Hospital improves patient experience in emergency department

It’s not often a patient returns to an emergency department just for a tour. But, on a sunny afternoon this past June, Elizabeth Carmichael was happy to do just that.

The 76-year-old Scarborough resident was invited back to The Scarborough Hospital’s General campus emergency department (ED) to view the many improvements that have been made since her visit last December – an experience that had her vowing “never to go to any emergency department ever again.”

These changes are the result of a committee the hospital set up in January of this year made of up of ED staff who examined how the patient journey could be improved from the time people walk into triage to the time they are seen by a doctor.

And Carmichael’s experience is a perfect example of the sort of journey the hospital is working hard to avoid.

Last December, Carmichael came to the General campus ED after an unexplained rash on her arms and legs continued to get worse. Her frustration began to build after she was forced to stand for long periods in the waiting areas while chairs were taken up by visitors. Carmichael’s anger grew when no nurse was available to help a patient with an IV beside her in the waiting area get to the washroom. The final straw came when she was taken to a cold exam room, which began to aggravate her asthma.

After getting “extremely angry” at the ED staff and complaining to her family physician, who works at the hospital, her concerns were quickly escalated to Denise Edman, Patient Care Manager of the General campus ED.

“The Scarborough Hospital’s mission is to provide an outstanding care experience that meets the unique needs of each and every patient,” says Edman. “We take complaints like Mrs. Carmichael’s very seriously and wanted to make sure that we were doing all that we could to prevent visits like hers from ever happening again.”

As a first step, committee members toured a variety of hospitals that have made major improvements in their EDs. “We looked at what practices could be adopted at The Scarborough Hospital that would best serve our diverse community,” explains Edman.

Some of the changes that have been instituted over the past several months include more clearly defining the areas for patient assessment, registration and waiting in the triage area. Dedicated red chairs have been set up for patients in the triage where nurses can continually observe them for any signs of distress. As well, a board in the triage is regularly updated with the current wait times.

A Rapid Assessment Zone (RAZ), implemented in conjunction with the medicine department at both the General and Birchmount campuses, has helped reduce the wait for an inpatient bed. When patients move into the RAZ, they are given a number and can see on an LED screen where they are in the queue.

“We have also strengthened our core team with more nurses and volunteers to assist patients, as well as an additional physician working Monday to Friday from noon into the evening,” says Edman.

“It’s wonderful to be invited back to see all these exciting changes,” says Carmichael. “I was very satisfied with the actual care I received at The Scarborough Hospital, and these changes have made everything else so much better.”

And there’s still more to come. A number of other improvements will be put in place in the near future, such as a digital sign in the triage with the current waiting times. “However, improving the care patients receive at The Scarborough Hospital is an ongoing process,” stresses Edman. “We encourage patients to continue to share their experiences – good or bad – with us.”