The Lack of Fluidity in Ontario’s Healthcare Systems

 A major problem in healthcare, not only in Ontario, but across Canada, is the lack of consistent flow of treatment and care.

A lack of “fluidity“.

I have experienced “broken” care first hand.

When I say “broken” I am not referring to a “damaged” system. My reference pertains to “gaps” in the fluidity of patient care.

Metaphorically our present system can  be compared to a long trip on public transit.

The patient travels through the system with the anxiety and worry of when the next bus or train will be unexpectedly delayed, perhaps even cancelled.

We have all been through the following scenario …..

The patient arrives at their local emergency department with whatever affliction or injury they are suffering from.

The treatment journey begins with their explaining the need for care to the receptionist window.

Next they take a seat until the triage nurse assesses their needs and warrants the severity of their need for care.

They are then moved to the next step in the ladder of care.

The dreaded “Emergency Department”.

Here they are further assessed.

Depending on the severity of their symptoms they are placed in que to await further assessment by an ER doctor.

The ER doctor assesses their needs and  issues the proper acquisitions to move them further up the ladder of care.

Perhaps to a specialist that is trained to properly assess and treat the type of affliction presented.

Now, laying on a stretcher, they wait to be assessed, yet again, by said specialist.

Finally the specialist assesses their needs.

If warranted they either admit the patient or arrange for care via an outpatient clinic.

Sound like the typical ER visit?

What happens to the flow of treatment if suddenly there is an accident with severe, multiple injuried?

This automatically causes the ER to become overcrowded.

Throwing a wrench into the already chaotic ER.

The fluidity process of treatment slows down.

Possibly causing the system to come to a standstill.

The doctors on-duty rush to tend the influx of severely injured.

The patient has been moved down the que line for treatment.

(Not forgotten, but put on the back burner to be dealt with later.)

The medical technicians, such as x-ray or respiratory techs, are temporarily pulled from the patient’s case to assist in the greater emergency.

Followed, of course, by the necessary amount of support staff, such as the nurses, social workers, clerical staff and even the housekeeping staff.

In scenarios such as this the hospital has no choice but to ‘borrow‘ staff from other departments.

Much needed to deal with the additional patients and the ripple effect created by the unexpected influx of the additional patients.

It is common practice and knowledge to bump less serious patients down the treatment que to facilitate patients with immediate care needs.

Those “bumped” patients are usually the ones who should not be in the Emergency Department in the first place.

They could of and should of went to a walk-in clinic or their family physician.

A large part of Emergency Room congestion is caused by people who appear in the department for afflictions that are not an “emergency“.

Problems that can easily be dealt with through a family physician or a neighbourhood walk-in clinic or utilizing the power of the internet, a ‘virtual‘ visit.

These ‘non-emergency‘ patients create the most common congestion problem that plagues Emergency Rooms everywhere.

I am a firm believer in the implementation of a “team approach” to patient care and treatment.

Let me attempt to explain what I mean in layman’s terms ….

From the initial point of treatment, the triage nurse, a “tracing” system is engaged.

As the patient travels through each step of their treatment they accumulate appropriate ‘members‘ to their team.

These team members will not change for the duration of the treatment.

The triage nurse now passes the patient on to the next step of their care.

Perhaps it is an xray technician or a phlebotomist  – or ‘both’.

All the current info is shared with the patient and with every professional involved in the care up to this point.

The test results arrive.

In comes the doctor who has already been prepped regarding your case by all who have been dealing with you up to this point.

Upon examination the doctor deems it necessary for the patient undergo further testing.

Depending upon the results they may decide that surgery or admittance to the hospital is necessary.

Now the surgical team and the admitting department are added into the mix

Up to this point, and beyond, every person that has been involved in the case have clearly explained their role and the course of treatment with the patient.

More importantly, they communicate with each other.

This chain of information and care should never be broken under any circumstance.

This ‘chain‘ should exist in ‘pre-care’ and ‘current care’.

It should not cease once the ailment has been dealt with and the patient is discharged.

It is a necessity that it extends into “post care”.

(I am writing a greater detailed and  descriptive explanation which I will soon publish. A greater detailed explanation of what I believe to be much needed in patient treatment systems.)

I believe that from the time of triage until the patient is post surgical and discharged to home they should be assigned a “team“.

A team with whom they can communicate with about any aspect of their treatment.

A team comprised of the same members from start till finish.

A team utilized by not only the patient but every professional involved in their case.

The same doctors, nurses and support staff throughout the whole process.

A team that doesn’t change with the exception of additional members as the needs arise.

This would ensure that all facets of the patient’s case are common knowledge to not only the patient but also to all involved in their care.

All inclusive members are to be fully aware of all aspects of the plan of care.

This would bring a consistent fluidity to the flow of treatment and to the flow of hospital logistics.

The patient is consistently, fully and completely informed of the status of their treatment and health.

The nurses and support staff fully aware of all aspects of the patient’s case.

The doctors fully educated in the plan of patient’s care.

From triage to discharge.

Being discharged from a hospital does not automatically confirm that you are “cured“.

Ninety percent of the time it means that you are not in the need of a hospital bed or nursing support.

Although you may very well still need aftercare.

When that “aftercare” is in play the provider will be completely informed.

Made aware of each and every step the patient “has” gone through, “is” going through and “will” be going through.

Filling in that gap in our healthcare system caused by one simple but complex thing.

“Fluidity”  ..….

NOTE:

This is merely the “Reader’s Digest” version of this concept. As I have stated,  soon I will be publishing a more formal and detailed essay on the subject.

So …..

Stay tuned, Campers!