rapid access to consultative expertise in the emergency department: race ed
TRANSCRIPT
Rapid Access to Consultative Expertise
RACE ED
February 26, 2016
Quality Forum
Eric Grafstein, MD, FRCPC Emerg Regional Department Head, Emergency Medicine, VCH-PHC CST CMIO
Sarah Riddell, MPA, MHA A/Manager, Performance Audit Office of the Auditor General of BC
Nicki Ordano, CAPM Project Coordinator Shared Care
Rapid Access to Consultative Expertise RACE
Joint partnership between Providence Health Care and the Shared Care Committee, in collaboration with Vancouver Coastal Health
THE PROBLEM:
From Family Physicians: • challenging to contact an Emergency Physician in a timely manner for advice.
From Emergency Physicians: • challenges with the number of interruptions during a shift.
Timely access to Emergency Physicians for Advice
THE SOLUTION: Emergency RACE Prototype (Feb 2 – July 31, 2015)
THE PROCESS:
In addition to providing the same service as other RACE providers:
the Emergency Physicians:
• Coverage provided on physician’s day off
• Fax information to appropriate ED if applicable
THE MARKETING: Vancouver Coastal Area
• RGH, LGH, SPH, VGH and UBC • Walk in clinics • Practice Support Program • NP Provincial Association • All Divisions of Family Practice in Vancouver Coastal • Vancouver Division of Family Practice FastFacts (biweekly email) • MediTran distribution to FP offices • RACE ED is highlighted on the RACE website, phone tree, twitter
Memos, posters and electronic announcements:
THE CALL METRICS: February to July 2015
• 346 calls over 6 months • Avg. number of calls per month 57 • Avg. number per day – 3 • Avg. call length 5 minutes • 76% of calls from physician’s offices • 10% of calls from walk – in clinics • 14% of calls from other areas
THE CALL METRICS cont. FP/NP Reasons for Call
THE CALL METRICS cont. ED Physician Recommendations
• 26% of patients were directed to less busy ED
Results
http://www.edwaittimes.ca/WaitTimes.aspx
Results cont.
• 99% almost always or often send patient information to the receiving ED in advance of the patient’s arrival.
• At least 8 unnecessary ED visits were avoided, though actual number may be higher.
• 43% of RACE ED physicians noticed a drop in calls to the ED for consults, which means fewer interruptions for patients and providers.
Results cont.
Lessons Learned:
• Not enough calls through RACE to maintain the service for Physicians to cover on their days off • Coverage is now provided by the Trauma Team
schedule at St. Paul’s Hospital
• Smaller communities didn’t feel the need • Some areas had a good network of communication already in place
• Only a quarter of pts were diverted to a less busy ED • Patients want to go to the ED they are familiar with
Feedback from Callers
Useful
Appreciative
Helpful
“Turtle Line”
Useful
Prompt Excellent
Great
Questions/Comments?
Nicki Ordano
Sarah Riddell