Improving transitions in care is an important priority in the health care system. To facilitate province-wide improvement on this issue, we’ve included a set of indicators related to timely and efficient transitions in the 2019/20 Quality Improvement Plans (QIPs).
We’ve been reading the 2,024 2019/20 QIPs submitted by hospitals, primary care organizations, LHIN home and community care services, and long-term care homes this past April. Now, we’re working to share our observations and spotlight stories related to the timely and efficient transitions indicators through our Timely & Efficient Transitions Webinar Series. This series of posts will summarize our observations as presented in the webinar series.
The first topic addressed in the Timely & Efficient Transitions Webinar Series was hospital overcrowding. Two webinars were held in July 2019:
- Part I summarized what hospitals described doing to address overcrowding in their 2019/20 QIPs
- Part II featured presentations from two hospitals about their work to address overcrowding
Hospital overcrowding in the 2019/20 QIPs
Issues with flow and capacity throughout the health care system tend to manifest in hospital overcrowding. Although this issue is observed in hospitals, addressing it requires organizations in all sectors of the health care system to work together.
There are three QIP indicators measured by the hospital sector that touch on overcrowding:
- Alternate level of care rate
- Care in unconventional spaces or ER stretchers
- Emergency department wait time to inpatient bed (mandatory indicator for eligible hospitals)
The 2019/20 QIP submissions showed that many hospitals are working on more than one of these indicators, and many hospitals cited initiatives that address more than one indicator.
Several recurring themes among hospitals’ approaches to address overcrowding were observed:
- External vs internal focus: Some hospitals worked with other organizations in their community to address transitions to and from the hospital, while others worked to improve their internal processes to enhance patient flow.
- Patient partnering: Many hospitals underpinned their work (whether internally or externally focused) by partnering with patients.
- Multiple approaches: Most hospitals cited using multiple approaches to address this complex issue.
Spotlight on Lake of the Woods District Hospital and Humber River Hospital
Two hospitals were featured as spotlight organizations and showcase the themes observed in the 2019/20 QIP submissions:
Lake of the Woods District Hospital (Lesley Brown, Manager, Quality/Risk)
- Lake of the Woods District Hospital is a small hospital (<70 beds) in Northwestern Ontario. This hospital has focused on building strong connections with the communities they serve and other organizations in the region. The hospital is attuned to the unique needs of their patient population (for example, patients may need to travel long distances, and may have limited supports in their home communities), and this awareness guides their work to address hospital overcrowding.
Humber River Hospital (Barbara Collins, President and CEO; Mehdi Somji, Manager, Clinical Process Optimization)
- Humber River Hospital is a large hospital in the GTA with >700 beds. This hospital has devoted considerable effort to improve flow within their system. The unique command centre system they have developed enables a deep understanding of flow within their organization and continual monitoring for improvement.
Both Lake of the Woods and Humber River hospitals are highly focused on the patient experience, and both are also addressing the complex problem of hospital overcrowding using multiple approaches. These hospitals show a deep understanding of the context they are working in, and have designed solutions that are tailored to their situation. This is a hallmark of a successful approach to quality improvement.
Check out the webinar slide deck for more details on how these hospitals are addressing overcrowding.
Are you interested in learning more about hospital overcrowding?
For more change ideas and tools related to hospital overcrowding, check out the Indicators & Change Ideas pages for:
Stay tuned for upcoming webinars in this series!
Dates and registration links can be found here: http://bit.ly/QIWebinars
