New Hours, New Process at Northside General Hospital's Emergency Department
Starting Dec. 4, changes are being made at Northside General Hospital’s emergency department (ED) to better manage the flow of patients through the ED. They include changing the ED’s hours and putting a new patient capacity process in place.
As of Monday, Dec. 4, the hospital’s ED will be open to the public from 8 a.m. to 4 p.m. daily. Patient triage and registration will stop at 4 p.m. This gives doctors and staff an additional hour to see patients safely.
A new patient capacity process will also be put in place. Patient capacity occurs when a unit or department reaches the maximum number of patients it can safely treat. A combination of the number of patients and how sick they are leads to patient capacity.
“Normally, patient capacity doesn’t happen all at once,” says Brett MacDougall, Director, Emergency Program of Care with Nova Scotia Health Authority’s (NSHA) Eastern Zone. “There’s a natural ebb and flow to any ED. Staff are well-trained and are able to recognize any situations or volumes that are ramping up. Then they are able to put measures in place to help deal with the patient volume and workload.”
Under the new process, doctors and nursing staff will assess the workload and patient flow in the ED throughout the day. This will help determine if all registered patients can be seen and assessed by a doctor.
If patient capacity is reached, people who are registered and waiting may not necessarily be seen that day. This will also depend on the seriousness of the patient’s health issue.
Under patient capacity, the priority is to see people who have been triaged with an emergency or urgent health issue. Registered patients triaged with less urgent or non-urgent health issues may or may not be seen by a doctor, depending on patient flow.
People triaged and registered with less urgent or non-urgent health issues after patient capacity is reached will most likely not see a doctor. An ED team member will give all people triaged with less urgent or non-urgent health issues other treatment options. Those options include coming back to the ED the next day, going to the nearest open ED or seeing their family doctor.
“We can’t always accurately predict if an ED will reach patient capacity,” says Dr. Neil MacVicar, Chief of Emergency Medicine for the Cape Breton Region in NSHA’s Eastern Zone. “By their nature, EDs are unpredictable because you don’t know who’s coming through the door next and how sick they are. Our team, including doctors, looks at the use and management of resources every day. Our goal is to see all registered and triaged patients but when patient capacity does occur, we need to have a process in place to safely manage patient volumes and treat the most seriously ill patients.”
These changes were developed with clinical leaders, nursing staff and the doctors who provide coverage at the Northside ED.
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