Photo caption: A nurse assists a patient in the Admissions and Discharge Unit (ADU) at Erie Shores HealthCare. The unit helps reduce wait times by providing space for patients awaiting admission or discharge.
By: Kevin Black, Manager Communications, Community Engagement and Public Affairs, Erie Shores HealthCare.
Waiting. For patients, it's unsettling. For staff, it's draining. For Erie Shores HealthCare (ESHC), it became an opportunity.
In the fall of 2023, as ESHC prepared for the annual surge season, leaders began examining one of the most persistent challenges in Ontario hospitals: delays slowing the flow of patients into and out of care. The team mapped exactly where patients were sitting idle, how long backlogs lasted, and what ripple effects they had across the hospital.
The review launched a two-year effort of planning, innovation, and refinement, leading to the creation of a specialized Admissions and Discharge Unit (ADU), an Emergency Department (ED) efficiency program, and a new partnership to ensure patients without primary care have timely follow-up.
Emergency Department Efficiency
Because the majority of inpatients arrive through the ED, the hospital focused on helping physicians manage the high patient volumes. A physician efficiency program was introduced. To qualify, ED doctors must complete an accredited course through the Centre for Emergency Medicine, funded by ESHC, and then apply the practices in real time. Physicians track their own efficiency through real-time personalized dashboards and overall department metrics. Over 70% of emergency physicians have increased their productivity since the program's launch.
"Efficiency isn't just about speed," said Dr. Braedon Hendy, Chief of Emergency Medicine. "Our goal is to support physicians in making timely, safe, and high-quality decisions. When we do that well, patients benefit and the department keeps moving."
Another part of the ED efficiency program involves expanding diagnostic imaging times. Extended CT and ultrasound hours have reduced patient wait times for tests by 20% and increased the total number of scans by 30%. The increased scans have led to a reduction in the length of stay of ED patients.
Admissions and Discharges
When an ED physician determines a patient requires admission and meets specific criteria, instead of waiting on a stretcher in the ED, the patient is transferred to the ADU while an inpatient bed becomes available. The transfer frees the ED space sooner for the next patient.
At the other end of the patient journey, those preparing for discharge can move to a newly created lounge within the ADU to wait with family for medications or instructions. Beds open earlier, allowing other patients to move into care without delay. The day after discharge, a nurse calls the patient to follow up on their condition and answer any questions.
One patient who used the ADU told staff: "On my previous visit, I was one of those waiting on a stretcher in the hallway. Now, I can wait in a welcoming space with my family and friends."
To measure progress, the hospital developed a new metric called Idle Bed Time, which represents the combined wait for admission and discharge. The average Idle Bed Time has reduced by nearly six hours per patient, resulting in dramatic improvements to hospital flow.
Follow-Up Care
Unattached patients who are without a primary care provider are now rostered to the Essex County Nurse Practitioner-led Clinic upon discharge. The clinic ensures continuity of care and, along with the follow-up discharge phone calls, helps to prevent repeat ED visits and readmissions.
Measurable Impact
In the inpatient units, from April to June, the time from ED admission to an inpatient bed decreased by four hours, representing a 62% reduction in the amount of time a patient waited for a bed compared to the same period a year earlier. By identifying and addressing issues immediately, ESHC reduced the time to initial physician assessment by 49%.
These efficiencies have resulted in a 24% reduction in the length of stay for high-acuity patients and a 33% reduction for lower-acuity patients. These improvements mean our community is receiving faster, more timely access to care.
"The results show how innovation, teamwork, and persistence can make a measurable difference for patients," said Kristin Kennedy, President and CEO of ESHC. "By rethinking how we use space and time, we've been able to improve patient experiences and create efficiencies that benefit the entire health system."