Feedback from physicians and staff is guiding the introduction of several initiatives designed to improve patient flow and reduce wait times at emergency departments and urgent care centres throughout Winnipeg, Shared Health and the Winnipeg Regional Health Authority reported today.

“Long wait times are a concern for all Manitobans but particularly for those seeking care from – and those working in – urgent care centres and emergency departments,” said Dr. Shawn Young, chief operating officer of HSC Winnipeg. “While wait times are holding steady despite a substantial increase in patient demand, we know many patients will continue to wait longer than normal throughout these busy summer months.”

A number of initiatives have been introduced, or are in the planning stages, that were generated by conversations with staff. Some of these discussions are occurring as part of recently created physician working groups that meet weekly to discuss ways to address patient flow challenges affecting the health-care system. These initiatives include:

• Providing additional home care resources on the weekend, to more easily support patient transitions back into the community after discharge;
• Creating a staffing pool of nurses with previous emergency and urgent care experience. Hospitals are reaching out to experienced ED/UC nurses to gauge their interest in becoming a casual resource who may be contacted to pick up available shifts. Advanced-care paramedics may also periodically receive call-outs inviting them to take shifts in emergency departments;
• Consideration of self-scheduling options. HSC Winnipeg leadership is meeting with staff to discuss the feasibility of self-scheduling, which would allow nurses to have some say in their shifts while still meeting departmental needs;
• Coordinated and consistent orientation for newly hired nurses in Winnipeg emergency departments. A four-week orientation program is supporting nurses who have accepted a position in an emergency department or urgent care centre. Nine nurses are enrolled in the program’s first class, which continues until July 8, at which time graduates will report for shifts at one of Winnipeg’s hospitals;
• Support from other specialty areas. ICU nurses are being reassigned to the emergency department within their facility toassist in resuscitation needs when staffing levels in the ICU allow; and
• Daily huddles allow for information to be clearly communicated and shared among the ED or UC teams.

“These initiatives are the direct result of conversations we’ve had with staff, physicians and site leadership, who have shared ideas on how to further improve patient flow and reduce wait times,” said WRHA CEO Mike Nader. “Those conversations are continuing to occur and new ideas are being developed to improve patient care and reduce wait times at emergency departments and urgent care centres in Winnipeg.”

These changes have helped to stabilize median waiting to be seen times at Winnipeg sites despite patient volumes surging over the past three months. The number of patients visiting emergency and urgent care sites in Winnipeg climbed to an average of 796.8 patients per day in May, which is close to a two-year high. This number is up an average of 26.7 visits per day from April and an increase of 50.3 patient visits per day over the same month last year. Patient volumes for the first three weeks of June were on pace to meet or slightly exceed May numbers.

Despite the surge, median waiting to be seen times at Winnipeg sites remain relatively steady, albeit significantly elevated, with preliminary data for June suggesting a small improvement following a six-minute month-over-month increase in May.

New initiatives follow a number of previously announced changes to address patient flow challenges that include the:

• expedited placement of ALC patients (alternate level of care) from hospital to long-term care;
• repatriation of stable patients who live outside of Winnipeg to continue their care, when clinically appropriate, at sites closer to home;
• prioritized arrangement of supports at home or in the community for inpatients, allowing them to be safely discharged more quickly;
• leveling of ambulance transport arrivals across facilities by shifting lower-acuity patient arrivals to urgent care centres rather than emergency departments; and
• use of the Physician-in-Triage model of care, which places a physician in the triage area at HSC Winnipeg as staffing allows to help manage and provide care for those waiting to be seen, with a focus on monitoring higher-acuity patients.

Patients are reminded to continue seeking help in an emergency, either by calling 911 or going to an emergency department or urgent care centre. All patients are assessed and triaged upon arrival and care will be provided, with the sickest and most injured patients prioritized.

Shared Health is launching a Summer Safety Series to educate Manitobans about some of the most common, preventable reasons for emergency department visits. Tips and reminders to avoid a preventable injury will be shared throughout the summer months on Shared Health’s social media channels.

Manitobans are reminded to familiarize themselves with care options in the community, including primary care and walk-in clinic options for less serious health concerns. More information can be found here: My Right Care.

Monthly ED wait time data, as well as an FAQ, is available here: Monthly Wait Time Reporting – Winnipeg Regional Health Authority.