We’re Open: Caring for the Walking Well in a Rural Emergency Department
Keywords:Non Urgent Care, Primary Care
Emergency departments (EDs) are increasingly unable to cope with patient volume, leading staff to question the arrival of those seeking non-urgent care. However, these patients ideally should be afforded appropriate management and treatment. In 2014, the Carbonear General Hospital ED in Newfoundland and Labrador took decisive action, engaging front-line staff and shifting the focus of care away from why patients were visiting to prioritize how best to treat those who did. By 2019, the ED had not needed to resort to hallway medicine, despite a visit volume that increased to 30,000 patients over five years, and staff grew into a close-knit, quality improvement and community force. From this experience, it is evident that small investments in education and system redesign can shift attitudes toward ED care for patients, and provide support for primary care in the community. It has already started in one hospital — we’re open for assistance with primary and non-urgent care.
Affleck, A., Parks, P., Drummond, A., Rowe, B. H., & Ovens, H. J. (2013). Emergency department overcrowding and access block. Canadian Journal of Emergency Medicine, 15(6), 359–384.
Durand, A. C., Palazzolo, S., Tanti-Hardouin, N., Gerbeaux, P., Sambuc, R., & Gentile, S. (2012). Nonurgent patients in emergency departments: Rational or irresponsible consumers? Perceptions of professionals and patients. BMC Research Notes, 5(525), 1–9.
Government of Canada. (1985). Canada Health Act. https://www.canada.ca/en/health-canada/services/health-care-system/canada-health-care-system-medicare/canada-health-act.html
Leung, A. K., Whatley, S. D., Gao, D., & Duic, M. (2017). Impact of process improvements on measures of emergency department efficiency. Journal of the Canadian Association of Emergency Physicians, 19(2), 96–105.
Patey, C., Norman, P, Araee, M., Asghari, S., Heeley, T., Boyd, S., Hurley, O., & Aubrey-Bassler, K. (2019). SurgeCon: Priming a community emergency department for patient flow management. Western Journal of Emergency Medicine, 20(4), 654–665.
McConnell, D., McCance, T., & Melby, V. (2016). Exploring person-centredness in emergency departments: A literature review. International Emergency Nursing, 26, 38–46.
Stoklosa, H., Scannell, M., Ma, Z., Rosner, B., Hughes, A., & Bohan, J. S. (2018). Do EPs change their clinical behaviour in the hallway or when a companion is present? A cross-sectional survey. Emergency Medicine Journal, 35(7), 406–411.
Whatley, S. (2016). No more lethal waits: 10 steps to transform Canada’s emergency departments (pp. 1). BPS Books.
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