Over the years I’ve written a lot about our annual holiday surge, when we typically see an increase in patient visits over the festive season. But higher patient volumes are quickly becoming the new normal.
Over the last six weeks, many hospitals across the Greater Toronto Area, including Osler, have seen higher than normal patient visits to the ED. Dr. Naveed Mohammad, Osler’s Vice President of Medical Affairs, recently told the Brampton Guardian, “We’re seeing record numbers. [On March 14], we saw 500 patients in 24 hours.”
The recent surge in patient volumes are the result of many factors: increased flu activity, reduced hours at walk-in clinics due to vacations and a shortage of in-patient mental health resources in the community. Even though we’ve made improvements to the ED to help increase the flow of patients and communication, we’re still feeling the pressure and have responded with a new approach called Code Gridlock.
Here’s how it works. Osler uses a stoplight system to monitor patient flow conditions to determine if the demand exceeds our ability to provide timely service – green (normal), yellow (urgent) and red (critical/gridlock). Each colour triggers a different response and when we surpass all three, and have more than 30 patients waiting for admission in the ED with less than 10 patients confirmed for discharge, we call Code Gridlock.
We know that high patient volumes don’t just effect the Emergency Department (ED), the impacts are felt hospital wide. Code Gridlock mobilizes the entire hospital to help reduce the number of patients waiting in the ED for admission to an inpatient unit.
Osler treats Code Gridlock like any other emergency situation and sets up a command centre to ensure our response is consistent and well organized. The command team directs our internal teams and engages with our partners at the Central West Community Care Access Centre (CCAC) and Headwaters Health Care Centre (Headwaters) to help move patients through the local system more efficiently to reduce pressure in Osler hospitals. Some measures include:
- Integrated Care Coordinators at Etobicoke General attend rounds to help identify non-critical patients that can be discharged with CCAC services;
- Additional Care Coordinators can be brought in at Brampton Civic to participate in family meetings so hospital staff can support more discharges; and,
- Some patients will be moved a hospital, closest to their home, that can provide an appropriate level of care, such as Headwaters.
Code Gridlock, along with numerous other preventative measures, is helping to keep our patients safe and ensure access to care during these extra busy times.