Image: (L to R) Christine Bucago, Advanced Practice Clinical Leader, Francis Agapay, Nurse Team Lead, Emergency Department, and Marc Greene, Manager, Emergency Department, expect the redesigned ED Multidisciplinary Assessment form to improve efficiency and the patient experience.
By Patrick Callan
When patients arrive at the Gerald Sheff and Shanitha Kachan Emergency Department, they are assessed by a team of clinicians who complete a thorough multidisciplinary assessment.
In an effort to improve efficiency and the patient experience in the emergency department, CAMH’s ED Multidisciplinary Assessment form has been redesigned and streamlined with 70 per cent fewer questions.
Located at 250 College Street in Toronto, CAMH’s Emergency Department is the only emergency department in Ontario that provides 24/7 emergency assessment and treatment focused exclusively on adults with mental health and substance use issues. The total number of emergency room visits has increased more than 70 per cent over the past five years – from 6,958 visits in 2012 to 11,878 in 2017.
“What we expect to happen is shorter wait times, less time in triage, quicker transitions, as well as a better experience for patients and the staff who are using the forms,” says Marc Greene, Manager, Emergency Department.
“We’re also hoping it will decrease the length of time staff are spending documenting and that gives them more time to engage with patients or other clinical care activities,’ adds Christine Bucago, Advanced Practice Clinical Leader.
The successful revision of CAMH’s ED Multidisciplinary Assessment form within CAMH’s clinical information system, known as I-CARE, is the result of extensive collaboration between a number of departments across the organization, including the Emergency Department, the Professional Practice Office, the Enterprise Project Management Office, Clinical Applications, Registration and frontline staff.
The leaner form removes a lot of redundancy and lets clients fill out some information upfront before they see a clinician, adds John Fernandes, Senior Project Analyst.
“This allows clinicians to focus on the problem the patient is here seeking help for,” he says. “We had a really good partnership with Admitting and because of their experience in the Emergency Department and using I-CARE firsthand, they know the tool well and what works and what may be redundant.”
Revising this form is part of a larger project to streamline a number of processes in the CAMH Emergency Department including triage, acuity streaming, and shifting towards a team-based model.
“We’re looking towards a more team-based model of care where a physician and a nurse or social worker will go and do the assessment together and use the tool as part of that process,” explains Christine.
The next phase of this project will look to continue making the journey through the Emergency Department more efficient while also improving the patient experience, adds Dan Harren, Project Manager, Clinical Projects.
“This work will benefit greatly from the implementation of the new and improved ED Multidisciplinary Assessment form and we are very much looking forward to seeing our project complement the work that’s already been done,” he says.