New unit to reduce wait times in Welland ER

Registered Nurse Rita Loeffen cares for a patient in the Welland ER.

A new unit in the Emergency Room at the Welland Site is designed to improve flow through the ER and reduce wait times for many of the less urgent patients.

With the opening of a Clinical Systems Investigation (CSI) Unit, more patients can be assessed and treated at the same time. A nurse can speed up a patient’s assessment process using standardized medical directives to order blood tests, X-rays or other procedures. Traditionally, patients must first wait to see the physician, who then orders blood work and other tests in order to make a diagnosis. The CSI process expedites the ability to get ER doctors the information they need before they see the patient for the first time.

“The CSI Unit is an innovative approach to accessing more timely care in the ER,” says Anne Atkinson, Niagara Health System Vice President Patient Services.

A similar unit opened at the St. Catharines General Site in October 2008 and has cut wait times virtually in half for patients triaged as Canadian Triage Acuity Scale (CTAS) Levels 3, 4 and 5 (Level 1 is life-threatening and Level 5 is non-urgent). At the St. Catharines CSI Unit, 277 patients were seen in March 2009. Total average wait time was 3.5 to 3.8 hours per patient, compared to 6 to 8 hours in the previous year prior to the opening of the unit. Planning is underway to open a similar unit at the Greater Niagara General Site in the near future.

The CSI Unit is able to re-route patients that would typically occupy a stretcher for several hours while waiting for test results or other information. CSI patients only occupy the stretcher while receiving direct care or assessment from the physicians or nurses, or they may have an Intravenous or other care initiated while sitting in a comfortable recliner. While waiting for tests or results, the patients wait in a dedicated CSI waiting room, freeing up the limited number of stretchers for other ER patients. “ERs are incredibly busy places, and we are proud of the doctors and nurses for their success in reducing patient wait times,” says Pat Morka, Regional Director, Emergency Medicine Program. “We anticipate the wait times will continue to improve as the doctors and nurses get more used to the new CSI process.”

Other strategies to improve wait times in local ERs include the recent hiring of nurses dedicated to managing patients coming in by ambulance to the St. Catharines, Welland and Niagara Falls ERs. In addition, the St. Catharines ER received a second round of funding last month — $1.1 million — to continue with the Pay-for-Results Program, part of the province’s Wait Time Strategy for ERs. «