Ontario Targets Shorter ER times

    McGuinty Government Launches Public Reporting Of Time Spent In The ER

    TORONTO, Feb. 19 /CNW/ -


    In a one-of-a-kind North American initiative, Ontario is setting clear
targets for reducing the total amount of time patients spend in emergency
rooms - and is publicly posting data about local ERs online.
    The province is setting two targets:

    -   For patients with minor or uncomplicated conditions, which require
        less time for diagnosis, treatment and observation: the latest data
        from October shows that 90 per cent of patients spent a maximum of
        4.6 hours in the ER; the target is 4 hours.
    -   For patients with complex conditions, which require more time for
        diagnosis, treatment or hospital bed admission: the latest data from
        October shows that 90 per cent of patients spent a maximum of
        13.5 hours in the ER; the target is 8 hours.

    Total time spent in the ER begins when a patient registers at the ER and
continues as the patient receives treatment. It ends when the patient is
discharged home or admitted to a hospital bed.
    Ontario has a three-pronged strategy for reaching these targets:

    -   Providing Ontarians with appropriate alternatives to ER care:
        providing more options where people can seek care such as local
        family health teams and nurse practitioner clinics and making it
        easier for people to access information about walk-in clinics,
        after-hours clinics, and urgent care centres through the new web site
    -   Increasing capacity and improving processes within the ER: programs
        such as the Hospital Performance Fund give hospitals with high
        emergency room volumes financial incentives to lower their times
    -   Speeding the flow of patients from the ER: ensuring that acute care
        beds are available for those who need them - this requires faster
        discharge of patients occupying hospital beds that are better suited
        to alternative levels of care such as long-term care or home care.

    Ontarians can visit www.ontariowaittimes.com to access information about
their local ER - data is current as of October 2008.


    "Our government is creating an unprecedented level of transparency and
accountability in hospital emergency care with the public reporting of time
spent in the ER," said Health and Long-Term Care Minister David Caplan. "We
are committed to lowering ER times by providing alternate options for
patients, improving ER performance and ensuring more hospital beds are
available in a more timely fashion."
    "The collecting and reporting of this information will help us monitor
our progress in improving emergency room performance," said Dr. Alan Hudson,
Provincial Executive Lead, Access to Services and Wait Times. "Hospitals can
now see how their ER is performing and use this information to improve their
emergency services."


    -   The time spent in ER data is being collected through the Emergency
        Department Reporting System which gathers information from
        128 hospital ERs.
    -   The majority of people who go to hospital ERs - up to 90 per cent -
        are not admitted to a hospital bed.


    Find out more about the reporting of time
spent(http://www.health.gov.on.ca/transformation/wait_times/wait_mn.html) in
ER data by hospital.

    Read about the government's $109-million
investment(http://tinyurl.com/cpsqvz) to reduce ER wait times.

    Search for alternatives to ER
care(http://www.health.gov.on.ca/ms/healthcareoptions/public/index.html) in
your area.

    For public inquiries call ServiceOntario, INFOline at 1-866-532-3161
    (Toll-free in Ontario only)
                                                      Disponible en français



    Reducing the time patients spend in emergency rooms (ER) is a complex
issue that requires improvements throughout the entire health system. That is
why Ontario is taking a comprehensive approach to reducing the amount of time
patients are spending in emergency rooms. The strategy includes:

    Providing Ontarians appropriate alternatives to the ER - supporting
patients with chronic conditions, creating more family health teams and nurse
practitioner clinics, and enhancing public awareness of alternative health
care options will help to ease pressures across the system. Some of these
initiatives include:

    -   Public education, with emphasis on alternatives to the ER. The new
        Your Health Care Options website - www.ontario.ca/healthcareoptions -
        is a one-stop source of information that will enable Ontarians to
        make informed decisions about where to go for immediate care in their
    -   Health Care Connect - an innovative, made-in-Ontario program devoted
        to helping Ontarians without a family health care provider find one
        in their community. Ontarians can call 1-800-445-1822 to register.
    -   A comprehensive four year strategy to prevent, manage and treat
    -   Long Term Care Nurse Outreach Teams - teams of nurse practitioners
        and registered nurses provide residents of long-term care homes
        timely and appropriate care and provide interventions in cases where
        unnecessary visits to the hospital and ER can be avoided.

