Rapid Assessment Unit at QEII treats 2,900 patients in first year

Thursday, September 29, 2011 - 6:25pm

In its first year, the RAU provided care to almost 2,900 patients, diverting the majority of them away from the busy Charles V. Keating Emergency and Trauma Centre. This has created more space in the emergency and trauma centre for patients who need emergency care. It has also resulted in fewer patients waiting on stretchers, allowing EHS paramedics to get back out in the community sooner. Without the RAU, overall wait times in the emergency and trauma centre would have been higher over the past year.

“Improving emergency care is a significant part of Better Care Sooner plan to enhance emergency health care for Nova Scotians and their families,” said Maureen MacDonald, Minister of Health and Wellness. “With this unit these patients are getting appropriate care sooner and this is helping to alleviate pressure at our province’s busiest emergency department.”

Of the 2,898 patients who received care in the RAU, 66 percent by-passed the emergency and trauma centre completely.

Patients referred to the RAU for care are considered medically stable and no longer require emergency care but still need to be seen by a specialist. Once in the RAU, a specialist completes the patient's assessment to determine if they either need to be admitted to the hospital or provided treatment on-site and then discharged from the QEII. On average, patients in the RAU received care and were either discharged or admitted to a bed within four hours and 15 minutes.

“Patient satisfaction is very high,” said Dawn Gavin, a Registered Nurse who helped set up the RAU and continues to work there. “This is a more comfortable and less stressful environment than the emergency department, and patients and families appreciate that we have more time to spend with them, involving them in their care.”

While almost 2,900 patients have been diverted to the RAU, the number of patients visiting the Charles V. Keating Emergency and Trauma Centre continues to increase significantly. This summer was the busiest ever for the province’s largest emergency department, with a record number of patient visits in July (5,927) and August (5,956 - the highest ever.) This continues a trend over the past five years that has seen the volume of patient visits increase from a total of 59,010 in 2007/08 to 63,206 in 2010/11.

"With the significant increase in patient visits to the emergency and trauma centre at the QEII, the rapid assessment unit has proven to be invaluable by allowing us to take some of the pressure off," said Dr. Sam Campbell, QEII Site Chief for Emergency Medicine. "The way we use the RAU continues to evolve, but it is definitely part of the solution for improving emergency care in the district."

In addition to the RAU, a number of other changes and improvements have been introduced over the past few years, to address the long-standing overcrowding challenges at the QEII Health Sciences Centre. By streamlining the care provided to different types of patients, the staff and physicians are making progress on improving wait times, the quality of care and the patient experience.

The Rapid Assessment Unit was officially opened on September 28, 2010 by the Minister of Health and Wellness, Maureen MacDonald, one of three projects announced for the QEII Health Sciences Centre as part the province's Better Care Sooner plan. The first patients were seen on September 29, 2010.

See fact sheet below for additional information

Media contacts:

John Gillis, Capital Health
Tel: (902) 458-5376 (pager)
johnw.gillis@cdha.nshealth.ca

Sherri Aikenhead, Nova Scotia Department of Health and Wellness
Tel: (902) 424-5886
sherri.aikenhead@gov.ns.ca

Capital Health comprises: the Capital District Mental Health Program; Community Health; Public Health Services; Addiction Prevention and Treatment Services; Integrated Continuing Care; Centre for Clinical Research; Cobequid Community Health Centre; Dartmouth General Hospital; East Coast Forensic Hospital; Hants Community Hospital; Eastern Shore Memorial Hospital; Musquodoboit Valley Memorial Hospital; The Nova Scotia Hospital; Musquodoboit Valley Memorial Hospital; Twin Oaks Memorial Hospital; Nova Scotia Environmental Health Centre; and the QEII Health Sciences Centre.

The Capital Health District also encompasses seven volunteer Community Health Boards that advise Capital Health through the development of community health plans and encourage public participation in health planning. For more information, visit the Capital Health website: www.cdha.nshealth.ca

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FACT SHEET

Rapid Assessment Unit
QEII Health Sciences Centre, Capital Health
Halifax, Nova Scotia

Total number of patient visits to the Rapid Assessment Unit: 2,898, as of September 28, 2011

Patients are referred to the RAU from a number of different sites:

  • 34 percent are first seen at the Charles V. Keating Emergency and Trauma Centre
  • 66 percent arrive from other sites:
    • 25 percent from home
    • 20  percent from other (such as nursing homes and other districts)
    • 10 percent from Cobequid Community Health Centre
    • 04 percent from Dartmouth General Hospital
    • 04 percent from Hants Community Hospital
    • 3 percent from clinics

The top five specialty services providing care through the RAU are:

  • General Surgery (867 cases)
  • Orthopaedics (704 cases)
  • Plastics (296 cases)
  • Neurology (216 cases)
  • Urology (211 cases)

Average length of stay in the RAU (from arrival to discharge or admission to a hospital bed): four hours and 15 minutes.

Patient visits to the Charles V. Keating Emergency and Trauma Centre have been increasing each year, from a total of 59,010 in 2007/08 to 63,206 in 2010/11.

  • For the first five months of the fiscal year, starting April 2011, there have been 28,249 patient visits, the busiest summer ever:
    • 5,233 in April
    • 5,620 in May
    • 5,513 in June
    • 5,927 in July (second highest number ever)
    • 5,956 in August (highest number ever)
  • By comparison, in last fiscal year (2010/11), there were 26,192 patient visits in the first five months.

In the face of increased patients visits, the staff and physicians at the QEII Health Sciences Centre continue to make improvements to wait times, the quality of care and the patient experience:

  • Ambulance offload times: over the past two years, ambulance offload times at the QEII Health Sciences Centre have improved, from 173 minutes OR LESS for 90 percent of all ambulance offloads in August 2009 to 141 minutes OR LESS for 90 percent of all ambulance offloads in August 2011. The target is 20 minutes, for 90 percent of all ambulance offloads.
  • Left Without Being Seen: patients choosing to leave without seeing a physician decreased from 8.1 percent of visits in August 2009 to 5.5% of visits in August 2011. The target is five percent.
  • The length of stay or wait time, from triage to departure from the Charles V. Keating Emergency and Trauma Centre, for less urgent (CTAS level 4) and non-urgent (CTAS level five) patients has improved. The new provincial emergency standards define the length of stay or wait time to be a maximum of four hours, for 90 percent of all CTAS levels four and five patients. As of June 2011, the length of stay at the QEII was 5.5 hours. This means that 90 percent of all patients (CTAS levels four and five) waited 5.5 hours OR LESS.

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