Lanark County Paramedic Service, Mississippi River Health Alliance Bring ‘Fit-to-Sit’ Approach to Lanark County Emergency Departments

Press Release – Mississippi River Health Alliance

Lanark County Paramedic Service (LCPS) has brought together hospital partners across the county, in partnership with the Mississippi River Health Alliance (MRHA) and Perth and Smiths Falls District Hospital (PSFDH), to implement a "Fit-to-Sit" approach in Emergency Departments — designed to improve patient flow, reduce ambulance offload delays, and keep paramedic crews available for 911 calls across the region.

When clinically appropriate, paramedics may safely transfer certain patients directly to the Emergency Department waiting area following a thorough assessment. Patients must meet strict clinical criteria — including being medically stable, low acuity, and able to sit comfortably — before this approach is used. Patients with more complex needs continue to receive care in the traditional manner.

Lanark County has seen a steady increase in demand for emergency services in recent years, placing added pressure on paramedic availability across the region. The Fit-to-Sit approach helps address one contributing factor — ambulance offload delays — by allowing paramedics to safely return to service sooner after transporting patients to the Emergency Department.

"Our crews are responding to more calls than ever before, and every minute matters," said Travis Mellema, Chief of Lanark County Paramedic Service. "Fit-to-Sit means that when your neighbour calls 911, there's an ambulance available to respond. That's what this is really about — keeping our community safe."

The approach is now in use across Emergency Departments in Lanark County, including Almonte General Hospital, Carleton Place & District Memorial Hospital, and Perth and Smiths Falls District Hospital, reflecting a shared commitment to improving access to emergency care across the region.

"Patient safety is always our top priority," said Brad Harrington, President and CEO of the Mississippi River Health Alliance. "This process is only used when patients have been assessed and meet clearly defined clinical criteria. Care is always prioritized based on medical need."

Arriving by ambulance does not change how patients are prioritized for care.

LCPS, MRHA, and partner hospitals continue to work collaboratively to strengthen access to care and meet the growing needs of the communities they serve.