Emergency wait times tackled
Reported February 26, 2009
The provinces massive plan to ease hospital wait times is already starting to have an impact on St. Josephs Health Centres emergency department but there are still challenges ahead, says the hospitals 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 hasnt 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 dont need to be in a hospital is one of the biggest challenges faced by facilities like St. Josephs, 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 provinces 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. Josephs typically has a higher percentage of hospital beds occupied by non-acute patients.
Weve got the biggest emergency department in terms of absolute numbers of people in the GTA who come here for care, Baker said.
Were actually the second or third largest volume emergency department in the province on a single night.
A bottleneck occurs when an emergency room doesnt have proper flow because there arent 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. Josephs 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 patients 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.
Weve 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 theyve 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 agencys director.
This means allowing patients who need long-term care to be treated at home. Coordinators also conduct follow-ups with the patient.
What youre 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 dont have to. Most people prefer to get their care closer to home.
St. Josephs 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.
