KHSC recognized as having most improved wait times in Ontario

As a result of a group of initiatives to improve patient flow, Kingston Health Sciences Centre (KHSC) has recently seen an impressive jump in rankings for wait-times in Ontario hospitals. When looking at wait times for admitted patients getting a bed on an inpatient unit, KHSC has improved from 67th place to 36th place of 73 hospitals in the province. Our ranking for overall wait-times has also improved from 53rd to 28th place.

“It’s unheard of to climb the rankings so quickly,” says Damiano Loricchio, Program Operations Manager for the Emergency Department (ED). “Even with limited resources, we are improving faster than everyone else.”

One of the initiatives contributing to the decreased wait-times is the work being done by a team of internal medicine care providers who operate the Admission Transfer unit (ATU) located on Douglas 1 at our KGH site. This space, which was repurposed and opened in March of 2017, is designed to improve patient flow by freeing up ED beds that are occupied by patients who have been admitted to the hospital and are waiting for an inpatient bed.

“After patients have been admitted and are waiting for their inpatient bed to open up, they are taking up valuable space in the ED that could be used to treat patients in need of emergency care,” explains Loricchio. “By moving admitted patients into the ATU while they wait for a bed on an inpatient unit, we can get patients out of the emergency waiting room and into the ED to be seen by a physician.”

Funding from the SELHIN has also allowed for the creation of a new position to oversee patient flow. The addition of an Administrative Coordinator position has had an overwhelmingly positive response and has helped with optimizing bed utilization and timely transfer of patients between units.

“When our patient volumes are high, supporting patients when they access our sites and services can be a complex task,” says Tom Hart, Director Patient Access, Flow and Clinical Resources. “Having the coordinator pull together the efforts of multiple teams across the hospital improves access for patients already in the ED and for patients who need our care and are waiting at home or in a bed with our regional partner hospitals.”

Other initiatives that have contributed to the improvement in wait times include a program called Home First, which helps identify if a patient simply needs more support in their home environment rather than being admitted to the hospital.

Another new clinic, the Rapid Access Chronic Disease Management Clinic, operates within the Urgent Care Centre at the HDH site.  It gives patients with multiple chronic conditions access to care from a nurse practitioner and has contributed to a reduction in repeat visits to Urgent Care and the ED within this specific patient population.

Earlier this winter, KHSC also developed a surge protocol in response to a higher-than-usual volume of patients seeking hospital treatment for influenza. Staff on inpatient units worked to accommodate patients by transforming areas where patients might not regularly receive care, such as sunrooms, into effective care areas. “Staff on the inpatient floors made phenomenal efforts while under a tremendous amount of pressure to care for these extra patients,” says Hart. “These improvements during a time of increased patient volumes could not happen without the hard work and dedication of every department in the hospital.”

Dr. Karen Graham, a physician in the ED at KHSC’s Kingston General Hospital site, is also noticing a significant improvement.

“Despite the high inpatient volumes in the hospital, we have been able to provide emergency care to our patients that need it, and admitted patients are able to receive care in a better inpatient environment,” says Dr. Graham.

“Overall it’s definitely improved, there’s no doubt.  Knowing we are providing safer, timely care is reassuring.”

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