Advances in Emergency, Urgent Care
The opening of the Clinical Systems Investigation area at Greater Niagara General Site means that all three ERs in Niagara Health now have rapid assessment areas, with the goal of reducing patient wait times. Pictured cutting the ribbon are, from left: Davene Korince, Regional Emergency Program Educator; Lucy Díelia, Interim Charge Nurse; Dan Belford, Clinical Manager; Marlene Caldwell, Charge Nurse; and Cindy Jenkins, Registered Nurse.
With the largest urgent and emergency care program in Ontario, Niagara Health is keeping pace with provincial initiatives to enhance patient care and ensure the care provided is consistent with what is considered the gold standard.
A new rapid assessment unit in the Emergency Room at Greater Niagara General Site is designed to improve patient flow through the ER and reduce wait times for 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 gets the doctor the information he/she needs before seeing the patient for the first time.
Niagara Falls resident Veronica King, 15, was a patient in the new Fast Track/Clinical Systems Investigation area in Greater Niagara General’s ER when it officially opened Sept. 23. Patients who are triaged as non-emergency cases are now receiving care in this area, to receive assessments and tests faster.
“We’ve seen positive results in St. Catharines and Welland where we have introduced similar units in the ERs. The CSI Unit is a great way to give less serious patients more timely care in the ER,” says Anne Atkinson, Vice President Patient Services.
The Welland CSI opened in June 2009 and at St. Catharines General Site in October 2008. Wait times are showing a marked reduction, in some cases by 50%.
At the Greater Niagara General ER, a number of other initiatives are being introduced to improve the patient experience and wait times. This includes a new model of physician staffing in the ER that has more ER doctors seeing patients at peak-time hours.
Historically, one doctor worked a 10-hour shift and another doctor worked a 14-hour shift at the GNG ER during a 24-hour period. As an interim step, the NHS is changing to a system where two doctors will work 12-hour shifts and another ER doctor will work a 10-hour overlapping shift, so there are two ER doctors working at the same time during peak hours. Ultimately, the goal is to have two ER doctors working around the clock.
“The changes that are underway at the GNG ER are no different than changes that have already been implemented successfully at other NHS sites,” says President and CEO Debbie Sevenpifer.
Urgent Care Centre opens in Fort Erie
In late September, the ER at Douglas Memorial Site officially changed to a 24/7 Urgent Care Centre (UCC), similar to our Port Colborne UCC, established July 6.
This brings the complement of UCCs operated by Niagara Health to three with the recent name change of the Prompt Care Centre at St. Catharines’ Ontario Street Site to a UCC. This UCC is open 14 hours/day, from 8 a.m. to 10 p.m., seven days a week.
In Fort Erie, patient volumes in the first few weeks of the UCC show that an average of 46 patients are coming every day, compared to the 57 patients in 24 hours seen when it was an ER.
So far, Port Colborne patient volumes are very good. There are about 50 visits every 24 hours, which is close to the volumes when the ER was in place, and 97% of patients filling out surveys say the care was good/excellent. Wait times are also improving – down to 1.6 hours.
“We expect that the trends we’re seeing in Port Colborne will also happen at Douglas site,” Anne says. «
