Saskatoon’s Emergency Departments (EDs) are well on their way to transforming the care and service experience for patients in Saskatoon Health Region by introducing new processes, technology and renovations to optimize space and care.

“The whole concept is to lean the process and eliminate steps for patients,” says Jamie Tradewell, clinical nurse coordinator at the Royal University Hospital Emergency Department.

The ED at RUH recently underwent minor renovations to treatment rooms and the triage and registration area to help facilitate a parallel process, where patients are greeted, assessed and registered at once rather than in separate processes. Previously, the patient saw a triage nurse, was sent to the registration clerk, once registered returned back to the triage nurse to possibly wait in line once again before awaiting treatment.

“CTAS (Canadian Triage and Acuity Scale) scores of four and five (the lowest acuity on a five-point national scale) go to the waiting room now instead of back to the line,” says Darla Farrell, also a clinical nurse coordinator at RUH. “I find this really cuts back on the line up.”

The renovations also include two new Minor Assessment and Treatment (MAT) areas, where less emergent patients are cared for and discharged home in an effort to reduce the wait for others who need emergency beds.

“The MAT area will be quite useful – it’s something we’ve never had before,” adds Tradewell.

Collaboration and teamwork are also at the centre of the new parallel process. Registration clerks and triage nurses now work together to find the best way to get information from the patient, rather than independently asking questions and sending them to their next destination.

“The registration clerks and nurses are getting an appreciation for what each other does,” adds Farrell.

Carol Sielski, patient registration clerk at RUH, admits there have been challenges during the implementation phase, including occasional delays as staff work through new patient flows and procedures, but recognizes several benefits for patients and staff.

“It’s definitely better for the patients because they don’t have to move around as much,” says Sielski. “We’ve certainly had to learn to work together. It’s been good so far.”

Saskatoon City Hospital’s emergency department piloted parallel triage and registration in June 2010 and has been successfully using the process since then. They’ve also recently moved to electronic triage – where patient information is entered by the registration clerk and electronically sent to the triage nurse who completes the e-triage form, previously done on paper. E-triage training at RUH will occur in November and is part of the SCM (Sunrise Clinical Manager) initiative to be launched in December.

“I think the electronic pieces will be an important change for the entire department,” says Tradewell. “It’s a work in progress.”

After successful implementation at RUH, St. Paul’s ED will introduce the parallel process and electronic technology in 2011.