Enhanced Home Care Coverage and Efforts Targeted At
Poorest Performing Emergency Rooms Lead the WayTORONTO, May 30 /CNW/ -
NEWS
Responding to challenges patients are facing in emergency rooms, the
Ontario government is taking numerous coordinated steps to reduce wait times
and improve patient satisfaction.
A major factor causing long emergency room (ER) wait times is the high
number of alternate level of care (ALC) patients occupying acute care hospital
beds, making it difficult to admit patients from the ER to hospital. ALC
patients are unable to be discharged because the appropriate level of care
they require is not always available. Today's announcement is making much more
of that care available.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 ERDr. Alan Hudson is Provincial Executive Lead, Access to Services and Wait
Times. With today's announcement, Dr. Kevin Smith, President and CEO of St.
Joseph's Healthcare in Hamilton, is being appointed Expert Panel Lead -
Alternate Level of Care (ALC). Dr. Smith will be working with Dr. Michael
Schull, Sr. Scientist, ICES and Director of Emergency Medicine at University
of Toronto, who was previously appointed as Expert Panel Lead for ER Wait
Times.
In April, George Smitherman, Minister of Health and Long-Term Care,
unveiled his government's top two overarching health priorities for the next
several years: reducing emergency room wait times and family health care for
all. Today's announcement is the first in a series and builds momentum on ER
wait times reductions.
QUOTES
"You cannot have a good performing emergency room so long as the ER can't
admit patients to hospital," said George Smitherman, Deputy Premier and
Minister of Health and Long-Term Care. "These changes will free up our
emergency rooms to do what they do best - treat emergencies."
"Fixing ER wait times is the foremost challenge for the entire health
care system," said Dr. Alan Hudson, Lead of Access to Services and Wait Times.
"It requires strong leadership by hospitals, LHINs and the community sector,
working together to deliver better care for the patients of Ontario. Given
that Ontarians make more than five million visits to ERs they deserve nothing
less."
"By enhancing the options patients have to receive the care they need in
the most appropriate setting, these investments will relieve pressures on
hospitals," said Dr. Kevin Smith, President and CEO of St. Joseph's Healthcare
in Hamilton and ALC lead. "By reducing pressures on ERs, we will reduce wait
times and increase patient satisfaction."
"The Ontario Hospital Association welcomes today's very significant
investments in hospital emergency departments and, just as importantly, in
health services provided in the community," said Tom Closson, President and
CEO of the Ontario Hospital Association (OHA). "We believe that this
comprehensive and innovative approach to shortening emergency department wait
times and ensuring that people get the care they need in the most appropriate
setting will benefit patients and strengthen public confidence in Ontario's
hospitals and health care system."
QUICK FACTS- There are 163 emergency rooms in the province, with 2.8 million
people making 5.25 million visits to these ERs each year.
- The Ontario Hospital Association indicates that seniors who are
awaiting access to appropriate care elsewhere, occupy 18.6 per cent
of hospitals beds in the province; 58 per cent are waiting for long-
term care (LTC) home placement.
- Nearly 60 per cent of LTC homes in the province have more than 50
residents sent to hospital each year.LEARN MORE
Learn more about Ontario's comprehensive strategy
(http://www.health.gov.on.ca/english/public/updates/archives/hu_08/health_care
_priorities_20080424.html) to improve access to care for all Ontarians.-------------------------------------------------------------------------
ontario.ca/health-news
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BACKGROUNDER
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ONTARIO'S $109 MILLON INVESTMENT TO REDUCE
WAIT TIMES IN THE EMERGENCY ROOMThe Ontario government is tackling emergency room (ER) wait times by
paying hospitals to improve ER performance and by providing more people with
alternatives to hospital care.
