Timely care

A letter from the Winnipeg Health Region

Winnipeg Health Region President & CEO
Wave, January / February 2016

Milton Sussman
Milton Sussman

One of the main goals of any health-care system is to provide timely care.

The Winnipeg Health Region is no different. In fact, our commitment to delivering "the right health care, in the right place, and at the right time" is emphasized in the Region's mission, vision, and values statement.

The importance of being able to do so is obvious: it could mean the difference between life and death.

The cover story in this issue of Wave illustrates the point. It tells the story of Dave Emberley, a Winnipeg man who suffered a heart attack about a month before Christmas.

As this article explains, Emberley survived his heart attack, thanks in large part to the timely care he received.

That care started with a call to 911, which set in motion a rapid treatment and transportation protocol known as Code STEMI. Under this protocol, paramedics can begin treating a patient for a heart attack as soon as they arrive on the scene, communicating with a cardiologist by cellphone. If the patient is deemed to be suffering a heart attack, he or she is rushed to hospital, where treatment is quickly administered.

The Code STEMI protocol started saving lives almost immediately after it was implemented more than a decade ago, a point that has been made in this magazine and elsewhere before. But the thing that many people may not realize is that the effectiveness of this protocol continues to improve with each passing year.

As Dr. Davinder Jassal points out in our story, the odds of dying from a STEMI heart attack after calling 911 in 2006 were one in 10. By 2015, the odds had fallen to one in 30. The steady rate of decline is neatly illustrated by our graphic on page 39.

Emberley's tale of survival underscores the importance of being able to recognize the warning signs of a heart attack and knowing what to do when you experience the symptoms. But it also illustrates how innovative ideas like Code STEMI can continue to be refined long after they have been adopted to provide better outcomes for patients. This kind of continuous improvement is critical to our goal of providing our patients and clients with the best care possible.      

There are other ways we at the Region are working to provide timely care. Take the new Central Intake system for endoscopies. As outlined here, appointments for endoscopies had previously been booked by individual physicians on behalf of their patients without being able to compare the wait times of various specialists. The end result was that a patient could wait for a long time to see a particular specialist, even if other specialists were available sooner.

The Central Intake booking system is designed to give physicians - and their patients - a chance to review all the available options before making an appointment, thereby reducing wait times.

As our story explains, there are 30,000 endoscopies carried out within the Region by specialists every year, so the idea of trying to make this system as efficient as possible only makes sense.

Dr. Dana Moffatt, Medical Director of Endoscopy Services for the Region, sums it up this way: "The perception within the health-care system is that wait lists for endoscopy services are incredibly long, but that's not entirely accurate. What we've found is that wait lists for a particular specialist may be long, but overall we have the capacity to shorten wait times by more effectively allocating our available resources. In other words, it's mainly an administrative challenge, and not just a lack of resources."

The new system was pulled together by people working for the Region, Manitoba Health, CancerCare Manitoba, and the Departments of Medicine and Surgery at the University of Manitoba. In that sense, the creation of the new booking system is also a good example of how different groups often work together to improve the delivery of care for Manitobans.

Sometimes, the pathway to providing timely care is not always clear cut.

Our flexible approach to providing home-care services to residents at the Bell Hotel is a case in point.

As this story points out, the Bell is a residence for the chronically homeless, including some who are not used to keeping regular schedules. That means home-care staff will sometimes visit the Bell only to find their client is not available. This poses a bit of a dilemma for home-care staff. How can you provide services to someone if they are not home?

Fortunately, the people working in home care were able to come up with a solution to the problem. On-site staff started building relationships with the residents to learn more about their needs and schedules. Meanwhile, the program created a block-scheduling system for residents. This meant one worker could visit several residents in succession. If one wasn't available, the home-care worker could move on to the next appointment.

The end result is a system that allows home-care staff to deliver care to people who need it. 

None of this is to suggest that we have perfected the formula for delivering care to all patients or clients at all times and places. Indeed, there are a number of areas where we could do a much better job of providing timely care.

For example, wait times in our hospital emergency departments are still often longer than they should be. As has been reported in this magazine previously, we still are some ways from meeting the benchmarks for delivering care that we have set for ourselves.

Nonetheless, there are small signs of progress. As my predecessor noted in this space last spring, the Grace Hospital has taken steps to reduce wait times in its emergency department, and efforts are underway to make improvements in other hospital emergency departments throughout the city.

As we move forward into this new year, I am confident that we can continue to build on this progress as part of our overall effort to provide timely care to our patients and clients. After all, that is one of the main goals of any health-care system. And it certainly is one of ours.

Wave: November / December 2015

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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