Horizon implements strategies to improve Emergency Department wait times

(HORIZON) – At Horizon Health Network’s four regional hospitals, wait times for Canadian Triage and Acuity Scale (CTAS) Level 3 patients (patients with urgent medical needs who may need to be admitted) are stabilizing to pre-holiday levels.

As seasonal health pressures brought on by a rise in the transmission of respiratory illness in New Brunswick continue, staff and physicians in our EDs remain extremely busy caring for a high volume of sick patients.

The situation and make-up at each of our emergency departments is different, and therefore the solutions needed for each facility are different. At all sites, staff, physicians, and leadership are working with dedication to quickly implement short- and long-term solutions.

Recent actions to improve wait times and capacity in our hospitals include:

• At the Dr. Everett Chalmers Regional Hospital (DECRH) in Fredericton, we have created additional bed capacity by moving some ambulatory care clinics to Oromocto Public Hospital, as well as moving Maternity Outpatient Clinics to another location in the DECRH. In total, twelve (12) additional beds have been created at the DECRH over the last few days. Further, we are planning to add an extra day at the Fredericton Urgent Treatment Centre in early February.
• At The Moncton Hospital (TMH), 24 new beds have been opened. Also, at TMH, we have also been able to redirect some patients who present to the ED with influenza-like-illness (ILI) symptoms to receive care at a clinic outside the ED.
• At Saint John Regional Hospital, the discharge of some patients has been accelerated or admission has been avoided by identifying and providing appropriate and timely services.
• At Miramichi Regional Hospital, the opening of new nursing home beds in the community has helped with the discharge of some patients.

Other Horizon-wide initiatives that are helping are:

• Social workers are intervening with patients in EDs to reduce social admissions. In December, 179 patients were seen by a social worker in an ED and provided support, resulting in 76 diversions (patients were not admitted to hospital).
• We are deploying our rehabilitation staff to ensure patients are prepared for discharge,  assisting with patient mobilization and daily living activities and providing equipment to patients, as needed, to avoid delays in discharge. Last quarter, this initiative saved 668 inpatient days across Horizon.

“Horizon remains fully committed to doing whatever it takes to improve conditions in our EDs and improving patient flow and patient experience throughout our health care system,” said Margaret Melanson, interim President and CEO. “This is always a busy time of year for our EDs, and our dedicated health care teams are working tirelessly to provide safe and quality care.”

We are also encouraged by initial work on collaborative initiatives with our partners at the departments of Health and Social Development and the New Brunswick Extra-Mural Program that will prioritize moving patients from hospitals to nursing and special care homes and increasing availability of community resources.

The occupancy rate for each of our four regional hospitals continues to be high (average of 106%, above the national benchmark of 85%), and our health care teams and physicians are constantly reviewing admissions and discharges to ensure we have space to care for urgent and emergency cases.

“Overcapacity is not only a New Brunswick issue; it is a system-wide challenge felt across Canada,” said Ms. Melanson. “The problem will not be solved overnight, however, we are committed to improving the care we deliver to our patients and their loved ones.”

Through our overcapacity issues, we are also continuing to prioritize surgical services and maintaining all planned surgeries.

We anticipate that patients with non-urgent medical needs will likely continue to experience longer than normal wait times and should visit sowhywait.ca to explore other options for care, such as a pharmacist, primary health care provider, after-hours clinic, virtual care (such as eVisitNB.ca), Tele-Care 811, or the Emergency Department. This includes patients who are experiencing symptoms of a respiratory infection. If you are experiencing a medical emergency, please call 911 or proceed to your local Emergency Department. Our dedicated teams are working very hard to care for our sickest patients, including those requiring trauma care, critical care, intensive care, and victims of sexual and intimate partner violence, and those experiencing urgent mental health needs and this will remain our priority.

Horizon has a plan to improve health care in New Brunswick. Our plan is focused on retention and recruitment efforts and improving the overall patient experience by addressing patient flow and access to services. Further details about Horizon’s four priority areas are available at HorizonNB.ca. This initiative also supports the Government of New Brunswick’s provincial health plan, Stabilizing Health Care: An Urgent Call to Action.

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