Participants examine “art of the possible” at ED Waits and Patient Flow Initiative visioning session

ED Visioning

How many times have you heard the story from someone you know, complaining about having to wait hours and hours in an emergency room before being seen?

Those who work in the health system well know the problem is bigger than just the emergency department (ED) – the real story is bottlenecks elsewhere in the hospital and system, which result in those long waits in ED.

But Saskatchewan’s health system is looking to turn things around, acting on Saskatchewan’s Growth Plan agenda to eliminate emergency department wait times by 2017.

On November 14-15, 2013 the Emergency Department Wait and Patient Flow Initiative held a provincial visioning session in Saskatoon.  The session included participants from health regions across the province as well as many other stakeholder groups including patient advisors, the College of Family Physicians, SUN and the MD Ambulance – just to name a few.

With the intent of understanding what great work is already underway across the province, Day 1 was focused on the art of the possible.  The day opened with a compelling presentation by Lawrence LeMoal, a member of the Patient Advisory Council of the Initiative’s Provincial Kaizen Operational Team.  A palliative patient with prostate cancer, Lawrence described his sometimes frustrating journey across the continuum of care.  He talked about the patient’s role in taking personal accountability for their health, from primary prevention and screening through to palliative care planning.

Keynote speaker Dr. Marco Duic from St. Joseph’s Health Centre in Toronto spoke on the work done in Ontario to reduce patient wait times in the emergency department.

His message was both challenging and refreshing – “meetings don’t move patients”.

The rest of the day was dedicated to understanding what is already happening in the province.  From Mamawetan to Sun Country – each health region presented their current state, their successes and their challenges with the intent of developing a provincial understanding of the similarities and differences.

Day 2 opened with keynote speaker Daniel Comerford from New South Wales (NSW) Australia.  NSW has put considerable effort into improving patient flow across the continuum of care from primary healthcare through the emergency room and from inpatient care to discharge back into the community/LTC.  It was an eye opening presentation that illustrated that efficient patient flow requires a systems approach and it is achievable.

With that, the group of 160+ rolled up their sleeves and got down to work – what would our future state look like?  Led by Susan Neidig from John Black and Associates, the group began to define attributes of a future state where there are no waits.  It was a paradigm-shifting exercise that forced us to consider what it would be like with zero waits.

With help of terrific facilitators, focus shifted to future state development.  The energy in the room was high, with doctors standing side by side with patients and administrators shoulder to shoulder with point of care staff.  The conversation was both frank and enlightening, culminating in the development of a future state map.

Next steps will entail synthesizing all of the evidence, building on Saskatchewan successes to date and lessons learned from our guest speakers, and using at the future state map as a guide for creating our go-forward plan.

“It has been so inspiring to see what we can achieve when we work together.  I’ve been nothing but impressed by the strides made in surgical care,” said Minister of Health Dustin Duncan to attendees. “But I have to tell you, I am so excited as the Minister of Health to be in at the front end of an initiative of this magnitude – one that will have such a profound impact on how we care for patients.”

This is the start of the journey, says Graham Fast, Lead for the initiative. “Great work has been going on across the province on ED wait times for the past two years; having a shared vision will allow us to think and work as one.”

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