The comprehensive $109 million strategy includes ways to reduce ER waits
inside and outside of hospitals:
EMERGENCY ROOM PERFORMANCE FUND, INFORMATION TECHNOLOGY ENHANCEMENTS AND
COACHING TEAMS TO ENHANCE HOSPITAL EFFICIENCY
($39.5 MILLION)
To improve performance the government is targeting 23 hospital ERs that
are facing the greatest wait time pressure - ($30 million)
As part of this initiative, Local Health Integration Networks (LHINs)
will target funding incentives to improve performance at 23 hospital ERs
facing the greatest challenges. LHINs will work with local hospitals and
community health care partners to implement health system solutions which will
help hospitals improve their Emergency Room access and reduce wait times.-------------------------------------------------------------------------
Hospitals by LHIN Allocations
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Central LHIN
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NORTH YORK GENERAL HOSPITAL $1,443,137
YORK CENTRAL HOSPITAL $1,322,570
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HUMBER RIVER REGIONAL HOSP-HUMBER MEM $956,182
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HUMBER RIVER REGIONAL HOSP-YORK-FINCH $926,331
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Central East LHIN
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SCARBOROUGH HOSPITAL-SCAR. GEN. SITE $1,385,523
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ROUGE VALLEY HEALTH SYSTEM-CENTENARY $1,231,317
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Central West LHIN
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WILLIAM OSLER - BRAMPTON $2,158,517
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Champlain LHIN
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OTTAWA HOSPITAL-CIVIC SITE $1,712,543
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OTTAWA HOSPITAL-GENERAL SITE $1,724,345
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HOPITAL MONTFORT $686,941
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Erie St Clair LHIN
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WINDSOR REGIONAL HOSPITAL-METROPOLITAN $1,683,242
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Mississauga-Halton LHIN
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TRILLIUM HEALTH CENTRE-MISSISSAUGA $2,126,558
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Hamilton Niagara Haldimand Brant LHIN
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ST JOSEPH'S HEALTH CARE SYSTEM-HAMILTON $273,542
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NIAGARA HEALTH SYSTEM-ST CATHARINES GEN $1,255,343
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South East LHIN
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KINGSTON GENERAL HOSPITAL $1,094,993
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Toronto Central LHIN
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ST JOSEPH'S HEALTH CENTRE $2,423,994
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TORONTO EAST GENERAL HOSPITAL $1,444,405
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ST MICHAEL'S HOSPITAL $1,363,525
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MOUNT SINAI HOSPITAL $824,695
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UNIVERSITY HEALTH NETWORK-WESTERN SITE $982,121
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SUNNYBROOK HEALTH SCIENCES-SUNNYBROOK $906,929
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UNIVERSITY HEALTH NETWORK-GENERAL SITE $619,691
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Waterloo Wellington LHIN
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GRAND RIVER HOSPITAL CORP-WATERLOO SITE $1,243,556
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Total $29,790,000
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(*) The final provider-specific allocations may change pending ongoing
planning between the LHIN, its hospitals and its community partners
in the development of multi-partner strategies to improve ER
performance.Creating Process Improvement Programs that Assist Hospitals in Improving
Patient Flow in the ER ($7.5 million)
The province will create programs to help hospitals improve processes and
patient flow in ERs. The programs, which will include specialized coaching
teams to visit all hospitals, will provide staff the ability to quickly
diagnose flow problems and then help implement new processes that improve
patient flow.
Collecting and Reporting Information to Monitor Progress ($2 million)
The government will collect and publicly report ER information in a
consistent way across the province to:- Hold hospitals and LHINs accountable by measuring their progress
towards targets;
- Provide direction for further improvements;
- Measure progress of the ER Wait Time Strategy as a whole.Information will be collected on ER length of stay. Other related
indicators will be tracked to allow hospitals to monitor and evaluate internal
operations.
INCREASED HOME CARE SERVICES AND ENHANCED INTEGRATION BETWEEN HOSPITALS
AND COMMUNITY ($38.5 MILLION)
Addressing the alternate level of care (ALC) issue will directly result
in reducing ER wait times. These initiatives will:- Increase the upper limits on hours of personal support/homemaking
services by 50 percent, from 80 hours to a maximum of 120 hours in
the first 30 days of service, and from 60 hours to a maximum of 90
hours in any subsequent 30-day period;
- Remove home care maximums on personal support and homemaking entirely
for patients waiting for a long-term care bed or receiving palliative
care services at home
- Improve the use of community care case managers inside hospital ERs,
who will help to find the appropriate level of care for patients by
arranging support so patients are able to leave hospital and be
treated at home;
- Reduce wait times by electronically linking hospital to Community
Care Access Centres (CCACs). This will ensure patients receive the
right care at the right time and place, avoiding unnecessary ER
visits or hospitalizations.
