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Big changes in store at Ornge: review

Oct. 9, 2013, Ottawa - Big changes are coming to ORNGE as the province’s medical transport agency puts its operations under the microscope to improve how it moves patients and further break with its troubled past.


October 10, 2013
By The Toronto Star

The location of bases,
the type of aircraft it flies and even how it responds to calls are all
on the table in a strategic review launched last month, said Dr. Andrew
McCallum, ORNGE’s president and CEO.

 

“My goal is to take
the corporation to a place where the maximum value is being added by
what we do, that we’re working to benefit patients the most, that we’re
integrated into the system in a way that in the past wasn’t occurring,”
he told the Star.

 

The agency, which gets
about 27,000 requests for transport a year and handles about two-thirds
of those calls, is looking at its “mission profiles” — how it uses its
mix of land ambulances, fixed-wing aircraft and helicopters to move
patients in the most efficient way possible.

For example, McCallum
said there is a “doughnut hole” around a helicopter base where a land
ambulance can respond just as fast. That accounts for the time it takes
pilots to plan their flight and get airborne.

 

“Helicopters win out
from about 35 to about 130 miles (56 km to 210 km) in terms of speed and
returning the patient to the receiving facility. Beyond that, you want
to use fixed wing (aircraft) because they’re twice as fast,” he said.

 

“In the past, I don’t
think that’s been built into the decision-making around the assignment
of the vehicle to the call,” McCallum said.

 

As a result, ORNGE is looking at where its bases should be located, McCallum said.

 

“That’s going to
require a lot of analysis. . . . It’s a little earlier to get into any
detail about where we’re going to go,” he said.

 

The review is also
examining operations in its call centre — “how we dispatch and what the
personnel are doing and how they make decisions” — and the training of
its paramedics.

 

“All of those things are going into the mix. There’s going to be a lot of change in the next four to six months,” McCallum said.

 

“One of the challenges
for me is to shepherd the organization through it. People can handle
the pace of change but it’s going to change a lot,” McCallum said.

 

Some of the very issues at the centre of the strategic review were raised earlier this year in a special report
by the Ontario chief coroner’s office into ORNGE’s operations. The
review examined 40 cases where a patient died and found eight cases
where ORNGE operational issues had some impact on the outcome. It found
problems with paramedic training and staffing, communication breakdowns,
delays in transport and decision-making and made 25 recommendations for
change.

 

Since taking over in
January, McCallum has been on a mission to boost morale, improve
efficiencies and put the organization back on track after allegations of
mismanagement in the previous administration.

 

But those efforts suffered a setback in May when an ORNGE helicopter crashed
near a midnight flight from Moosonee, Ont., killing the two pilots and
two flight paramedics onboard. The cause of the crash remains under
investigation.

 

The accident also set
back McCallum’s efforts to launch a strategic review, which got underway
in earnest last month when he sat down with stakeholders and ORNGE’s
employees, including its pilots.

 

That’s a break from
the past when helicopter pilots in particular complained that managers
were ignoring their expertise and opinions.

 

“They gave us their
thoughts and contributed I think in a really significant way to where
we’re going to head. They gave us information about the aircraft and the
base locations that was uniquely useful,” McCallum said.

 

ORNGE is also looking
at replacing the aging Sikorsky helicopters it currently uses at bases
in northern Ontario. The agency hasn’t decided on a replacement but the
AgustaWestland AW139 helicopter already in the ORNGE fleet is among the
options.

 

“One of the most efficient ways to operate any fleet is to have a single type of airplane,” McCallum said.

“We have to pick the
right aircraft for the mission ensure that we have sufficient load
carrying and speed, capacity with all-weather capability,” he said.