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BC adds $22 million to ER care incentives

VANCOUVER – British Columbia’s busiest emergency departments will receive an extra $22 million in patient-focused funding this year to help ease congestion and reduce patient wait times, the provincial government has announced.

“We are building on the success of emergency decongestion pilot projects in the Lower Mainland, where up to 40 percent more patients experienced shorter waits in some Vancouver and Fraser Valley hospitals,” said Health Services Minister Kevin Falcon (pictured). “With almost 2 million visits to B.C. emergency rooms last year alone, this investment will help ensure patients receive timely, high-quality patient care.”

Falcon said the improvements in patient wait times last year were achieved despite a 15 percent increase in emergency room volumes, attributed primarily to the H1N1 flu.

The additional funding will be distributed among 15 B.C. emergency departments that account for almost half of the ER visits in the province, including hospitals in the Lower Mainland, on Vancouver Island, in the Interior and in the North.

“Innovation in the emergency department – from bedside technology and life-saving research to funding initiatives such as this – is revolutionizing the way we provide emergency care,” said Dr. Eric Grafstein, head of emergency services for Providence Health Care. “Since the emergency decongestion pilot project began, we’ve made design and care improvements that have resulted in reduced wait times, shorter emergency department stays for patients waiting for a hospital bed, and improved staff morale.”

Patient-focused funding is a method of tying the money health authorities receive to the quantity and quality of healthcare services they provide.

The emergency department funding will be invested in a variety of site-specific projects aimed at moving patients either into a hospital bed or back into the community within defined target times. The BC Health Services Purchasing Organization, established in the spring, directs dollars based on recommendations from clinical experts from each health authority.

“Patient focused funding allows us to build on the already great emergency care we provide at three of our busiest hospitals,” said Interior Health CEO Dr. Robert Halpenny. “I know our front-line staff will welcome the opportunity to improve our efficiency and deliver the most timely care to the patients we serve.”

Each emergency department measures the time patients arrive to when they are treated and either discharged or admitted to the hospital, and categorizes these patients based on the complexity of their medical needs. With patient-focused funding, reducing wait times earns financial rewards the health authorities can re-invest in further improvements to patient care.

For example, Nanaimo Regional General Hospital introduced ER “streaming” during the pilot phase of this project. During waiting periods, patients who met the streaming criteria were seated in chairs in the designated streaming area, allowing stretchers to be used mainly for initial assessments, treatment of the more acute patients, or for patients who are too frail or ill to sit in a chair. By introducing this simple triaging technique, the hospital reduced wait times by 20 to 40 percent.
The $22 million investment is part of the $250 million announced earlier this year that will be used to implement province-wide, patient-focused funding. By 2012-13 the proportion of money tied to patient-focused funding is expected to reach 20 percent of eligible healthcare spending while the other 80 percent will remain as block funding.

This includes $80 million in 2010-11 and $170 million in 2011-12. Health authorities have access to this money on top of their projected budget increase of 15 percent over the next three years and will continue to enhance service quality and patient care.

Since 2001, the BC government together with regional hospital districts and foundations have committed over $460 million to improve and expand more than 30 emergency departments across the province.

Posted November 4, 2010