A nurse on the line? Essex-Windsor EMS pitches change to how 911 calls are handled

Essex-Windsor EMS would like clinicians to help with 911 dispatching, in an effort to direct services to where they are most needed. CTV Windsor’s Sanjay Maru e

If you ever need to call 911 in Windsor-Essex, there could come a time when the voice on the other end isn’t just a dispatcher — but a doctor or nurse helping decide what kind of care you actually need.

That’s the idea behind a proposal Essex-Windsor EMS brought directly to Ontario Health Minister Sylvia Jones this week, after EMS Chief Justin Lammers met with her Tuesday at the 2026 Rural Ontario Municipal Association Conference in Toronto. This comes as rising call volumes and system bottlenecks continue to test ambulance availability across the region.

Lammers said the challenge is no longer just about adding more trucks or paramedics, but about making better decisions earlier in the process.

“Our healthcare system is under stress, and we need to get efficient in how we are dispatching ambulances,” Lammers said in an interview with CTV News.

What’s being proposed

The proposal would introduce trained clinicians into the 911 dispatch process to help assess certain medical calls in real time. EMS said that added clinical judgment could help determine when an ambulance is truly needed and when other care options may be more appropriate.

Lammers said the concept is already well established outside the region.

“When we look at models that are successful in other parts of the world, they have clinicians inside of the communication center,” he said.

Lammers said the approach could allow EMS to respond more efficiently by tailoring the response to the call, whether that means sending a smaller unit, a single paramedic, or directing a patient to primary care instead of dispatching an ambulance.

How it works elsewhere

A similar model has been operating in Niagara Region since 2019, where nurses assist with secondary triage for lower-acuity 911 calls.

Marty Mako, commander of mobile integrated health with Niagara EMS, said the approach was developed after patterns in emergency call use began to change.

“There has been a significant increase in people using 911 for low-acuity calls — situations that aren’t time-sensitive or life-threatening,” Mako said.

Rather than defaulting to an ambulance response, nurses help assess what kind of care best fits the situation.

“The goal is to make sure the patient gets the right care, at the right place, at the right time,” he said, adding that can mean alternatives to an ambulance trip in some cases.

“You may still need to go to the emergency department, but you don’t need an ambulance. Could you get there on your own later in the day with the help of a friend or family member? Could your issue be seen in an urgent care clinic, a walk-in clinic, or perhaps by your family doctor, whether that’s the same day or the next day?”

According to Mako, who said the addition of clinicians into Niagara’s 911 dispatch process did not result in any additional cost to taxpayers, redirecting those calls has a direct impact on emergency readiness.

“Every call we triage more appropriately helps preserve our fleet and our resources for what they were intended for,” he said.

Why the issue is urgent locally

In Windsor-Essex, EMS officials said seasonal illness and limited hospital capacity can quickly magnify the impact of even small increases in call volume.

That strain is reflected in how often the region has entered “Code Black,” a status used when no ambulances are available to respond to new calls.

According to EMS data, Windsor-Essex recorded 358 minutes of Code Black in 2024, and in 2025, that figure is projected to rise to 540 minutes.

On Jan. 14, during a winter storm in Windsor-Essex, the region entered Code Black for 12 minutes.

“At the current point in time, we are in surge with influenza and hospital capacity,” he said.

“When we have events that increase our call volume, we can tip into decreased resource availability, such as a Code Black.”

Those same pressures are felt inside emergency departments, according to Jonathan Foster of Windsor Regional Hospital.

Foster said ambulance arrivals can occasionally create operational challenges even when hospitals are actively trying to move patients through the system.

“We experience this on a daily basis, with bursts of high traffic where EMS arrivals cluster at once,” Foster said.

He noted that a significant portion of patients arrive by ambulance despite having stable conditions.

“30 to 40 per cent of our emergency department visits come by ambulance, and not all of those cases truly need an ambulance arrival or to be seen immediately,” Foster said.

From the hospital’s perspective, Foster said the EMS proposal could help prevent unnecessary congestion before patients ever reach the emergency department.

“We strongly support EMS in their proposal for this,” he said.

“There’s a lot of evidence showing it works well in other communities.”

He added that earlier clinical guidance could help patients identify alternatives when emergency care isn’t required.

“It helps people identify options if they’re not truly having an emergency, whether that’s urgent care, primary care, or other services in the community,” Foster said.

What happens next

Essex-Windsor EMS said a new priority dispatch system is expected to roll out in February 2027, standardizing how 911 calls are assessed.

Officials stress that adding clinicians into the dispatch centre would be a separate step — an additional layer of clinical triage rather than part of that rollout.

For now, EMS says discussions with the province are ongoing as it looks for ways to improve efficiency while keeping ambulances available for the most serious emergencies.