The Emergency Department (ED) Return Visit Quality Program launched
in 2016 with the goal to foster a culture of quality in Ontario’s EDs. In this
program, participating EDs are provided with data reports that identify return
visits resulting in admission for which the initial visit occurred at their
site. They conduct audits to investigate the causes of these return visits,
identify any quality issues or adverse events that may be present, and take
steps to address these issues.
Emergency Departments care for a very diverse range of patients,
including populations who may not have regular primary care
physicians, and who may be unhoused or have severely limited financial resources.
University Health Network and Michael Garron Hospital have kindly
shared their experiences providing phones for vulnerable patients to improve
care.
The Problem:
The EDs at Toronto General Hospital and Toronto Western Hospital at
the
University Health Network (UHN) recognized that some ED patients did not have a way to be reached
for follow up care or to share test results. Michael Garron Hospital (MGH)
noticed a similar problem in their ED. The COVID-19 pandemic amplified this disconnect
between vulnerable populations and health providers.
Change Idea:
- UHN’s Phone Connect Project: The ED team collected old cell phones and partnered
with Bell Mobility for cell phone and SIM card donations for distribution to
vulnerable patients
- MGH’s Phone Equity Program: Distributed 200 mobile phones unlimited text and talking
capabilities were distributed to priority populations identified by ED
clinicians (physicians, nurses, and social workers) during Emergency care
Results:
- Phones distributed to patients created a lifeline between patients
and their care providers for follow-up care, to share test results, and to book
follow-up appointments
- Patients felt cared for as whole human beings
- The handsets were also leveraged to facilitate connection to
community health services, such as social services, food security, and access
to primary care
This is a remarkable example of how thinking outside the box can
support upstream care, improve patient care, and reduce unnecessary ED visits.