Zone Specific Actions
Patients Admitted from Emergency Department within 8 hours (%) (Top 15 Sites)
Zone
South
Action Item
Increase utilization of medical protocols to
standardize and expedite care.
Medicine Hat Regional Hospital:
ED2Home and AIM Learning Sessions
EMS / ED Integration.
Rural Facilities – Southwest:
Encourage physicians to continue to evaluate
patients in a timely manner following diagnostics
and/or treatment for decision regarding admission
to hospital
Chinook Regional Hospital (CRH):
Has been experiencing volume increases of 10%
to 12% sustained over the past 6 months.
Calgary
Enhancement and refinement of over capacity
protocol triggers.
Implementation of a clinical decision unit with the
Emergency.
Increase and improve our timeliness of
Repatriations of patients from urban and regional
facilities back to their home community or
referring site within 24 hours of decision that
patient can be repatriated.
AHS Performance Report – Q3 2011/12
Actions Completed to Date
Subsequent Actions Planned
• Protocols may have contributed to decreased
overall LOS, despite increased volumes.
Consistencies in use need to be improved.
• ED2Home ongoing.
• Completed Learning Sessions.
• Complete additional Learning Session,
planned for January 2012.
• Utilize information from Continuum Tool to
• Implement a new Communication Tool – to be
• Ongoing system wide improvements and flow
• Continue with system wide improvements and
optimize patient flow.
• Maintain good communication between Acute
Care and physicians
initiatives supporting inpatient bed capacity for
ED patients have been initiated.
• Minimal progress to date since beginning of
September due to high volumes in the
Emergency and increased surgical volumes.
• Site Occupancy Trigger #2 (site capacity over
110%) needs more refinement with regards to
action plans and responses.
• Calgary Zone Physician champion has been
identified.
• Presentations to various group regarding
Clinical Decision Unit and Medical Assessment
Unit models
• AHS policy approved and rolled out. Ongoing
work underway to increase awareness and
utilization of the repatriation process.
• Zone Medical Administrative Committee Lead
Task Force has identified key steps/issues in
used between disciplines, - eg – EMS, Unit to
Unit, Facility to Facility.
flow initiatives.
• Current focus on developing and implementing
•
•
•
•
load levelling plan between sites, using refined
occupancy and capacity triggers. Goal is to
mitigate risk of variable Emergency Inpatients
(EIP)s between sites.
EMS will be employing a new process in
January 2012 where all EMS crews must go to
the #1 site in REPAC unless it is a destination
protocol.
Engagement of ED and IP physician leaders in
understanding Clinical Decision Unit / Medical
Assessment Unit (CDU/MAU) models.
Formal evaluation of existing MAU models
expected in Q4. Build a business case.
Ongoing work to increase awareness and
utilization of the repatriation process.
Page 1 of 3
Zone Specific Actions – continued
Patients Admitted from Emergency Department within 8 hours (%) (Top 15 Sites)
Zone
Action Item
Central
Actions Completed to Date
Heart Function Optimization initiative to decrease
readmission.
•
Explore opportunity to open 2 of 4 closed ICU
beds at Red Deer Regional Hospital.
Discharge Management practice improvements.
•
•
•
4 Cardiac Step Down beds in Telemetry Unit to
improve patient flow between ED, ICU & inpatient
units.
Edmonton
Implement Care Transformation.
Phase II – October 2011 – June 2012.
AHS Performance Report – Q3 2011/12
• Track & monitor change ideas by March 31,
2012.
• Review budget to determine further bed
•
•
•
• 4 beds were redesignated and opened in
•
•
•
•
•
Update Over Capacity Protocol by Nov 2011.
process and with report back with action plan
in January 2012.
Soft launch of 13 change ideas on Cardiology
Unit – staff and patient education are
underway.
8.42 RN positions posted and hired; one bed
opened Nov 1, 2011.
Rapid rounds implemented at Olds,
Drumheller, Rocky Mountain House, Stettler
and Lacombe Hospitals. Will continue to
monitor the effectiveness in facilitating timely
admissions and discharge of patients from the
ED’s.
The median wait time is 11.18 hrs which is an
improvement of 2.3 hrs.
Subsequent Actions Planned
•
November 2011.
Cardiac Monitors have been installed.
Trained over 300 staff at UAH and RAH to
work on Transformational Teams (TT)
assigned to implement actions designed to
improve inefficiencies by June 2012.
Process redesign on track for Care
Management.
Developed standard daily activities for Acute
Care, Community Sub Acute and Transition
Units, EMS and Glenrose Rehabilitation
Hospital.
•
openings.
Introducing Rapid Rounds Jan 25, 2012 –
looking to implement on two acute care units in
areas with plan to rollout gradually to the
Central Zone north geographic area.
Perform an ED Flow project in Drayton Valley
to address long wait times from decision to
admit to an inpatient bed.
Implement an ED process improvement plan
for Ponoka, and re-open 6 additional inpatient
subacute beds by April 2012.
Explore the feasibility of additional monitored
beds to address surgical step down
requirements.
Working Groups at RAH, UAH and SCH to
identify top 3 areas of the discharge process
for further process mapping
Develop bed map for the Edmonton Zone
(RAH, UAH, SCH) starting January 2012.
• Develop escalation standards of work by
February 2012.
Page 2 of 3
Zone Specific Actions – continued
Patients Admitted from Emergency Department within 8 hours (%) (Top 15 Sites)
Zone
Action Item
Develop and Implement a Zone Winter Capacity
Plan by Jan 2012.
Actions Completed to Date
•
Winter Capacity Plan and associated budget
approved.
Subsequent Actions Planned
•
•
North
Implement Process Improvement at Westview
Health Centre by Mar 31 2012. Complete
Renovation projects at Westview Health Centre.
•
Implement the ED to Home Initiative to enable
seniors to be at home with appropriate supports,
i.e. home care
•
•
•
ED Improvement team attended Streamlining
Processes Nov/ Dec.
Project Charter developed for improvement of
doctor to disposition times. (Goal to improve
4 hr target by 10% and decrease Leave
Without Being Seen (LWBS) by 44%.)
Northern Lights Regional Health Centre
(NLRHC): Positions have been hired and
EMS homecare referral program initiated
December 2011.
Queen Elizabeth II Regional Health Centre
(QE II) hiring for positions is in progress.
In place and ready to be implemented in the
event of an ED overflow.
Ongoing Implementation of ED Overcapacity
Protocol to address crowding pressures and wait
times.
•
Add to new ED capacity at Queen Elizabeth II
Regional Health Centre.
• ED construction continues with an estimated
AHS Performance Report – Q3 2011/12
completion date of February , 2012.
• Submitted request for additional staffing to
operationalize newly expanded ED on hold
pending process improvement project
• ED has approval to engage in a process
improvement project to begin in January 2012.
•
•
By Jan 2012, implement approved Winter
Pressures initiatives including:
o 11 temp beds at RAH
o 18 temp beds at UAH
o 9 Mental Health temp beds at Grey
Nuns Community Hospital
o 9 temp beds at SCH
o 6 ED stretchers at SCH
Increased Home Care on evenings and week
ends.
Complete renovations for bed conversions
(Maternity to medicine) by Mar 31, 2012.
Continue monitoring progress.
• Continued work of the Continuing Care
Collaborative and implementation of ED to
Home project for elderly persons in the
community with multi-faceted needs.
• Expand options available to seniors.
• Have plan available for implementation if
needed.
• Pending approval of additional staffing,
targeted recruitment, hiring and orientation of
Emergency Department to service.
Page 3 of 3