New era begins for emergency care in London

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After years of planning and preparation, the first six months of 2005 have seen an unprecedented amount of change to emergency services in London.

At 3 p.m. on February 15, the Emergency Department at St. Joseph’s Hospital, the acute care site of St. Joseph’s Health Care, London, closed its doors for the first time in 75 years. As part of the citywide restructuring of hospital services, the department transferred to London Health Sciences Centre (LHSC). At the time, LHSC operated three Emergency Departments in London – at University Hospital, South Street Hospital, and a children’s emergency at Victoria Hospital.

At 8 a.m. on February 16, the former St. Joseph’s ER reopened as the new Urgent Care Centre. New signs, a fresh coat of paint, and a seven-day advertising campaign announced the arrival of this new health care option for Londoners. Open from 8 a.m. to 10 p.m. seven days a week, the Urgent Care Centre is designed to treat non-life threatening illnesses like cuts, sprains, and broken bones. The Centre is an ideal fit with St. Joseph’s Hospital’s new role as the citywide centre for ambulatory care and day surgery. Communicating the change was a major challenge. To get the word out, the hospitals jointly developed a major print and radio advertising campaign in the form of a seven-day countdown. Local media covered the changes extensively. When the doors to the Urgent Care Centre opened, patients with appropriate conditions were waiting.

“People are getting it,” says Karen Dyer, Director of St. Joseph’s Urgent Care Centre. The Centre is already exceeding projected volumes, and the number of patient transfers to Emergency is well below expectations at less than two per day on average.

This was just the first phase of change to emergency services. The closure of the aging and undersized LHSC South Street ER, the busiest in the city, had long been planned. Because of funding and construction delays, and the fact that related programs such as critical care needed to move at the same time, the move could not be executed until June. A second phase of advertising began, again in the form of a seven-day countdown, but with key differences. Radio ads now featured a woman’s voice, and print advertising included a photo of the expanded ER at LHSC University Hospital, which had quietly gone into service in the summer of 2004. A direct mail piece was sent to every household in London-Middlesex and included a full-colour sticker identifying the locations of the new ERs and the Urgent Care Centre.

Replacing the South Street ER is a new, state of the art Emergency Department at LHSC Victoria Hospital, located beside the existing Children’s Emergency. Much larger that the South Street facility, the Victoria Hospital ED has the capacity for 90,000 annual visits. Innovative design features include decentralized nursing stations, separate areas to care for critically ill and injured patients, acutely ill adults, less acutely ill adults, and patients with minor illnesses and injury. It is equipped with X-ray facilities in its crucial care/resuscitation area, and is immediately adjacent to the main X-ray department where facilities will be available to conduct CT and ultrasound examinations. A dedicated elevator is available to move patients to the intensive care unit and operating suites. The children and adult departments share a common entrance but have separate triage desks and waiting areas.

Lead by the City of London, which contributed 15 million dollars toward acute care restructuring at both London hospitals, including LHSC’s ER, community and corporate donors were introduced to the new facility at an open house on June 8. Dr. Gary Joubert, the citywide Chief of Emergency Medicine, spoke on behalf of ER physicians and staff.

“Our team sees first-hand the impact of health care every day and how it touches the lives of patients,” he said. “I’m at a fortunate place to witness how your contributions truly make a difference in people’s lives.”

The South Street ER, which opened in 1941 as part of a major expansion of what was then called Victoria Hospital, officially closed its doors at 7 a.m. on Sunday, June 12, 2005. The five patients in the ER at that time were transferred to the new LHSC Victoria Hospital Emergency Department by ambulance and patient transfer vehicle. The transfers were complete before 8 a.m., signaling – after years of planning and six months of unprecedented change – the end of the beginning of a new era of emergency care in London.