Members in the Media

Sharing patient discharge info helps Windsor FHT keep patients out of hospital

Windsor Star article published January 5, 2017. Article in full pasted below.
Brian Cross, Windsor Star

Windsor Regional Hospital’s two emergencies are getting fewer patients with sore throats and other minor ailments, an encouraging trend that started once the hospital began sharing patient discharge information with the Windsor Family Health Team.

The health team — which provides primary care (family doctoring) to 6,400 patients in Windsor, not including the 10,000 students and staff it serves at St. Clair College — uses this daily information to identify ways it can better serve its patients.

For example, when the team finds out a patient is being discharged after a hospital stay, the patient can be contacted for a followup appointment with his doctor. That continuing care translates into better care outside the hospital and fewer readmissions.

And when health team patients use the emergency for minor problems, the data can show why they chose the emergency instead of the health team. Since the data sharing began in 2014, the health team has expanded and revamped its after-hour coverage, so urgent cases can be seen the same day or the next day. From 5 p.m. to 8 p.m. Monday to Friday, a health team doctor sees only urgent cases.

Since 2013, the health team’s rate of emergency department visits for less severe ailments has dropped from 172.2 per 1,000 patients annually to 110.2, a 36 per cent decline. And its rate of hospital admissions for such conditions as asthma, congestive heart failure, COPD (lung disease) and diabetes has gone from 3.8 per 1,000 to 2.6, a 32 per cent decline.

The numbers add up to hundreds of fewer hospital visits, said Mark Ferrari, the health team’s executive director.

The data, he said, “just gives us an idea of who we need to be proactive, to reach out to … to give them followup care.”

He noted that when patients are served at the health team instead of the hospital, the result is big cost savings and shorter waits for people who need acute care at the hospital.

The health team is focusing on ailments that rank as 4s or 5s on the five-level Canadian Triage and Acuity Scale, in which the most severe cases are rated as 1s and the least severe are 5s.

“These are things where you don’t necessarily need to be triaged in a hospital emergency,” said Ferrari. “That’s why we focus on those 4s and 5s because it could be anything. It could be a sore throat, suture removals, back pain, the flu, vomiting — all those things that are considered less urgent.”

Up until three years ago, emergency department visits were increasing annually at Windsor Regional. But in the last two years, the number of visits has dropped by 4,000, to 120,000 a year, due solely to the decline in 4s and 5s, said vice-president Ralph Nicoletti.

“And certainly the family health team is a factor,” he said, also crediting the addition in recent years of more walk-in clinics in Windsor.

Though the drop in 4s and 5s is helpful, he added the hospital continues to see a significant number of patients coming in who are “very, very sick right now.”

Nicoletti said the situation is changing toward what the hospital envisions for the future, when a single acute hospital with an emergency department will replace Windsor Regional’s two current locations, and an urgent-care centre located at the former Grace Hospital site will serve the less acute patients. The health team is actually planning to move into the same building once the urgent care centre is built, further reducing the need for its patients to go to the emergency.

The health team, which pays its doctors a salary, has openings for about 250 more patients and is looking to hire a fifth doctor, which would add up to 1,650 more spaces. Located at 2475 McDougall Ave., it uses a team of medical professionals to manage and prevent disease, and promote good health.

Click here to access the Windsor Star article