Emergency department (ED) wait times are more than just a metric – they are a reflection of the challenges and opportunities in delivering the timely, compassionate healthcare that patients need and deserve. For hospitals across Ontario, the struggle to balance rising patient volumes, staffing shortages, and limited primary care access is all too familiar. 

Scarborough Health Network (SHN) is turning the tide with AcceleratED Care: A radical new experience for patients and staff that is not only reducing wait times, but changing the very nature of how emergency healthcare is delivered – including reimagining emergency department design. 

“AcceleratED Care redefines the patient journey by seamlessly integrating physicians and nurses in the rapid medical examination zone to assess and initiate care efficiently for stable, mid-acuity patients,” said Dr. Elan Ambalavanar, Chief and Medical Director of the Department of Emergency Medicine at SHN. 

“Grounded in our commitment to safe, compassionate care, this innovative model eliminates unnecessary wait times to provide a superior ED experience.”

SHN has already retrofitted the Birchmount and General hospital EDs to enable faster access to care. Now, SHN will become the first hospital in Canada to build an ED specifically designed to support AcceleratED Care from the ground-up, when the new Northpine ED at Centenary Hospital begins construction this year.

Retrofits and renovations to support faster care

With AcceleratED Care, most patients are assessed by both a nurse and a physician quickly after they enter the ED, which reduces the number of times patient need to repeat their medical concerns, and enables tests and treatment options to begin earlier in their visit. But putting a physician at the front of house (known as the front-end model of care) is just one piece of the puzzle. 

The AcceleratED Care experience requires transforming the very design and layout of each ED to optimize patient flow and support faster, more efficient care. In order to accommodate the front-end model, the Birchmount ED retrofit included the addition of:

• Rapid Medical Examination Rooms for immediate assessments and tests;

• Fast-Track Zones for patients with less urgent conditions to ease pressure and improve efficiency across the department; and

• Private High-Care Areas for close monitoring and faster treatment of critically ill patients. 

The upgraded spaces feature more comfortable waiting areas with enough seating for families, private collaboration spaces for staff, and self-check-in kiosks to speed up the intake process and reduce front-end bottlenecks.

When SHN piloted the AcceleratED Care model at Birchmount Hospital in November 2023, it showed impressive outcomes. This pilot led to the Birchmount ED being ranked among the top five fastest EDs in Ontario each month since its launch, with initial performance indicators showing that 90 per cent of non-admitted patients were seen within two hours of arrival.

By September 2024, patients seen within 30 minutes of arrival had increased by 20 per cent. 

The Deepa and Narinder Lal ED at General Hospital, which adopted AcceleratED Care in December 2024, underwent similar renovations. ED staff and leaders are now tracking improvements to wait times and the overall patient experience, anticipating data similar to that which resulted at Birchmount.

“The new AcceleratED Care experience has resulted in better overall quality of care, and prioritizes efficiency, teamwork, and staff wellness,” said Dr. Norm Chu, an emergency physician who spearheaded this model at SHN. 

“Improving the workflow and reducing strain on our team are key components in ensuring that patients receive the best possible experience, while supporting staff and physicians to succeed in a busy and fast-paced environment.”

Designing for the future: Centenary Hospital Northpine ED

When the new Northpine ED at Centenary Hospital opens, every aspect of the facility will have been meticulously configured to support faster diagnosis, immediate treatment, and better patient outcomes.

Drawing on insights from improvements made to its sister EDs, the Northpine ED layout at Centenary will be structured to minimize unnecessary movement, ensuring that both staff and patients move seamlessly through the facility. This is not simply about adding more space – it is about creating an environment that supports efficient decision-making and a faster, easier patient journey.

“It’s incredibly rewarding to see how AcceleratED Care is improving both the patient and staff experience,” said Geleta Ansebo, Manager of Emergency Care at Birchmount Hospital.

“Our teams look forward to continually seeking opportunities for improvement to build on this initiative and propel our success.”

As the AcceleratED Care experience continues to evolve, including improving collaboration and workflow with other areas often involved in emergency care such as diagnostic imaging and mental health, SHN’s focus on designing facilities that work in tandem with care delivery will have a lasting impact on emergency care in Scarborough and
beyond. 

Driven by the exceptional leadership of SHN’s ED physicians and staff, these upgrades were made possible through the strong support of donors, government partners, and the local community. By creating environments that are built for faster access to care while maintaining exceptional quality, SHN is setting a new standard for emergency department design: One that puts the patient experience and safety at the forefront.

By Melody Keshishian
Melody Keshishian is a Communications Specialist at Scarborough Health Network.