Our Stories

Innovation

Putting patients first at the Dartmouth General Hospital emergency department

Many people across Canada have a story about long waits in emergency departments. The priority of who is seen first is determined through a triage process, but that process is difficult to explain to someone who is in pain with a minor ailment and has to wait.

Often those are the people who give up and go home before they are seen by a health care professional. In fall 2012, that is what was happening at Dartmouth General Hospital. The department was overcrowded, wait times were long, patient complaints were growing and staff were stressed. The need for change was urgent. Capital Health created an interdisciplinary patient flow committee. With the help of IT and a management engineer, they gathered data, surveyed patients and challenged each other to find efficiencies in a facility already operating over capacity.

This resulted in a realigned process where low-acuity patients saw a doctor within 90 minutes. They bypassed the waiting room and went from triage and registration to a repurposed hallway area. Staff and physician schedules were shifted to match patient arrival patterns. The changes were evaluated monthly and adjusted as necessary. Staff were consulted every step of the way.

The proof is in the numbers. In 2012, only 12 per cent of this group was seen within 90 minutes. One year later, that number was at 50 per cent. Work is continuing and the goal is to reach 100 per cent.

Patient survey results also show a remarkable tripling in satisfaction rates.

This work is a testament to one of our strategic directions: to transform the person-centred health care experience. Accreditation Canada notes that improving client flow can only be achieved by “evaluating client flow data and considering all sources…and pattern of demand” and “strong leadership support.”

Projects like this help us reach our goal to exceed clients’ expectations. We are focused on our priorities and are in relentless pursuit of excellence in care and service.