GRH emergency department makes progress in improving care times; further action planned

Grand River Hospital is improving treatment times for patients in the region’s largest emergency department. As part of the hospital’s goal of continuous improvement, GRH will launch new projects to provide better care and information for patients.

GRH has made progress in responding to the most seriously ill and injured patients. For example:

  • GRH has seen a drop in length of stay in the emergency department for patients needing an inpatient bed. This includes the total time in the emergency department from first being triaged, seeing a care provider, receiving tests and an admitting diagnosis and then being sent to an inpatient bed.
  • That time has dropped from the start of 2009 (49.4 hours) to December 2012 (22.3 hours) to December 2013 (15.3 hours);
  • GRH’s time to diagnose and administer clot-busting medications for stroke patients is consistently faster than the provincial standard of 60 minutes. GRH provided the medication in 57.5 minutes on average in February 2014; and
  • Ambulance off-load delays in the emergency department have dropped 55 per cent from January 2013 at 127 minutes to 55 minutes from November 2013 through January 2014. Improved turnaround allows emergency responders to return to the community faster.
The hospital will have a full complement of emergency room physicians and nurses by this summer, with significant interest by health professionals in joining GRH’s emergency department.

“GRH’s emergency department as well as programs throughout the hospital have worked together to move admitted patients from emergency to inpatient units and other areas where their care can continue,” said Karin Olson, GRH vice president of clinical services and chief nursing executive.

“The hospital has added new inpatient beds, developed an extended assessment unit right next to the emergency department to support people experiencing a mental health crisis, and added new processes to relieve ED congestion whenever possible. We’ve also appreciated the assistance of the Region of Waterloo in supporting ambulance off-load time improvements,” explained Olson.

GRH has experienced a key success by having emergency department physicians provide care directly in the triage area of the department in certain cases. This step allows physicians to more quickly assess patient needs and proceed to treatment and tests as appropriate, significantly reducing waits in certain cases.

“After a very encouraging pilot project, we have found over time that having an emergency physician in triage reduces the number of patients leaving without being seen and increases patient satisfaction. This is the kind of responsive care that we want to provide for patients,” said Dr. Robert Wickett, chief of staff for Grand River and St. Mary’s hospitals’ emergency departments.

The physician in triage service is available depending on patient needs in the emergency department at a given time. The hospital continues to rely on the services of its highly-skilled nurse practitioners and range of professionals in the emergency department to provide care.

GRH is also bringing new tools into effect to provide better information for patients. GRH has put in place a version of the real-time web-based emergency department wait time clock pioneered by St. Mary’s General Hospital. Waterloo Region technology company Oculys has developed the application and adapted it for Grand River Hospital’s needs.

The clock provides real-time information to patients on the current wait time to see a care provider, the number of people registered and waiting to be seen in the department as well as the expected wait for the next six hours. The tool is available at

“Since launching our emergency department wait times website in 2012, we have found it to be an extremely valuable resource for our patients, their families, and our staff,” said Don Shilton, president of St. Mary’s General Hospital. “We are pleased that Grand River Hospital has taken this initiative, giving patients in the community a real-time picture of what’s happening in each department so that they can choose the care provider – emergency department, urgent care, or walk-in clinic – that best suits their needs.”

“Oculys is proud to partner with Grand River Hospital to bring the ED wait time clock to this community. Kitchener-Waterloo is now the first region in Ontario to have access to ED wait times for two local hospitals. The technology is based on over 1,000 hours of research and offers patients a 90 per cent confidence level, meaning 90 percent of patients are seen in the emergency department by a physician or nurse practitioner by the estimated wait time,” said Franck Hivert, president and CEO of Oculys.

Community surveys that Grand River Hospital has conducted since 2011 consistently show emergency department treatment times as a key concern for patients. GRH will continue to focus on improving treatment times for patients with less serious illness and injuries.

For more information, please contact:
Mark Karjaluoto, Director of Communications
Office: (519) 749-4300 extension 2788
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