Ottawa Paramedic Service Improves Operations with Five-Level Dispatch System

In a bid to improve EMS response with the resources it has at hand, the Ottawa Paramedic Service (OPS) has replaced its old dispatch coding system with a new five-level system. Known as the Medical Priority Dispatch System (MPDS), the new system went live at the Ottawa Central Ambulance Communications Center on April 10, 2024.

"Essentially, the old Dispatch Card Priority Index (DCPI) system only had two codes, while the new system MPDS has five different color codes,” said OPS Chief Pierre Poirier. “As such, the MPDS is much better for determining life-threatening events such as cardiac arrests, and also determining what isn't a life-threatening event. It allows us to better manage our resources to get to patients in a timely manner.” For the record, the most serious and life-threatening calls are ‘code purples’, while the least serious are ‘code greens’ for non-urgent calls where there is no immediate threat to the patient’s life.

From a Dispatch standpoint, moving from two to five codes provides useful information to the OPS’ paramedics, better responsiveness to the most seriously ill patients, and more flexibility to the OPS for managing its limited resources. That’s because “code purple calls may be somewhere between 2 and 5 percent of all the calls that we do,” Chief Poirier said. (Second-level code reds, which are 38% of the OPS’ calls, also represent high acuity requests but are not in or near cardiac arrest; such as ischemic chest pain and anaphylaxis.) “Under the old system, 77 percent of our calls were considered to be the highest priority. So the MPDS really is a much more effective and efficient tool for dispatching paramedics, whereas the old tool was a very blunt instrument."

By using the new Dispatch system — which does require dispatchers to ask 911 callers more questions to assign the right MPDS levels — “our ability to respond to the most serious calls should improve,” said Chief Poirier. “It also helps us to better manage non-life threatening calls that we can safely hold in the queue, and assist our paramedics in getting their breaks and getting off work on time.”

The OPS’ move to the MPDS comes as the agency is trying to reduce its level of ‘Level Zero’ events when no ambulances are available for calls. However, “I am very hesitant to say that it'll directly help,” Chief Poirier said. “I think it will help us manage the flow of our calls during the day, which could help reduce the number or the occurrence of Level Zeros. But we're collecting data right now before we make any assertion such as that.”

As for the MPDS’ performance to date? “We took our first call at 3 AM on April 11th,” the Chief replied. “Since then, the MPDS has performed well. We're still adjusting to its impact upon staff and the overall change management for the organization, but to date, it's gone very well.”