trained paramedics. Paramedics will then send a referral back to the patient’s primary palliative care team for follow-up instead of taking them to an emergency department. Currently, paramedics are required to bring 9-1-1 patients to overcrowded hospital emergency departments, even when there are appropriate care and treatment options available.

Under this new care model, Ottawa paramedics that have received special training will assess the patient’s condition when they arrive on scene. They will be able to provide treatment, including administering medication for pain relief, shortness of breath, hallucinations, agitation, nausea, vomiting and terminal congested breathing. The patient will remain in ultimate control of the care they receive and can at any time insist on being taken to the hospital. Other pilot projects will include additional care options, including mental health and addictions crisis centres.

Ottawa Paramedic Services are among the first municipal land ambulance services in Ontario piloting new models of care. The ministry welcomes new proposals from municipalities who are considering the implementation of the new models of care that fit their community’s needs and will accept proposals on a rolling basis. Interested municipal ambulance services should check the new Patient Care Model Standards when considering implementation of the new models of care. The standards include two options for pilot projects in 2020:

  • Transport to Alternate Destination, which will enable transportation of eligible patients to non-hospital destinations where they can receive appropriate treatment
  • Treat and Refer, where paramedics will be able to provide on-scene treatment and referral to health care providers within the home or community setting.

In municipalities piloting new patient care models, paramedics will assess patients’ conditions and needs and provide alternative care options to eligible patients. Paramedics will also request patient consent to be treated at home with follow up or referral to an appropriate healthcare provider or transport them to an appropriate community-based health care setting that meets their needs in a safe and timely manner.

Learn about the process for implementing new models of care and new standards

Ontario Improving Access to the Right Care in the Right Place