May 31, 2018

ED to Urgent Care: transition a team effort at Victoria

A conversation with Cynthia Posner, a Registered Nurse at Victoria General Hospital’s Urgent Care centre

How has the transition from an Emergency Room to an Urgent Care Centre at Victoria General Hospital benefitted your patients?

The patient experience has improved dramatically in terms of how fast they are getting to see a doctor. [Figures show that Victoria’s wait times have decreased by nearly one third, and length of stay is down by approximately 25 per cent.] The patients, for the most part, are not as acutely ill as they were when we were an Emergency Room. In the waiting room, even when it’s full, we seem to have a higher turnover, so that the ER doctors, nurse practitioners, and our physician assistants are able to see the patients a lot quicker due the decrease in acuity.

How have Victoria staff adapted to the shift to Urgent Care?

In any transition, there are a lot of challenges and a lot of hurdles but I think, for the most part, we’re adjusting quite well. There are always going to be hiccups along the way, but I think we’re pretty good at problem-solving and we’re all putting our best effort forward.

We’ve always been team players. We try to look at the positive side (of the changes) and try to improve on things whenever we see there is an issue or challenge. We’re always being asked for our input, and we’ve asked the patients for theirs as well.

Throughout the transition, our focus has always been on the patient. Our patients have always come first – there’s no doubt about that. We’re pretty experienced; we’re all ER nurses, so we’re ready for any emergency if it comes in. The bigger successes are getting the patient back to see a physician a lot faster. We have nurse practitioners and physician assistants that are on staff all the time, so that’s a big boon to seeing patients faster. And I think the nurses are really working a lot harder to try to get the patient seen faster and in a more efficient way. I think that’s a very positive thing.

From your perspective, what are some of the key differences between Urgent Care and an Emergency Department?

When we were an ER, my recollection is that we used to see 80-90 people every 24 hours. I don’t have the exact statistics, but I know that we see up to 135 people now, so things are moving along a lot quicker and we’re seeing a lot more patients.

The acuity of most patients is a lot lower. We can process a patient faster without doing a lot of deep investigation when their symptoms are only minor. We’re seeing a lot of lacerations, we’re seeing a lot of fractures and other situations that, for the most part, don’t require hospitalization. I think we still have some work to do in educating the public on the difference between urgent and emergency care, but when patients come here, they are getting fantastic care. We can identify their medical condition right away. We’re still doing lots of diagnostics, and we’re doing the best to get them through as fast and efficiently as we can without compromising quality of care.

In our urgent care centre, we have top-notch practitioners. Everybody is well aware of how to treat anyone in an emergency and, of course, in an urgent situation. So I’m very comfortable that anyone could walk into our urgent care centre and they would get the best possible care. We have a great staff. I’m proud of them. On the whole, I think we have the best hospital in the city, I can tell you that.

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