The algorithm constructed here allows the choice of the most cost-effective factors to be improved, subject to a given budget. It is expected that, by taking all the above factors into consideration, emergency departments efficiency can be improved. We also obtained additional support for our results by interviewing emergency departments physicians and nurses from various hospitals. ResultsĪll the implemented and new factors are shown to have a significant influence on the length-of-stay and crowding. We implemented it in a case study which takes into account factors that are known to be influential, e.g., reason for arrival, occupancy in the emergency department, and arrival time, as well as factors that are explored for the first time in this paper, such as patient heart rate, the number of accompanying escorts, and the number of tests assigned to patients (e.g., blood tests and urinalysis). We propose an algorithm that can assist emergency department managers in determining which of these factors to address, given budgetary constraints. This research offers a method for emergency department managers to use available data from their departments to identify new factors that significantly influence emergency departments crowding and patient length-of-stay. While some factors affecting length-of-stay are well known, there may be additional factors that have not yet been properly addressed. SCOPE Niagara is a partnership between Niagara Health, Niagara Practitioners Healthcare Alliance and Home and Community Care as part of the Niagara Ontario Health Team - Équipe Santé Ontario Niagara.Overcrowding in hospital emergency departments that arises from long length-of-stay is an unfortunate common occurrence. “SCOPE Niagara has given me confidence with my work, knowing I have somewhere and someone to turn to when help is needed to navigate the system and get the best care for my patients.” Victor Ogala from Grantham Medical Clinic in St. “I cannot say enough about how grateful I am for this service, especially being a new doctor to this area and still finding my bearings,” says Dr. Opportunities to expand the program are currently being explored, including orthopedic services, mental health and addictions. All of my appointments have scheduled times, which helps with time management, work and family.”Īs of May 2023, there were nearly 500 calls to SCOPE Niagara, which varied in nature, such as requests for support with general internal medicine, diagnostic imaging and kidney care. “I was not required to have long wait times in the ED for appointments, scans and blood work. “I was very impressed with the service that SCOPE offered for my family doctor in coordinating my care with the General Internal Medicine Rapid Assessment Clinic and diagnostic imaging,” says Niagara resident Lukas Gotfryd, who is grateful for the timely care the program provided. “As SCOPE Niagara continues to grow, it will attract more family physicians and primary care providers to the program.” Darija Vujosevic, Clinical Lead, Niagara Ontario Health Team and SCOPE Niagara Steering Committee Member. "We are fortunate to be a part of this extension to create a local solution for seamless patient care in Niagara,” says Dr. The program has since grown and has been effective in streamlining care and averting both ED visits and hospitalizations. The program originated in 2012 to support family physicians in Toronto. The primary care providers connect with SCOPE Niagara’s nurse navigator, who directs them to the most appropriate service, providing support for complex and urgent patients in real-time. SCOPE Niagara connects family physicians and nurse practitioners to a dedicated team of specialists from Niagara Health and from Home and Community Care. “By creating pathways, we are able to help identify and improve gaps in care all while reducing unnecessary visits to the ED.” “The program provides an easy, quick connection between community primary care providers and the hospital,” says Sarah Furnival, SCOPE Nurse Navigator and recipient of this year’s Nursing Excellence Award - Excellence in a Non-Traditional Nursing Role. Since its launch in May 2022, SCOPE Niagara – Seamless Care Optimizing the Patient Experience - has registered more than 135 family physicians and nurse practitioners. A program that connects Niagara Health physicians with community primary care providers diverted an average of 90 per cent of calls each month away from emergency departments in its first year.
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