Ontario's hospitals are constantly innovating to find solutions to the most pressing issues they face daily, while also improving patient care and experience. Hanover & District Hospital (HDH) exemplifies this commitment by leveraging community partnerships to create a more integrated and seamless care experience for patients and families.
Integrating a Nurse Practitioner into the ED
HDH struggled with increased patient volume in its Emergency Department (ED), particularly among CTAS 1 and 2 patients who require immediate medical treatment. As a result, other patients were experiencing long wait times, there were lengthy ambulatory offloads, and ED physicians became increasingly stressed.
To help resolve these issues, HDH created a unique program and submitted it to the government for consideration. The program would seek funding for a Nurse Practitioner in the ED, a team member that would fast-track assessments by seeing low to moderate acuity patients, undertake orphan patient follow-ups, admit non-complex patients to the medical-surgical unit and support repeat visits.
The government approved funding for the program and the results were successful: the Nurse Practitioner helped manage ED wait-times and supported patient flow and navigation through the health system. The initiative's impact was felt across the board, enabling ED resources to be focused on higher need cases. Patient satisfaction scores in the ED have also been very positive since commencing the program.
Dana Howes, President and CEO, reports that "the addition of a Nurse Practitioner in the Emergency Department has been transformative. By fast-tracking assessments for low to moderate acuity patients and supporting follow-ups, we've significantly reduced wait times and improved patient flow. This initiative has allowed our ED physicians to concentrate on higher-need cases, effectively utilizing our resources. The positive feedback from patients reflects the success of this program, demonstrating our commitment to providing timely and efficient care. We're grateful for the government's support in funding this initiative, and we're proud of the improvements we've achieved in patient satisfaction and overall emergency care."
Connecting Patients to Home Care Through Partnerships
In the Hanover community, access to home care is very limited. In the absence of existing community clinics where patients could seek regular care, HDH's ED was being accessed for clinic-type visits which created increased patient volume.
To solve this, HDH worked with Home and Community Support Services to create a hospital-operated home care support clinic, enabling patients to receive the right care, at the right time and place without needing to access the ED. The clinic is staffed by Registered Practical Nurses (RPNs), enabling them to work to their full scope of practice. Physicians have also expressed their support for the program, which has successfully improved patient care and averted ED visits.
Last year, the clinic saw over 3,000 visits and it was expanded from three 8-hour shifts per week to having daily 12-hour shifts. President and CEO, Dana Howes, remarks that "partnering with Home and Community Support Services has been instrumental in providing better patient care at HDH. By working together to create the home care support clinic, we ensure that patients receive the right care at the right time and place, reducing unnecessary visits to the Emergency Department. This collaboration exemplifies our commitment to meeting the healthcare needs of our community efficiently and compassionately."