HDH Addressing Increased Patient Volumes

January 20, 2023

Over the last few years, Hanover & District Hospital (HDH) has faced unprecedented patient volumes in all areas of the hospital, creating significant overcapacity challenges. HDH is the second busiest Emergency Department in the Grey Bruce Region. The patient volumes in the Emergency Department have increased by 19.8% from the previous year, and 35% from pre-pandemic levels. Acuity has also increased by 21.2% from last year, and nearly 40% from pre-pandemic levels. HDH has been working closely with the Ministry of Health (MOH) and Ontario Health West (OHW) to address these challenges. In collaborating with MOH and OHW, HDH was able to secure funding to support innovative initiatives to address the increased patient volumes of the Emergency Department (ED), and support patients who do not have a family physician.

The hospital introduced a Nurse Practitioner (NP) to its Emergency Department in late August of this past year, and it has made a significant positive impact on patient flow and care delivery. HDH has utilized the NP to operate a “fast track “ which essentially is an approach to manage patients who are admitted to the Emergency Department with non-emergent complaints so that they can be treated and discharged more quickly. It prevents “bottle necking” of patients and helps manage the patient flow of the department. In turn, it allows the physician to concentrate on more acute and medically unstable patients.

The NP has been the care provider for 15% of overall ED visits since the introduction of this role in late August. Dr. Marc Labelle, Chief of Emergency agrees, “The introduction of a Nurse Practitioner to the ED has been very positively received by both staff and physicians, but most importantly by patients. Patients are very pleased with their care from the NP. The position certainly brings benefits in addressing patient volumes and flow challenges and allows physicians to center their care on more urgent patients presenting to the ED”.

Dana Howes, President & CEO states, “It is a model that works extremely well and should be emulated across the province; especially in busy, rural Emergency Departments. Nurse Practitioners have advanced education and are highly skilled to care independently for patients. I strongly believe that Nurse Practitioners have a significant role in addressing the capacity issues of the health system in Ontario – Especially, in Emergency Departments. NPs are a resource that we need to be using more.”

It is important to note that the funding for this model is set to expire on March 31, 2023. HDH is actively tracking metrics, and working collaboratively with OHW to advocate that this funding continue. Other resources implemented through the one-time ED funding include hiring additional Personal Support Workers (PSW), and supports in Patient Registration, Ward Clerk and Environmental Services coverage as well as expanding Diagnostic Imaging coverage. All of these additional resources have been a great asset to the Emergency Department.

HDH has continued to be a stable source for healthcare for the south Grey-Bruce region that is consistently available for Hanover and surrounding communities. Howes expresses, “HDH is so thankful for the funding that has been received along with the support shown for HDH’s vision of providing a more efficient ED by OHW.”