The Scarborough Hospital and Toronto EMS – Turning It Around

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The Scarborough Hospital (TSH) is ranked as one of the top four hospitals in Toronto that has worked with Toronto Emergency Medical Services (EMS) to decrease ambulance turnaround times in its Emergency Rooms (ER). By making offloading patients a priority, the ERs at both the General and Grace campuses have been praised by Toronto EMS as among the best in the city.

With strong leadership from Louise LeBlanc, Patient Care Director of Emergency and Urgent Care, the philosophy at TSH is simple – “when someone comes through the ER doors, that person is our responsibility. It doesn’t matter if they walk in or are stretchered in by EMS.”

By making seemingly simple, yet effective improvements in its ERs, TSH is more prepared than ever to continue to lead in turnaround times. For example, scheduling additional staff, such as a second triage nurse during peak times to assist in the assessment of patients upon their arrival, scheduling nurses to help out in the waiting area and reception, and ensuring there are several unoccupied stretchers waiting at reception are all key to ensuring patient flow.

The efforts by Louise and all ER staff at TSH have not gone unnoticed. In a local newspaper earlier this year, Bruce Farr, Toronto EMS chief said: “Louise runs the best ER in town. When we go into Louise’s ER, we’re somebody.”

Recognizing that they are all part of the same team has helped TSH ER staff and Toronto EMS work together to make the offloading process as efficient as possible. “At TSH, we recognize EMS as part of our ER team,” says Louise, “and in return, they recognize themselves as part of the team as well. The working relationship we have is excellent.”

As one of the top performing hospitals in the city, TSH is also involved in several committees at the Ministry level, which look at this issue globally. “We are happy to help in any way we can and welcome the opportunity to participate when asked to join,” says Louise, who is pleased with the outcomes she has seen already. For example, a new distribution process was recently implemented, which works to balance ambulances between hospitals, ensuring that no one hospital receives more than its share.

With plans for a new Emergency and Critical Care Centre (ECCC) at TSH’s General Campus, the efficiency of this ER will undoubtedly improve even further upon its completion. According to Louise: “We already have good efficiencies at TSH but the new ECCC will give us a great deal more space to provide quality care to all of our patients.”

The ECCC will be a multi-level centre that will greatly enhance the hospital’s existing services. The expanded 15,000 square foot ECCC at TSH’s General Campus will have a new public entrance (west side) and a separate ambulance entrance (south side). “Thanks to the input we have received from Toronto EMS, we are confident that the new ECCC is designed in a way that will best serve ambulances and make offloading patients as efficient as possible,” says Louise. The location will permit easy access to elevators for transfers of patients to critical and inpatient units, operating rooms, and more sophisticated imaging services, thus ensuring patient flow through the ER.

Serving a population of close to one million, TSH handles more emergency and urgent care patients than any other hospital in Toronto or the GTA. TSH is committed to building capacity to meet the evolving needs of the urban community it serves. The Scarborough Hospital (TSH), Canada’s largest urban community hospital, delivers innovative, high quality patient care, advocates for our community’s health and wellness issues, and is a leader in research, teaching and learning. TSH is a regional treatment centre for dialysis and is renowned for its sexual assault care centre and mental health programs. Affiliated with the University of Toronto, TSH is also a referral centre for vascular surgery, pacemakers and corneal implants.