Improving patient flow

A letter from the Winnipeg Health Region

Winnipeg Health Region President & CEO
Wave, January / February 2013

Arlene Wilgosh

Regular readers of this column may recall that I last used this space to touch on some of the challenges we at the Winnipeg Health Region face as we strive to provide quality health care at a time of tight budgets and economic uncertainty.

At the time, I talked about the need to redouble our efforts to make sure we provide the very best care as efficiently as possible, and ensure taxpayers are getting good, or better, value for their dollar.

Today, I'd like to expand on that theme by providing you with some details of a new initiative we are launching that will help enhance the delivery of health care.

The Winnipeg Health Region's Board of Directors recently approved a plan to improve the flow of patients through our hospitals, a move that will enhance the delivery of care throughout the system, ensure resources are being used appropriately, and reduce wait times in our Emergency Departments.

How can we achieve all this by enhancing patient flow? Let me explain.

Patient flow is a term used to describe how people move through various components of the health-care system, regardless of where they entered it.

When patient flow is operating efficiently, it means our patients are getting the right care at the right time in the right place. When the system fails to move patients efficiently, these failings can manifest themselves in extended waits, often in our Emergency Departments and ambulance bays.

Put another way, while wait times in Emergency are often cited as a problem, they are, in fact, more accurately described as a symptom of an underperforming health-care system.

In this respect, our Emergency Departments act as windows into the heart of our health-care system. When waits in Emergency - or elsewhere, for that matter - get to be too long, the quality of patient care begins to diminish. Improve patient flow throughout the system, and you reduce wait times.

In order to measure the success of this initiative, the board has set five key patient flow targets to be met by 2015. These targets are clear. These targets are measurable. Meeting these targets will require us to change, innovate, and be accountable.

As you can see by the chart on this page, the targets we have set for ourselves call for significant improvements in how quickly we deliver care to patients visiting our Emergency Departments. But they also demonstrate that we are committed to making sure our Emergency Department resources are used efficiently. For example, statistics show that as many as 45 per cent of all visitors to Emergency Departments fall into a category that includes patients with less serious health issues. Many patients in this group could be receiving care elsewhere, such as their family doctor or a QuickCare Clinic, usually at less cost to the system. Our goal is to reduce the number of visits from this group to 20 per cent. You can read more about these targets on our website at

I would also like to emphasize that the targets we have set for ourselves were not pulled out of thin air. They are based on standards that have been developed elsewhere in Western Canada and stand as a useful benchmark for us.

Of course, setting goals is one thing, achieving them is another. To that end, I'd like to thank our staff for working to identify many different actions that can be taken to help us meet our objectives.

They include:

  • Establish community paramedics to handle non-urgent patients, reducing the need for them to visit an Emergency Department.
  • Provide primary care physicians with better access to diagnostic testing, thereby reducing the need to transfer patients to Emergency Departments for such services.
  • Promote the use of nurse practitioners in long-term care facilities to avoid use of acute care systems.
  • Implement Emergency Department surge plans to increase efficiency.
  • Review and adjust home care processes and assessments to facilitate discharge planning from Emergency Departments.

Achieving our goals will not be easy, nor will it happen overnight. But I can tell you that we are committed to meeting these targets. In doing so, we will build a better, stronger, safer, and more efficient health-care system in Winnipeg, one that we can all be proud of.

Winnipeg Health Region Patient Flow Targets

Category Current Target
Percentage of non- admitted patients in and out of ED within four hours 51 90
Percentage of admitted patients in and out of ED within eight hours 33 90
Percentage of patients in ED longer than 24 hours 5 0
Percentage of ambulances to unload patients within 60 minutes 77 100
Percentage of group that includes non-emergency visits to ED 45 20

Wave: January / February 2013

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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