CKHA: ED outcomes should be top priority

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The Chatham-Kent Health Alliance (CKHA) is recognizing the Erie St. Clair Local Health Integration Network’s (LHIN) newly released Integrated Health Service Plan (IHSP) 4 which has identified improving outcomes in hospital Emergency Departments (ED) as their #1 priority.

A CKHA press release issued on Monday says the IHSP report acknowledges that ED performance is a health system performance indicator and a measure of effectiveness for many organizations, including those with responsibility for preventative care.

CKHA officials say the LHIN’s report identifies improving ED outcomes as its first strategic priority, noting that ED congestion is ‘telling us how effectively our primary healthcare, community care, mental health and hospital programs are working collaboratively to serve patients.’

The report goes on to identify focus areas associated with improved ED outcomes, beginning with admitted populations, CKHA officials say.

“The LHIN’s attention to ED outcomes as its top priority is a welcomed message from CKHA, particularly given the focus and performance improvement CKHA has achieved on the metrics that matter most for those in need of access to emergency medicine.,” CKHA officials stated.

Top 10 Performer

“We are a top ten ED performer when it matters most – critically ill patients that require an admission to hospital,” stated Colin Patey, President & CEO of the CKHA, in a press release.

“I’m extremely proud of our incredible team and their efforts to move our organization from the middle of the pack to a top performer on what we view to be our most important outcome measure.”

CKHA officials say they acknowledge that the time from a decision to admit a patient to the time the patient gets the bed is the most important metric of performance because the longer a patient that requires an admission waits in the ED the greater the risk of adverse health outcomes and the fewer beds available to take in the next patient waiting.

“On this metric, CKHA is currently 3rd best in the province with a wait-time of approximately 3.8 hours, compared to a provincial index of 29 hours,” CKHA officials states.

15 point improvement in ED ranking provincially

In reviewing the 2015 Performance Ranking for Emergency Departments across the province, CKHA officials say their organization had one of the most significant performance improvement increases in the province, improving by 15 points from 44th in the province to 29th overall.

In his covering note to CKHA in March 2016, Dr. David Ng, emergency department lead for the Erie St. Clair LHIN, congratulated the CKHA team noting: ‘congratulations on your hard work and great leadership!’

CKHA has been provincially and nationally recognized for its use of innovative approaches to improving patient flow and the patient experience in the ED, CKHA officials say.

“We know that improving Emergency Department metrics is a full team effort,” Patey stated.

“We do not want the negative comments or erroneous information that has been stated by community leaders lately to overshadow the incredible effort of the entire CKHA team in making this substantial 15 point ranking improvement. It is important that we thank and recognize the tireless efforts of our healthcare providers, physicians, nurses, housekeepers, technologists, everyone who contributes to providing the best Emergency Department experience to every patient, every time.”

Wait time term is ‘misleading’

CKHA officials say the term “wait times” can be misleading.

“It does not reflect the time somebody sits in the waiting room, rather, it’s how long a patient is in the department from beginning to end,” CKHA officials say.

“It can include how long someone waits to be assessed, the time needed for test results to come back or the analysis required to make the right diagnosis and treatment plan before going home or being admitted.”

Patey added: “As you wait, just know that the team is doing everything they can to provide the best possible care to our patients and as quickly as possible without compromising quality of care.”

CKHA officials say less urgent or non-urgent patients may in fact be in the ‘waiting room’ the longest as patients with more critical needs are attended to first.

“While there is a desire, commitment and effort underway to reduce wait times and improve the patient experience for all those who use CKHA services, the organization remains focused on fulfilling the main role of emergency services,” CKHA officials stated.

“That role is to best serve patients with unforeseen and unpredictable illness, starting with those in need of immediate intervention.”

CKHA is eyeing change

CKHA officials say changing the processes, systems and flow in the Emergency Department is not enough. As pointed out in the IHSP 4, change, driven by collaboration among healthcare providers, is necessary across the entire healthcare system.

“We are doing our part to improve our processes and systems to better manage flow in the Emergency Department,” Patey stated.

“But as the LHIN acknowledges in it’s own plan, it’s time for changes right across the system to improve access to primary, community and urgent care for those who require it. Progress and success depends on collective ambition, collective leadership and collective action. Therefore, we expect our LHIN partner to step forward, make the courageous and right decisions the system depends on it to make, and only then will excellence be achieved.”

2 COMMENTS

  1. This last paragraph of the release clearly is a warning to the LHIN from the CKHA that they had better accept the CKHA’s 66% endorsed future plan which closes the Sydenham Campus ED because if they don’t they will be going against their own direction for the future of health care. The “courageous and right decision” is for the LHIN to step back and look at why the only way the CKHA can move forward and better the ED care in Chatham is to close the Sydenham Campus ED and not be bullied by the Administration at the CKHA into making a hasty decision.
    It almost sounds like for the sake of meeting the LHIN’s expectations the loss of a few lives from the Wallaceburg, Walpole Island and surrounding communities that may occur due to the increased distance from an ED is an acceptable position to take.

  2. What the CKHA, Medical Advisory Committee and the local LHIN need to have the courage to do is to form a group of ER Physicians and health care workers who are experienced in actually working in small rural emergency departments. While I have the utmost respect for every doctor and health care worker who works in Chatham-Kent when it comes to an emergency department that services over 21,000 people I want to hear from the doctors and health care workers who know what works – those in the field actually doing the work. I would like to know what their experience tells them but alas they feel too intimidated to speak out. Specifically the leadership at the CKHA should have the courage to seek their input and actually listen to what they have to say. There are small rural emergency department experts across Ontario and I sincerely encourage the LHIN to seek out their wisdom.

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