Sometimes it’s good to be second, or in the case of St. Paul’s Hospital Emergency Department, third. That’s the opinion of Tracey McCaig-Beattie, Manager of Nursing Emergency Services at SPH when she talks about the improved parallel triage and registration process and the electronic display and tracking board.

“There were definite advantages to being last. We were able to see what worked at Saskatoon City Hospital and RUH, and what could be improved for our emergency department,” says McCaig-Beattie. “We were able to make some changes to the process and in the end, have a very workable product.”

The triage board at St. Paul’s Hospital.

Similar to RUH and SCH, SPH was able to cut registration and triage times in half – from 15 minutes prior to the ED process changes, to as little as five in some cases. A team of employees registers and assesses patients arriving at the ED, rather than sending them into a series of lines where they often repeatedly answered many of the same questions. McCaig-Beattie says it’s a much safer process, however like anything, the line-ups can be frustrating to some.

“Obviously we treat the sickest patients first. One of our steps is to actually triage the line and see who needs care quickly,” she says. “For someone waiting in a line, this can seem unfair, but we have to put patients who need care the most in front.”

Parts of the process improvements include an electronic display and tracking board, a component of the Sunrise Clinical Manager (SCM) technology project. Staff enter information about a patient’s visit into the ED computers. That information can then be tracked by care providers and followed by a physician to provide the best care and discharge possible.

Following the launch at SPH, all three emergency departments are now able to track and display more detailed information that better represents the department’s workload. Working with the software provider and with a tool developed in-house, they are able to bring more subjectivity to a patient’s triage and acuity scale score, enabling more resources to be delivered to the sickest patients.

“The process implementation improves communication in the emergency department – from doctors to nurses to housekeeping,” says Blaire Schwartz, an RN in SPH’s emergency department. “Once we are completely online and can get away from the parallel process of electronic and paper records, it will really improve flow.”
The overall goals of the project are to minimize wait times for patients, standardize the triage, registration and care process, and observe ED flow as patients are treated and either discharged or admitted.