Sunday, May 26, 2019 • 13:00 - 14:30
Track 3 - Crowded House - Crowding Track
Track Chair: Dr. David Lewis

Crowding - Influencing Policymakers and the UK 4-hour Target: The RCEM Experience - Dr. Taj Hassan

Description:

Learning Objectives
At the end of this presentation, participants will be able to:

Pearls

Crowding - Canadian Status and Solutions - Dr. Alecs Chochinov

Description: Patient flow challenges continue to plague Canadian EDs. While output block has justifiably received most of the attention and research efforts, future planning must also examine throughput efficiencies and measures to reduce the input of complex medical and psychosocial patients who are increasingly contributing to ED crowding.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Provide an overview of trends in ED wait times across Canada.
  2. Review the respective contributions of input, throughput and ouput to ED flow.
  3. Explore areas for future study and collaboration to reduce ED crowding.

Pearls

  1. ED crowding is multifactorial and causes many vary sharply day by day.
  2. Choose Wisely, not only for better patient care, but for better flow.
  3. Over the long term, public health and social determinants of health may be the most impactful factors in reducing ED crowding.

Debate: Redirection vs. Accommodation Strategies - Dr. Judy Morris and Dr. David Lewis

“Send them Away”

Description: Redirection strategies have been used by Emergency Departments in Canada and abroad to deal with overcrowding. A review of the evidence on redirection strategies will be discussed as well as the barriers that are often encountered when trying to implement these strategies.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Review the evidence on redirection strategies.
  2. Know how successful redirection strategies have been in QC.
  3. Review the barriers to implementation of redirection strategies.

Pearls

  1. Redirection strategies work!
  2. Redirection strategies can be safely implemented for patients.
  3. Redirection is one of the tools that can help decrease overcrowding.

Dr Judy Morris is an Emergency Physician at Hôpital du Sacré-Coeur de Montréal, a tertiary care trauma center. She is a member of the ED’s research group and a CAEP and AMUQ (Associaiton des médecins d’urgence du Québec) board member.

“Welcome Them All Here”

Description: This debate reviews the literature with respect to ED strategies to reduce the impact of crowding.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Know about the evidence for co-location of services in ED.
  2. Know how successful redirection strategies have been in NB.
  3. Give examples of successful co-location strategies.

Pearls

  1. Patients seeking care at the ED often doubt primary healthcare’s capacity to respond to ‘urgent’ problems. This belief results from cumulative past experience of care-seeking.
  2. It is very difficult to change patient behaviour.
  3. Changing patient behaviour – Six common errors – 1. It’s just common sense, 2.It’s about getting the message across, 3.Knowledge and information drive behaviour, 4.People act rationally, 5. People act irrationally, 6. It is possible to predict accurately.

Dr. David Lewis is an Emergency Physician, Associate Professor, Dalhousie Medicine New Brunswick. PoCUS Director and Informatics Lead. Co-Scientific Chair CAEP19

Lightning Oral - TBC

Panel discussion - Drs. Dr. Taj Hassan, Alecs Chochinov, Judy Morris, David Lewis

Description

Learning Objectives
At the end of this presentation, participants will be able to:

Pearls