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.

At the beginning of any patch to the BHP please provide the following information upfront:

  • 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.

The Secondary BHPs are ED Physicians working at the London
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

Patching Post Infographic
Patching Post Infographic

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. Matt Davis Patching Profile

Dr. Matthew Davis

Dr. Matthew Davis joined SWORBHP in 2010 as the program’s first EMS Medical Fellow. He held the position of Medical Director of Education and Medical Director of Lambton College and Fanshawe College Paramedic Programs from January 2013 – April 2017. Dr. Davis has also been the Local Medical Director for the Central Services (Elgin, Oneida, Oxford, Middlesex-London). As of April 2017, Dr. Davis transitioned into the role of Regional Medical Director. Dr. Davis graduated from Queen’s University with a Bachelor of Nursing Science and a Master of Science in 2002. He graduated from medical school at McMaster University in 2007, and completed his FRCPC Emergency Medicine residency training at Western University in 2012. He is currently an Emergency Physician at London Health Sciences Centre and an Associate Professor in the Division of Emergency Medicine at Western University. He is actively involved in multiple prehospital research projects and has presented his research at various international conferences. Dr. Davis has published research on topics including prehospital ECG utility, ACR utility for ED management of patients, morbidity and mortality associated with lift assists, and predictors of posttraumatic stress in paramedics.
Dr. Sean Doran Patching Profile

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 Patching Profile

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 Patching Profile

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 Patching Profile

Dr. Lauren Valdis

Dr. Valdis joined SWORBHP as the Medical Director of Education in April 2018. She completed her EMS fellowship training from 2015-2016 with the SWORBHP team. During which she had a special interest in training and education initiatives. Dr. Valdis completed her Royal College Emergency Medicine residency at Western University, graduating in 2017. Prior to this, she completed her medical training at the Windsor campus of the Schulich School of Medicine and Dentistry at Western and holds an undergraduate degree in Physiology and Health Sciences from Western University. Dr. Valdis is currently an Assistant Professor in the Division of Emergency Medicine at Western University and an Emergency Physician at London Health Sciences Centre. She regularly participates in undergraduate and postgraduate teaching through the medical school. Although she is (again) working back in London, from summer of 2018 to spring 2020, Dr. Valdis practiced at Windsor Regional Hospital and was privileged to work alongside the outstanding professional prehospital colleagues in the South.
Dr. Don Levy Patching Profile

Dr. Don Levy

Dr. Don Levy has been involved as a Base Hospital Physician since 2003 in Windsor-Essex and involved with continuing education with EMS in this role. He has a keen interest in prehospital emergency medicine care and in the past served as the Medical Director of EMS in the Southwestern Region in New
Brunswick. He served as Chief of Emergency Medicine from 2010 to 2019 at Windsor Regional.
Dr. Karalyn Church Patching Profile

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 Patching Profile

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 Patching Profile

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.