This piece was also featured in: Waterloo Region RecordPublished: Feb. 16, 2013 | [ WEB ]
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WATERLOO REGION —
From patients with non-emergency medical problems to delays in accessing medical test results, officials at the Waterloo Wellington Local Health Integration Network say there are many reasons why the region’s emergency rooms appear to be overflowing.
And for the many causes of long wait times, they also said they have many solutions in the works.
“The issues are different and therefore the solutions are different depending on the population group,” said Bruce Lauckner, chief executive officer of the local network. “We’re working very closely with (hospitals) to implement solutions we know do work.”
For critical care patients — which the health system is primarily designed for, according to Lauckner — the quality and timeliness of care in the emergency room is excellent.
But patients with urgent, but not critical, medical problems and those with minor medical issues are the ones facing the lag in the emergency room.
One problem is that many emergency room patients — about 80,000 a year across the Waterloo-Wellington area — do not need emergency services. These patients, Lauckner said, have minor conditions that could be taken care of by their family doctor or by walk-in and urgent care clinics.
“We recently surveyed one of our hospitals and 93 per cent of the people who went to the emergency department in that category … have a family doctor,” Lauckner explained. “And of that (93 per cent), 75 per cent were visiting during the daytime when their doctor’s office is open.”
Lauckner said the health network is working with local doctors and nurses to help inform patients that they can access their family, often in the same day, rather than emergency room when they have non-urgent needs.
At St. Mary’s General Hospital, the number of non-urgent patients has dropped by about 20 per cent in the last six months — an improvement the health network attributes to the new online wait time schedule that patients can check before heading to the hospital.
Along with live wait time information, the website lists other health care providers a patient can seek out, deterring them from going to the hospital if it’s not necessary.
John Ruetz, senior director of health system integration, said similar live wait time websites will be launched for Grand River and Cambridge Memorial hospitals in the next two to three months, with hopes of seeing similar results.
A successful initiative in streamlining medical test results in the emergency room at Guelph General Hospital will be adopted at Kitchener hospitals soon. The change at Guelph has contributed to lowering its wait times to provincial targets.
This improvement can specifically help those patients with urgent but not critical needs who get stuck waiting for test results that can determine whether they need to be admitted to hospital or sent home.
“If you can help the test be ready when the physician is ready, that helps streamline the process,” Lauckner said.
While changes are being implemented within the local health network, the provincial government is continuing to support changes across the health care system.
John Milloy, MPP for Kitchener-Centre, said the current government was the first to begin tracking wait times at hospitals and setting targets. These measures have spurred the important conversations about the problems hospitals are facing and are leading to solutions.
“I think there’s been a huge effort to try to understand what the pressures are on emergency rooms and why there is such a challenge in terms of reducing wait times,” Milloy said.
The province is also continuing to fund initiatives that directly and indirectly help reduce the wait in emergency rooms. One example is the new extended assessment unit for mental health crises at Grand River Hospital, which opened in November.
The unit is moving mental health patients out of the emergency room faster, giving them the specific care they need and opening up space for other patients.
Funding programs like mental health or home care can have long-term benefits in reducing emergency room wait times by treating patients before they reach a crisis situation, Milloy said.
Ruetz said the mental health unit at Grand River is an example of a specific solution that meets the needs of an individual hospital’s demographics.
“We do have to recognize that the service profile between all our hospitals is different,” he said. “Some of the services that Grand River is offering aren’t services that are available at other places … and that is changing the profile of the patients that are showing up.”
Ultimately, health care officials say the combination of changes to the health system and individual hospitals are working and should continue to reduce emergency room wait times in the region to meet provincial targets.
“The strategy is working, but it’s taking time,” Lauckner said.
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