The province’s massive plan to ease hospital wait times is already starting to
have an impact on St. Joseph’s Health Centre’s emergency department but there
are still challenges ahead, says the hospital’s top official.
CEO Carolyn Baker said initiatives rolled out through the Ministry of Health in
the last two years have reduced ER wait times but the number of beds occupied by
non-emergency patients hasn’t been decreasing at the Queensway area hospital.
“At this point, we have not seen any improvement in the numbers of people who
are waiting here for alternate levels of care,” she said Feb. 23. “Last week, we
had 72 patients waiting here who should have been somewhere else.”
Accessing care for those who don’t need to be in a hospital is one of the
biggest challenges faced by facilities like St. Joseph’s, say healthcare
officials, particularly with a growing senior population and the prevalence of
chronic disease like diabetes and mental health issues.
To divert people from emergency rooms, the government has invested $38.5 million
for increased home care and $22 million for the province’s 14 local integrated
health networks.
An additional $4.25 million is being invested in nurse-led outreach teams.
Other initiatives unveiled this month include a new website (www.ontariowaittimes.com)
that provides data on time spent in the ER, public education and outreach, and
Health Care Connect, a new program that helps people without a healthcare
provider find one.
Of the seven hospitals in the Toronto Central network, St. Joseph’s typically
has a higher percentage of hospital beds occupied by non-acute patients.
“We’ve got the biggest emergency department in terms of absolute numbers of
people in the GTA who come here for care,” Baker said.
“We’re actually the second or third largest volume emergency department in the
province on a single night.”
A bottleneck occurs when an emergency room doesn’t have proper flow because
there aren’t enough beds. New acute care patients coming into the hospital are
also left to sit and wait.
According to the Ontario Hospital Association, hospitals reported in January
that over 3,000 patients were waiting in an acute bed for alternate care on any
given day, representing about 19 percent of all beds in Ontario.
One of the newer initiatives at St. Joseph’s is a clerk position who is
effectively “the equivalent of an air traffic controller position inside the
emergency department.”
The person is responsible for making sure a patient’s diagnostic information,
including lab tests and X-rays, are gathered so a physician can quickly
determine if the patient needs to be admitted or referred to another consultant.
“We’ve been doing that for over a year and that has resulted in significant
improvement in times that people wait inside the first waiting room once they’ve
got in,” Baker said.
A new strategy called Waiting At Home is also trying to bridge the gap between
hospitals and other support services in the community.
Spearheaded by Community Care Access Centre, coordinators working in hospitals
transition people out of both in-patient units and emergency rooms, and “help
them make a warm landing back in the community”, said Stacey Daub, the
provincial agency’s director.
This means allowing patients who need long-term care to be treated at home.
Coordinators also conduct follow-ups with the patient.
“What you’re really trying to do is get to people to the right place of care,”
Daub said. “And no one wants to be admitted to a hospital if they don’t have to.
Most people prefer to get their care closer to home.”
St. Joseph’s particularly stands to benefit from these new initiatives, as it is
a community teaching hospital that services a population of about 500,000.
About 87 percent of patients who come to the emergency room are in the local
catchment area, including north of Bloor St., where aging populations reside.
“We basically see the full spectrum,” Baker said.
