Saturday, May 31, 2008

Ontario Invests $109 Million for ER Wait Times & EMS Delays

As previously reported EMS has been in a no win situation in Ontario (and many other jurisdictions) when arriving at the emergency room. The ER refuses to accept the patient and EMS cannot abandon them. The Ontario government has announced $4.5 million targeted for dedicated nurses to accept patients who arrive by ambulance to ease the EMS pain.

To minimize ER overcrowding money is also being targeted at alternate level care (ALC) to allow chronic care patients in the emergency room to be transferred out and minor injury patients to seek primary care elsewhere.

Ontario's $109 million investment includes:

  • $39.5 Million for a Performance Fund targeting Ontario's 23 poorest performing emergency rooms, IT enhancements and coaching teams to enhance hospital efficiency
  • $38.5 million for increased home care personal support and homemaking services and enhanced integration between hospitals and Community Care Access Centres
  • $22 million in new priority funding for Ontario's 14 Local Health Integration Networks (LHINs) to invest in local solutions to further address ALC pressures
  • $4.5 million for dedicated nurses to care for patients who arrive at ERs by ambulance to ease ambulance offload delays
  • $4.5 million for new nurse-led outreach teams to provide more care to patients in long-term care homes to avoid transfers to the ER

According to survey studies by ICES scientist Dr. Michael Schull , chronic patients occupying ER beds waiting for ALC are a major cause of ER overcrowding. Interestingly, emergency room physician and nursing staffing had been previously identified as potential causes of overcrowding but this does not seem to feature predominantly in current research or funding.

I was left wondering whether overcrowding correlates strongly to ER wait times, since most ED patients are never admitted. As we found in our own office, more space does not necessarily equate to lower wait times but it is a good first step. Regardless, rather than penalizing hospitals that perform poorly the government is targeting additional funding towards them and offering expert assistance in streamlining patient flow.

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