NEW FUNDING FOR LOCAL ALC PROGRAMS ($22 MILLION)
Ontario is providing $22 million to the 14 Local Health Integration
Networks (LHINs) to help provide community alternatives to hospital care. This
includes services that will let Ontarians - particularly seniors - stay or
heal at home.
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LHIN Allocation
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Erie St. Clair $1,112,220
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South West $1,996,900
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Waterloo Wellington $1,080,975
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HNHB $2,315,339
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Central West $886,362
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Mississauga Halton $1,253,903
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Toronto Central $3,894,703
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Central $1,588,122
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Central East $1,688,675
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South East $1,135,105
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Champlain $2,085,333
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NSM $844,470
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North-East $1,297,147
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North-West $820,744
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Total Province $22,000,000
-------------------------------------------------NURSES DEDICATED TO EASE AMBULANCE OFFLOAD DELAYS ($4.5 MILLION)
Ontario is providing funds to put in place nurses dedicated to care for
patients who arrive by ambulance. Ambulance patients with life-threatening
conditions will continue to be given priority. This initiative will allow
paramedics to return more quickly to the community and be able to respond to
other calls.
NURSE-LED LONG-TERM CARE OUTREACH TEAMS ($4.5 MILLION)
Fourteen nurse-led outreach teams will be created to provide residents of
LTC homes timely and appropriate care, and stabilize residents who need more
urgent attention. These teams of nurse practitioners and registered nurses
will travel to LTC homes to assess urgent problems, determine the need for
hospital care and provide interventions in cases where unnecessary visits to
the hospital and ER can be avoided.
Examples of these interventions include intravenous therapy, antibiotic
management and administering oxygen. An example of this overall initiative can
be seen at the Shalom Village LTC home in Hamilton. There, some 30 to 65 per
cent of seniors receive non-urgent care from nurse practitioners instead of
seeking care at the nearest hospital ER.-------------------------------------------------------------------------
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FACT SHEET
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ALTERNATE LEVEL OF CARE PATIENTSPatients in an acute hospital bed are there because they need acute care
services. This means they need short-term, intensive medical treatment for an
illness, injury or recovery from surgery.
Once patients complete this "acute care" phase of treatment, they often
require an alternate level of care (ALC). ALC patients are individuals in a
hospital bed who would be better cared for in an alternate setting.
What is an alternate level of care?When patients need an alternate level of care, it means they may require:
- a long-term care home bed
- complex continuing care bed
- a convalescent care bed
- a rehabilitation care bed
- home care
- palliative careMore than 18 per cent of patients who are currently in a hospital bed in
Ontario are in need of an alternate level of care.
How do ALC patients contribute to backlogs in the emergency room?
New patients come into hospitals through the ER or through scheduled
appointments for surgery. Patients receive acute care services and then go
home or await an alternate level of care.
When patients remain in an acute hospital bed because the alternate level
of care they need is unavailable. This means they are not receiving care in
the appropriate setting. They are also in a bed that could be better used for
a patient who needs acute hospital care. This creates a domino effect in
hospitals when there are no beds available.
Patients who arrive in the emergency room and need to be admitted to an
acute care bed are then stuck in an ER bed awaiting transfer to a regular
hospital bed.
When all the ER beds are occupied, physicians do not have beds to examine
or treat patients. This creates long wait times in the ER which are very
stressful for both patients and staff.-------------------------------------------------------------------------
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For further information: Laurel Ostfield, Minister's Office, (416)
212-4048; Mark Nesbitt, Ministry of Health and Long-Term Care, (416) 314-6197
