How Osler’s EDs are “humming like a sewing machine”

This week’s guest blogger is Dr. Naveed Mohammad, VP Medical Affairs

It’s no secret that Osler is home to one of the busiest emergency departments (ED) in Canada. Last year, more than 214,000 people visited the EDs at Brampton Civic and Etobicoke General for care, which accounts for an additional 3,400 patients over the previous year. With this kind of volume increase, our teams in the ED need to be at the top of their game.

On any given day, we strive to meet specific targets in the ED – length of stay, time to physician assessment and time to inpatient bed among others to help deliver a better patient experience. We recently reached a new milestone in the ED at Etobicoke General as our 30-day 90th Percentile Time to Physician Initial Assessment (PIA) was reduced to just 1.5 hours for the first time. This means that patients were seen by a physician within 90 minutes, ranking Osler second in the province for this metric.

Two days later, the same team beat its own record and reduced the 30-day 90th Percentile Time to PIA to just one hour. As one physician put it, “we’re humming like a sewing machine.”

These incredible results show that our ED teams are performing at an incredibly high level. In addition to the talent of Osler staff, physicians and volunteers in the ED, a number of measures have recently been put in place to help move patients through the ED more quickly and efficiently.

Some of the changes that are making a difference in Etobicoke General’s ED include:

  • Designated “see and treat” zones in the Ambulatory Treatment Centre (ATC) and Fast Track zones that help to expedite care
  • Demonstrations of exceptional teamwork where physicians arrive early to help move patients and relay information between members of the care team

We’re also making positive changes to the ED at Brampton Civic to help see and treat patients faster:

  • Our ED Patient Experience Team is helping to keep patients comfortable and informed while they wait for treatment
  • Increased physician hours and “flex shifts” are enabling physicians to support busy areas of the ED at any time during the day
  • A new Mental Health Patient Flow Initiative is helping to move mental health patients out of the waiting area and into care quicker

While all of these initiatives help to increase the efficiency of the ED care team, these changes serve a double purpose to enhance the patient experience. A trip to the ED can be a stressful experience but shorter wait times, more frequent contact with patients and better information sharing helps make patients feel more comfortable throughout their journey.

Congratulations to the multi-disciplinary teams who are truly coming together in the ED to provide patient-inspired health care without boundaries!

The Partnership Payoff: More Collaborative Patient Care

Osler is working hard to build strong relationships with our partners at the Central West CCAC and Headwaters, as well as primary care providers in the community, to create a more seamless experience for patients as they move across our local health care system. Here are just a few examples of how we work with our partners to close information gaps to improve care.

Hospital to Home

I’ve written before about our regional Hospital to Home (H2H) and the positive impacts it’s having on patients in the community. Since the program began eight months ago, H2H nurses have conducted more than 3,100 visits to nearly 450 patients. Not only has H2H had a positive impact on patients, the program has helped to improve admission and readmission rates at the hospital:

  • Average length of stay for admitted patients was reduced by 3 days
  • Readmission rates have decreased from 11.5 per cent to 9.2 per cent
  • Hospital admissions have been reduced from 21.4 per cent to 13.8 per cent

Another benefit of the program is that H2H nurses are able to access a patient’s electronic health care record when they are in the hospital and in the home so they can ensure continuity of care.

We captured one patient’s experience moving through this program in a new video. See how an integrated nursing team is helping to improve information sharing and creating smoother transitions between points of care.

Telehomecare

In 2013, Osler became host of the Ontario Telemedicine Network’s (OTN) Telehomecare program for the Central West region. This program helps patients living with Chronic Obstructive Pulmonary Disease (COPD) and Heart Failure take control of their health from home using technology. Each patient works with a dedicated Telehomecare nurse who monitors their health and provides coaching to help them learn to manage their condition.

Throughout the six-month program, Telehomecare nurses provide reports to a patient’s primary care provider to ensure they are aware of a patient’s progress and can help inform care plans when there is a change in condition. This collaborative approach involves the patient, nurse and primary care provider to ensure that the best possible outcome is achieved.

Nearly 3,500 patients have participated in this program since it began and the benefits are clear. Patients enrolled in the program saw significant reductions in hospital admissions and fewer visits to the emergency department. See how Telehomecare is benefiting patients in our region:

Osler’s AGM was a ‘ground breaking’ event

Over the past year, we’ve celebrated a number of incredible achievements at Osler and this week is no exception. These new milestones are in addition to the amazing work that our teams do every day in providing care and treatment through the millions of patient interactions we encountered this year.

Clearly, there has been a whirlwind of activity at Osler over the past few months and we’re just getting started. On June 28 we were thrilled to once again welcome The Honourable Eric Hoskins, Minister of Health and Long-Term Care, to Etobicoke General as we reach another milestone in our redevelopment journey.

We kicked off our Annual General Meeting (AGM) with a celebration of our redevelopment progress and broke ground on our new four-storey wing. After expressing his excitement for the future of health care in our community, Minister Hoskins donned a hard hat and picked up a shovel to officially mark the start of construction. He was joined by Dr. Shafiq Qaadri, MPP for Etobicoke-North (Etobicoke General’s riding), Yvan Baker, MPP for Etobicoke-Centre, and a number of local, provincial and federal dignitaries to dig in and make history.

For many patients, Etobicoke has been their first and only entrance into Canada’s health care system. Our community relies on the patient-inspired care and innovation Etobicoke General continues to provide. Having support from all levels of government, and across the health care community means that we will be able to continue to provide patient-inspired health care now and well into the future. Expanding Etobicoke General is just one way we’re doing it.

At our AGM following the redevelopment celebration, the Osler Board of Directors welcomed Vanita Varma as the new Board Chair and bid farewell to outgoing Chair John Davies, Vice Chair Neil Davis and Dr. Rajiv Gupta, an ex-officio member of the Board and former President of the Etobicoke Professional Staff Association. I’ve had the privilege of working alongside these men who have been instrumental in moving Osler forward and have no doubt that the positive impacts of their participation will be felt for years to come. John is also the deserving recipient of this year’s Kay Blair Community Service Award, underscoring his dedication and commitment to serving the needs of Osler’s community, patients and families with compassion, kindness and understanding.

I had the pleasure of introducing Cauis Dobson and Jacob Luxton, students from Grey Highlands Secondary School in Flesherton, as the winners of our third national student app contest. These two young stars developed Emerg. Master, a gaming app that includes characters in both Headwaters and Osler emergency departments and offers detailed information about how the hospitals connect patients with community care. The app is now available for download on Android devices from Google Play. Congratulations Caius and Jacob!

We also unveiled our 2015-16 Annual Report, which highlights the amazing things that happen at Osler each and every day to provide patient-inspired health care without boundaries. None of what we do would be possible without the commitment of Osler’s talented staff, physicians and volunteers. I invite you to experience a day in the life of Osler by viewing our report online at OslerReport2015.com.

There was no shortage of excitement in the weeks leading up to our AGM. We celebrated our first-ever Interprofessional Recognition Week from June 13-17, acknowledging the exemplary work performed by individual professionals and clinical teams. Our annual Staff Appreciation BBQs also took place at each site as one of many ways we thank our dedicated staff, physicians and volunteers for going beyond every day.