Dear Colleagues,

Today, the Ontario Hospital Association, the Ministry of Health and Long-Term Care, the University of Toronto and the Canadian Institute for Health Information released Hospital Report 2005: Emergency Department Care. As you will recall, this is an annual series (along with reports on acute care, rehabilitation and complex continuing care) that provides a "snapshot" of how Ontario hospitals are performing during a particular time period. The ED report is based on data from 2003/04 fiscal year with some from 2004/05. A copy of the ED report is available online.

Overall, the report found that Ontario EDs are performing well in handling more than four and a half million visits in fiscal year 2003/04. Not surprising, Severe Acute Respiratory Syndrome (SARS) affected EDs, thereby reducing the number of ED visits by as much as 5.1 percent.

I'm pleased to report that UHN is one of only five hospitals ranked as a "high performing" hospital in the area of Clinical Utilization and Outcomes. This means that we have a low rate of readmission to the ED for some conditions (ex. asthma) and that we utilize our resources effectively.

Our Patient Satisfaction scores are disappointing. However, it is likely that our poor patient satisfaction scores are due to our patients and staff's frustrations with the ED "logjams." For many Ontarians, especially those without a family physician, the ED serve as the primary "point-of-entry" into our health care system. Timely access to an inpatient bed is difficult, especially given the reduction in the 1990s to the number of beds in the GTA.

To improve patient flow through our hospitals, we've implemented a number of effective strategies:

  • To reduce the number of admitted patients who are waiting in the ED, we've i​ncreased our GIM capacity by opening seven additional beds. This is a logical step to reduce some of the ED "bottleneck." 
  • Staff in the inpatient units are working very hard to ease the ED bottleneck by bringing up patients, juggling beds and moving patients off-service when needed, and reducing unnecessary delays. 
  • A Steering Committee has been struck with senior managers from Emergency, GIM, Finance, Dr. Catherine Zahn, Dr. Michael Baker, and the Directors of Operations to report on our progress and to identify ongoing problems in our EDs. Senior management is committed to improving our ED service, and we are meeting on an ongoing basis to develop innovative and effective strategies.
  • We're also committed to tracking and reporting on several benchmarks related to patient flow, including the proportion of admitted patients who wait less than four hours before receiving an inpatient bed.

In the area of System Integration and Change, UHN scored above the peer group average for our use of data for decision-making and use of clinical information technology in the EDs. Information technology has clearly enhanced the way UHN manage our resources and delivers patient care. 

Finally, UHN has done a significant amount of work to improve our use of standardized protocols in the EDs. We believe that we have improved since the time of this report and we are committed to making real progress.

Staff in our EDs should be pleased with being recognized for the outstanding level of patient care they provide, each and every day. While there's always room for improvement in our health care system, the same thing goes at UHN and we are making real progress.


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