This document outlines a pilot project between Emergency Medical Services (EMS) and a hospital (RGH) with the goals of reducing ambulance turnaround times and ending the practice of EMS crews waiting in hospital hallways. The project will trial strategies like having EMS crews promptly clean ambulances and make them available again for calls. In the hospital, all EMS patients will be immediately accepted and EMS crews won't have to wait for paperwork or patient transfers between departments. The working group will discuss changes needed and the hospital will have discretion to end trials for the day if patient acceptance becomes an issue.

1. Ending EMS Hallway Waiting
RGH Pilot Project - Overview
Multiple Goals for both EMS and the Hospital will be sought during this Project.
In The Ambulance Bay:
- EMS has had success in the past with improvement projects in the Ambulance Bay.
- This Project will also be used to model behaviour for EMS crews and implement
additional strategies to return EMS crews to in-service status as quickly as possible.
- Turnaround times will be collected and improvements sought daily during the Project.
LEAN Process Improvement Practices will be trialed as well.
- Crews will be instructed to promptly clean their stretcher, their ambulance and restock
all supplies, then park outside of the bay in preparation for their next call.
- Crews may still require time to do paperwork, eat or have a break, however their
Ambulance will be available to respond within EMS service standard guidelines.
In the Hospital ER:
- During the Project the primary goal of the Hospital will be to do whatever is
necessary to ensure Paramedics are not asked to wait in the ER Hallway.
- All patients brought in by EMS will be accepted immediately into the ER.
- Paramedics will place patients promptly on available hospital beds or if they meet the
waiting room guidelines, into an assigned ambulatory waiting area.
- We’d like to explore the idea of consistently placing stretcher patients on hospital beds
RIGHT AT TRIAGE for their comfort and safety, allowing one member of the EMS crew
to return the EMS stretcher to the Ambulance bay where they will clean, restock and
promptly return the Ambulance to in-service status.
- Paramedics will give a patient report ONLY ONE SINGLE TIME, to EITHER a triage
RN or the bedside RN. The current practice of giving multiple patient reports on even the
most minor patients eats up valuable time, is redundant and unnecessary.
- Any overflow stretcher patients will be placed on EMS provided cots and left with
RVGH staff to care for. In phase one of the Project, we will most likely end the study for
the day if RGH calls a halt because of an inability to accept care of the patient.
- Paramedics will not be asked to wait for charts or other Admitting Department
paperwork. Single sheet EAR (Emergency Assessment Record) forms printed by a triage
RN will be delivered with the patient to the bedside.
- Goal times for Bedside Transfer of Care will be established.
Emergency Department inpatient moves to accommodate placement of EMS patients will
not involve EMS staff or resources.
This is a preliminary planning meeting for a project with a very short proposed timeline.
Time is of the essence.

2. Ending EMS Hallway Waiting
RGH Pilot Project - Overview
- The working group will discuss changes to REPAC, staffing adjustments and
accommodations for System Status Alerts. The option to end the Project for the day will
be at the discretion of the Hospital in consultation with the EMS Supervisor.
This is a preliminary planning meeting for a project with a very short proposed timeline.
Time is of the essence.