Building a better health care system

A letter from the Winnipeg Health Region

Winnipeg Health Region President & CEO
Wave, November / December 2014

Arlene Wilgosh
Arlene Wilgosh

If there is one thing that consumes health-care providers and administrators alike here at the Winnipeg Health Region, it is the desire to build a better system, one that provides the right care at the right time in the right place.

In many cases, this comes down to figuring out new ways to improve patient flow, a term used to describe the movement of people through the health-care system.

As I have noted previously, patient flow is the secret sauce of effective health-care systems. If you can get patients moving through the system, getting the right care at the right time in the right place, you have a recipe for reduced wait times, enhanced quality and improved access to care.

All of which brings us to the newly-created clinical decision unit (CDU) at Health Sciences Centre Winnipeg.

Introduced earlier this month, the CDU is designed to enhance the flow of patients through the emergency department.

As faithful readers of this column will recall, we have set ambitious goals for reducing emergency department wait times. For 2015, we are aiming to:

  • Treat and discharge 90 per cent of non-admitted emergency room patients within four hours.
  • Find a bed for 90 per cent of emergency room patients who have been admitted to hospital within eight hours.
  • Not allow any patient, admitted to hospital or not, to remain in an emergency department for longer than 24 hours.
  • Unload patients from all ambulances at hospitals within 60 minutes.
  • Ensure the number of non-emergency patients attending hospital emergency rooms does not exceed 20 per cent.

The CDU will help us achieve these goals. As our story on page 41 points out, a good number of patients who visit our emergency departments end up staying there longer than expected for various reasons. Generally speaking, these patients fall into one or more of the following categories:

  • Patients who have been medically cleared but are not safe to be discharged without supports or have no home to go to.
  • Selected patients who are stable and require further assessment that may take a day or two.

Now, rather than staying in emergency, these patients will be identified as early as possible and transferred to the CDU, and its inter-professional team of doctors, nurses, physiotherapists, occupational therapists and social workers. All of these health-care providers working together will be tasked with taking care of these patients, thereby freeing up emergency staff to tend to new patients who are arriving in emergency and the more urgent cases already there.

The establishment of the CDU at HSC represents one of many steps we are taking and will need to take going forward in order to achieve our goals in emergency.

Some of these initiatives will sound familiar, others not so much.

Most people, for example, are probably familiar with Home Care. This program plays an important role in improving patient flow by ensuring patients treated for stroke and heart attack, as well as seniors who require ongoing support for a short or longer period, can return to their home as soon as possible with support from visiting Home Care staff.

That’s great for the patient, but it is also good for the health-care system because it helps free up hospital beds for others in need. Going forward, we will continue to look for ways to improve our home care program and better serve our clients.

A less familiar example of a program that is helping to improve patient care is the Hospital Home Team. Under this relatively new program, a team of health-care providers cares for clients who tend to be high users of emergency services. This means an interdisciplinary team is available to treat these clients in clinic and, on occasion, in their own home, thereby reducing the need for them to visit an emergency department.

It is through these and other innovative improvements in the delivery of care that we will be able to continue building a better health-care system, one that provides the right care at the right time in the right place.


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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