Patching
Overview
Overview
The Southwest Ontario Regional Base Hospital Program (SWORBHP) oversees the provision of online medical control 24 hours a day for paramedics in the SWORBHP Region. Over the past 4 months we have been trialing the use of a centralized patch model which largely consists of a small group of physicians with expertise and/or interest in prehospital and transport medicine. From this pool, one physician is “on call” to answer the patch phone for all paramedics within the SWORBHP Region between 07:00 and 23:00.
If you are calling the Primary BHP and your call goes to voicemail after multiple rings, please attempt the Primary BHP line one more time. If you are unable to reach the Primary BHP after two attempts, please utilize the Secondary BHP.
Due to the use of multiple diverters and the current cellular provider being utilized, the Primary BHP has a very short period to answer the phone before voicemail kicks in (we hear far fewer rings that what you are hearing on your end).
We are investigating ways to ensure that the Primary BHP has a longer period to answer the phone before voicemail kicks in and our solution is likely months out. As such, we request that two attempts be made to contact the Primary BHP.
As the pilot project enters its fourth month we have seen improvement in the patch calls being directed to the correct BHP. There still remains patches that are being directed to the Secondary BHPs instead of the Primary BHPs. We have identified the reason for this and require your assistance to ensure calls are being directed to the correct BHP. Paramedic Service issued cell phones have all been updated with the correct numbers. However, we realize that many paramedics utilize their own personal cell phones and have the BHP numbers preprogrammed into their phone. If you have not already done so, we ask that you please update the phone numbers within your personal cell phones to ensure that your calls are directed to the correct BHP.
- Your full name
- Your scope of practice (PCP or ACP)
- Your Service
- Run number
(we understand in critical situations this might not be available at the time of the call) - What order you are calling for
(This helps the BHP shape the information you are providing about the details of the case)
Please ensure that you provide an early notification to the receiving hospitals during critical patient transports (e.g. cardiac arrest patient whereby the BHP provides order for transport). This helps ensure that the Emergency Department (ED) team has adequate preparation time and thus allowing for a smoother transition of care.
Health Sciences Centre (LHSC) – Victoria Campus. They are the 24/7 Secondary BHPs. They have previous experience answering patches for both PCP and ACP Services.
History of Centralized Patching
History of Centralized Patching
The Purpose of the Initial Project
The Purpose of the Initial Project
- Determine feasibility and sustainability of centralized
patching in the SWORBHP Region;
- Determine satisfaction amongst frontline paramedics utilizing this patching model;
- Troubleshoot IT issues and assess technical quality of
patches in real world setting;
- Determine instances of patch failures and compare to the current patch model;
- Assess sustainability of this model from a human resource perspective;
- Obtain feedback from both paramedics and Base Hospital Physicians (BHPs) who are providing this service to assist with system improvements;
- and Prepare for future state where online medical control may have a larger role in prehospital care.
Base Hospital Patch Physicians
Base Hospital Patch Physicians
Dr. Matthew Davis
Dr. Sean Doran
Dr. Doran recently joined SWORBHP in 2017 as the Local Medical Director. Dr. Doran completed a Royal College of Physicians and Surgeons Emergency Medicine Residency at the University of Western Ontario. He received his Medical Doctorate Degree from Western University. In addition to this he obtained a Bachelor of Education and a Bachelor of Science in Biology from Western University. He also holds a Bachelor of Arts in Law and Psychology at Carleton University. Dr. Doran is currently an Assistant Professor in the Division of Emergency Medicine at Western University and an Emergency Physician at London Health Sciences Centre.
Dr. Paul Bradford
Dr. Bradford has worked in the provincial Base Hospital program for 18 years and joined SWORBHP in October 2008 as a Local Medical Director. He is an Emergency Physician, Trauma Team Leader and Critical Care Assistant. He is a Medical Director of Trauma at the Ouellette Site of Windsor Regional Hospital. Dr. Bradford attended medical school at Queen’s University, did his Family Medicine training in Sudbury, and his ER training at UWO; completing his Masters from RMC in Military Trauma System design. He has experience in Base Hospital and Trauma program accreditation review teams and as a Medical Director and Chief of ER. He has taught ATLS, ACLS, PHTLS, ITLS, Tactical Combat Casualty Care, and currently teaches in Paramedic and Physician Assistant Programs. LCol (Ret) Bradford has a military background with over twenty six years of service, 2 tours of duty peacekeeping, and was the Commanding Officer of 23 Field Ambulance for 5 years. He has certification in Aeromedical Transport, and Aviation Medicine.
He has served on the Federal Disaster Assistance Response team to Hurricane Mitch, and deployed to the Winnipeg flood, the Eastern Canada Ice Storm. He has training in CBRNE and disaster planning. He helped draft the auxiliary provincial medical directives and assists with the local Hazmat/CBRNE Provincial Response Team, and local disaster preparedness. He is the Senior Area Medical Officer for Veterans Affairs for Southwestern Ontario. His research interests include trauma, prehsopital care and primary responder PTSD.
Dr. Sunil Mehta
Dr. Mehta recently joined SWORBHP in 2020 in the new role of Local Medical Advisor and in 2021 became a Local Medical Director. Dr. Mehta completed his Bachelor of Science at University of Waterloo and then medical training at the Schulich School of Medicine and Dentistry at Western in 2006. He completed his Family Medicine residency at Western University with Emergency Medicine training. He currently works as an Emergency Physician at Grey Bruce Health Services – Owen Sound and has served as Chief of that department since 2015. He has also served as an investigating coroner in the region since 2016.
Dr. Lauren Valdis
Dr. Don Levy
Brunswick. He served as Chief of Emergency Medicine from 2010 to 2019 at Windsor Regional.
Dr. Karalyn Church
Dr. Church is a graduate of the Royal College of Physicians and Surgeons Emergency Medicine Residency at Western University. Prior to that, she completed both her Undergraduate and Medical degrees at the University of Vermont, in Burlington Vermont. While in Vermont, Dr Church worked as both a volunteer EMT and served on the Colchester Technical Rescue Squad for regional based search and rescue. Following a decade of work at LHSC, she has jumped the 401 and can now be found at St Thomas Elgin General
Hospital where she is a consultant Emergency Physician and Adjunct Professor at Western University. Dr Church has a specific interest in emergency services in rural and underserved areas and continues to practice at many different hospital sites across the province via a provincial locum locum physician project.
Dr. Tony Meriano
Dr. Meriano is an Emergency Physician at Windsor Regional Hospital with 21+ years of practice. He has experience with trauma team and critical care as well as with the Canadian Forces.
Dr. Mary Fotheringham
Mary Fotheringham, MD, MSc, FRCP completed her medical degree at Dalhousie University in 2009 and residency in Emergency Medicine at the University of Toronto in 2014. Since 2015 she has practiced Emergency Medicine at London Health Sciences Centre. She is an Assistant Professor and Clinician Teacher at Western University and is the Director of Simulation for the Division of Emergency Medicine. Her passions include medical simulation, prehospital Event Medicine, and Star Trek.