Northern hospitals using nurse practitioners to relieve emergency department pressure

By Eric Shih
Local Journalism Initiative Reporter
Thunder Bay Source

The Lake of the Woods District Hospital is using a new system of having nurse practitioners help relieve pressure in the emergency department.

The Fast Track Clinic had a soft launch in May, with an official opening earlier this month.

According to the hospital, the new system works by assessing patients who arrive at the emergency department and sending those who need urgent but not immediate emergency care to the fast track clinic to be seen by a nurse practitioner.

“The NP Fast Track clinic emerged from the need to provide timely and comprehensive care to patients with lower acuity conditions presenting in the emergency department,” said Kaye Balajadia, the hospital’s vice president of patient care and chief nursing officer, said in an email.

“The significant need for primary care services as well as walk in clinics in the Kenora District also contributed to this idea.”

Balajadia said nurse practitioner led clinics have been implemented in various healthcare systems around the world and hospitals in Dryden, Geraldton, and Thunder Bay have implemented similar approaches. Riverside Healthcare has implemented a similar program.

Riverside Health Care’s Emergency Department at La Verendrye General Hospital (LVGH) has a Nurse Practitioner on-site 7 days a week. Currently, Patients who are triaged as higher acuity are seen by the Physician, while the patients who are triaged as less urgent are seen by the Nurse Practitioner.

The addition of an NP has allowed for reduced wait times and improved patient flow through the Emergency Department.

Balajadia said since nurse practitioners have a defined scope of practice guided by standards, limits, and conditions set by the College of Nurses of Ontario, this distinguishes them from physicians, as their “responsibilities and capabilities are delineated within these established frameworks.”

She added some patients may notice differences and improvements in the emergency care delivered by nurse practitioners, including emphasizing patient education, health promotion, and disease prevention; providing a greater focus on holistic care, empowerment, and involvement in their healthcare decisions; and enhancing coordination with other healthcare professionals, resulting in more efficient and integrated care.

Balajadia said the project came about through careful planning and collaboration among healthcare professional, front line staff, community partners and hospital leadership.

According to the hospital, the new system addresses seasonal surges in patient volumes, long wait times and helps mitigate the consequences of emergency department staffing.

Balajadia said the hospital has faced a reduction of the number of physicians providing cover in the emergency department in the past two years and it may decrease even further from 12 to nine by July.

“Although we are receiving some external locum support, our local physicians are still having to cover at least 70 per cent of shifts in most months, despite their 45 per cent reduction in local physicians providing support to [emergency department],” she said.

Balajadia said while the new system represents an innovative model of care to optimize resources and improve patient outcomes and experience, it’s possible there may be changes.

“Our healthcare system continues to evolve based on various factors such as provider availability, patient needs, and advancements in medical practice,” she said.

The nurse practitioner fast track clinic will be open seven days a week from noon to 8 p.m.