    Increasing capacity and improving performance within the ER - programs and
initiatives include:

    -   Hospital Performance Fund - an incentive program that is designed to
        improve performance at 23 hospital ERs facing the greatest
        challenges. LHINs work with local hospitals and community health care
        partners to help hospitals improve their ER access and reduce the
        time patients spend in the ER.
    -   Process Improvement Programs - programs to help hospitals improve
        processes and patient flow in the ERs. The programs, which 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.
    -   Dedicated nurses to ease ambulance offload - Funding has been
        provided to put in place nurses dedicated to care for patients who
        arrive by ambulance. This allows paramedics to return more quickly to
        the community and be able to respond to other calls.
    -   Measuring and reporting the time patients spend in ERs - collecting
        information, reporting the time people spend in the ER on a public
        website, measuring and rewarding improved performance, so that
        Ontarians can see the steady progress being made.

    Speeding the flow of patients from the ER - close to 19 per cent of
patients who are currently in a hospital bed in Ontario are in need of an
alternate level of care (ALC), such as a long-term care bed or a
rehabilitation care bed. An ALC patient occupying an acute care bed can create
a domino effect in hospitals when there are no other beds available, causing
people to spend a longer time in the ER. That's why the government is
investing in a number of initiatives that are working to relieve the ALC
pressures in Ontario hospitals. In 2008/09, the government has invested:

    -   $94 million as part of the Aging at Home Strategy - an unprecedented
        four-year, $1.1 billion initiative to provide support to seniors and
        their caregivers to stay healthy and live with dignity and
    -   $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

    The government is adding 1,750 new long-term care home beds in selected
communities across the province.

    For public inquiries call ServiceOntario, INFOline at 1-866-532-3161
    (Toll-free in Ontario only)
                                                      Disponible en français



    The Ontario government is publicly reporting time spent in hospital
emergency rooms (ERs) on www.ontariowaittimes.com.
    The site provides detailed information on "total time spent in the ER."
This is maximum time spent by 9 of 10 patients in the ER and is measured from
the time patients register or initially see a triage nurse (who assesses the
level of urgency for treatment), until the time they leave the ER. The time
patients leave the ER may be when they are sent home after being treated or
when they are admitted to a hospital ward or inpatient bed, if medically
    While a patient is spending time in the emergency room, doctors and
nurses may be diagnosing or treating their condition, or ordering tests and
waiting for results in order to determine the best treatment. Sometimes
treatment for a condition requires admission to a bed in the hospital, which
may result in a patient spending more time being cared for in the ER before a
bed becomes available.
    The Emergency Department Reporting System was developed and implemented
across the province in early 2008 to collect information about time spent in
ERs. The data is being collected from 128 hospital ERs. This data represents
almost 90 per cent of all ER visits in the province.
    The ER data being reported is not real-time information and is four
months old. Ontario is continuously enhancing its reporting process, which
will enable us to report more recent ER information to Ontarians.
    This information (the time spent by nine out of 10 patients) is being
reported in three categories:

    -   All ER patients
    -   Patients whose conditions are minor or uncomplicated that require
        less time for diagnosis treatment or observation.
    -   Patients who have complex and/or life-threatening conditions that may
        require more time for diagnosis, treatment or admission to a hospital

    The data in the table below is based on ER visits completed for the most
current time period (October 2008) at hospital sites that have implemented the
reporting system. The table shows an analysis between the current total time
spent in ER versus the baseline (April 2008), total time spent, and a
comparison against provincial targets where it applies.

                                                             vs.     Current
                               Current -       Percentage Baseline     vs.
                   Baseline -  October         Completed     Net    Baseline
                  April 2008    2008   Target   Within     Change  Percentage
                    (Hours)    (Hours) (Hours)  Target     (Hours)   Change
     patients         9.4       9.2       N/A       N/A      -0.3      -2.7
    Patients with
     minor or
     conditions       4.8       4.6       4.0      86.0      -0.2      -3.8
    Patients with
     conditions      13.9      13.5       8.0      80.0      -0.4      -3.0

    For public inquiries call ServiceOntario, INFOline at 1-866-532-3161
    (Toll-free in Ontario only)
                                                      Disponible en français

For further information:

For further information: Steve Erwin, Minister's Office, (416) 326-3986;
Andrew Morrison, Ministry of Health and Long-Term Care, (416) 314-6197

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