Teamwork gets ED through its busiest day ever
Although flu season is officially over, patient volumes in Richmond Hospital’s ED continue to remain high. On Friday morning of April 10 — even with 47 patients already in the ED — no one envisioned what was to come.
What a day it was!
It was determined early that 37 of the 47 new patients in the ED would require admission to an acute care bed. But with 29 acute care beds already occupies by ALC patients, few, if any, acute care beds were available to move new ED admissions onto a unit in a timely manner.
Adding to the complex situation, Richmond Hospital’s Birth Centre was already on diversion, even as more patients continued to arrive though the ED’s doors. At one point, ED volume reached 79 patients. Of those, 39 people required admission and another 30 people were held in the waiting room, awaiting triage and assessment. And outside the ED’s doors, eight ambulances were parked, waiting to bring high acuity patients into a care area that was already teeming with a large volume of patients.
“It was the busiest I have ever seen our Emergency Department in my 22 years here,” said Gail Malenstyn, interim director, Critical Care, Emergency, Medicine Services and Patient Flow.
All hands on deck
News of the ED situation spread quickly through the hospital, and a number of measures were taken.
- Nurse Educators and other available staff rushed to the ED to lend their hands and expertise to decongest and help patients who needed it.
- Two patients were sent to every floor as hallway patients.
- With support from a BC Ambulance supervisor, an ambulance diversion was enacted twice, for two hours each time (typically a diversion lasts for 20 minutes).
- The OR slate was reviewed, resulting in the cancellation of one surgery which gave us an additional bed for an admission from the ED.
- PCCs and physicians reviewed patients to see if any could be safely discharged.
- Home Health reviewed patients to see if any could be discharged safely with increased home supports.
- Extra staff were called in to set up TBUs and to support ED functions.
- Richard Chan came in from home and set up a triage clinic in the waiting room.
- And, lastly, an available x-ray room was put into service to assess waiting room patients.
ED visits remain high, but manageable
Although Richmond Hospital’s ED continues to be busy, no day since has come close to matching April 10’s patient volumes. No single can any reason be cited for the crush of ED visits that day.
“People came to our ED on April 10 for a variety of reasons,” Malenstyn said. “Throughout that busy day, I felt an overwhelming sense of pride watching the teams come together to provide high quality and uncompromised patient care. I’m honoured to be part of this amazing hospital team.”