box10.gif (1299 bytes)







Patient flow

Capital Health launches project to improve access

EDMONTON – Capital Health has announced a major initiative to improve access and reduce delays for patients, from Emergency through inpatient hospital care and community care services.

The “Emergency Services and System Capacity” (ESSC) project aims to improve coordination and make better use of hospital beds and other resources, says Michele Lahey (pictured), Capital Health Executive Vice President. “In the past three years, we’ve added 300 hospital beds and nearly 1,000 long-term care spaces. But the pressures on the system continue to grow, including delays in admitting patients from our Emergency Departments. So we’re taking a fresh look at how to better use all of the resources and expertise in the system to take care of all our patients on a given day.”

The ESSC project is a multi-part initiative, rolling out in stages over the next 12-18 months. It includes ongoing efforts within the Emergency Departments to improve throughput and support patients while they wait, such as the successful “Triage Liaison Physician” role. It also complements ongoing work with EMS providers to improve ambulance turnaround times.

The core issue is system-wide capacity, and so the core of the plan is centralized management of beds and care spaces to increase capacity across the system. In January, “bed managers” at the four major hospitals and the community sector began assigning beds within their sites and coordinating across the region on a daily basis, to speed up admission.

They also balance the load across the system by coordinating with the Regional Transport Office to transfer patients between sites anywhere in the region.

Systematic bed management is already getting patients admitted faster and beginning to reduce the numbers of admitted patients waiting in Emergency, according to the region. Over time, it will free up more hospital beds by moving patients out of hospital faster when they are waiting for long-term care or other community care spaces.

The new bed-management system is also the critical infrastructure for the “full capacity protocol,” which began implementation early this year.

Under the “full capacity protocol,” admitted patients waiting in Emergency in any of the four major hospitals will be moved onto designated flex areas on inpatient units whenever the number exceeds 25% of the available stretchers. The protocol will also include moving patients out of hospital to flex capacity in long-term care.

“The ESSC project is the most comprehensive change we’ve made in 10 years as a region,” says Lahey. “It represents a new approach to healthcare management in Canada – making the system really work as a system. But there’s no magic bullet; this work will help us manage the pressures on the system, not eliminate them. We have an aging population and epidemics of diabetes and other chronic diseases; we need to keep adding beds and other resources, but at the same time we can and will make better use of all those resources.”

About Capital Health
Capital Health in Edmonton is Canada’s largest health region and is affiliated with the University of Alberta, providing integrated health services to one million residents in Edmonton and the surrounding area. Capital Health acts as a referral centre to central and northern Alberta, the North and the Prairies, providing specialized services such as trauma and burn treatment, organ transplants and high-risk obstetrics.