Guelph General Hospital Reduces Offload Times
Guelph General Hospital (GGH) has been working diligently over the past several months to reduce the time patients wait with a paramedic crew in the hospital. This happens when there is no space available in the Emergency Department for care to be transferred to hospital staff; a process called Offloading. The hospital has successfully reduced the average delay from a high of 4.9 hours in October 2022 to just 42 minutes in June 2023, thanks to improvements made with emergency services partners.
Patients are now able to have a much better experience and paramedics teams can get back on the road faster thanks in part to three initiatives:
- Collaborative workflow planning between hospital staff and emergency services partners
- Planning for the redevelopment of space in the Emergency Department, where patients are monitored while waiting to be seen by hospital staff
- A new Offload Nurse role in the Emergency Department (recruitment is underway)
“It is difficult to hear how our patients, staff, and partners are negatively impacted by offload delays. We knew we had to work together to find a creative solution and new way of doing things. I am proud of the committed effort from everyone involved to improve this situation, it really is a demonstration of the rich history of collaboration we have here in Guelph-Wellington,” said Mark Walton, GGH President & CEO.
In August, hospital staff and emergency services partners held an extensive planning session to improve how patients are offloaded. The session involved looking at new ways to co-design procedures and common practices; keeping patient safety at the forefront of all efforts. For example, areas of care in the hospital were toured to find alternative places patients could be safely offloaded.
A room in the Emergency Department is being redeveloped as a bay for up to three patients, for paramedics to use prior to a patient being registered in Emergency. This moves patients into the Emergency Department faster and provides a better space for observation while they wait.
The role of Offload Nurse is being added in the Emergency Department, with a registered nurse scheduled for 12 hours a day, 7 days a week to provide Offload support. Funding from the provincial government enabled the creation of this role, which has been successfully implemented in other hospitals already. GGH has eagerly embraced this as a proven way to achieve more effective offloading.
“We are really pleased with the collaborative effort between Guelph-Wellington Paramedic Services and GGH staff to support patients being offloaded at the hospital in a more efficient manner. With these improvements to processes, our skilled teams can now spend more time responding to calls,” said Stephen Dewar, Chief, Guelph-Wellington Paramedic Services.
In June 2022, the offload wait time was 3.8 hours. That rose in the fall and thanks to the concerted efforts of everyone involved during 2023, it is now less than an hour. The time to be seen by a physician in Emergency has also dropped from a peak of 5.9 hours in October to 4.4 hours in August. In addition, over the course of 2023 hospital staff have successfully reduced the time patients wait for an inpatient bed from Emergency to 8.1 hours from a high of 43.3 in January.
“We know that waiting is incredibly stressful. We also know that there likely will be a rise in how many people are accessing our hospital in the months ahead as flu season fast approaches. While we cannot predict the impact, we are hopeful that with the changes we are making those wait times and unnecessary stress will be significantly reduced,” said Melissa Skinner, GGH Vice President Patient Services and Chief Nursing Executive.
Hospital staff and emergency services partners will continue to monitor and adapt as required in a dedicated effort to continue to keep Offload times to a minimum.
- Average Offload times – June 2022, 3.8 hours; October 2022, 4.9 hours; May 2023, 54 minutes; June 2023, 42 minutes.
- Time be assessed by a physician in Emergency – June 2022, 5.6 hours; October 2022, 5.9 hours; June 2023, 4.5 hours; August 2023, 4.4 hours.
- Time for patients being admitted to be taken to an inpatient bed – June 2022, 26.7 hours; January 2023, 43.3 hours; May 2023, 19.7 hours; June 2023, 8.1 hours
- The Your Health : A Plan for Connected and Convenient Care announcing the Offload Nurse role can be found here
- The City of Guelph website provides more background on the Guelph-Wellington Paramedic Service
Guelph General Hospital (GGH) is a dynamic, comprehensive acute care facility providing a full range of services to the residents of Guelph and Wellington County. Services include 24-hour emergency coverage, advanced technology and diagnostic support, and specialty programs. GGH is a regional provider of general vascular surgery and a designated provincial Bariatric Centre of Excellence. GGH is also a proud partner in the Guelph Wellington Ontario Health Team. Visit us online at www.gghorg.ca or @guelphgeneral.
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