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Nursing research aims to improve emergency room care

If you’ve ever visited a hospital emergency room, then you know the anguish that comes with sometimes having to wait for extended periods of time to see a health care professional.

A trio of University of Windsor nursing professors is trying to solve that problem by getting a better understanding of why non-urgent patients go to emergency rooms. Maher El-Masri recently received funding from the Erie-St. Clair Local Health Integration Network to study the issue and will work with colleagues Judy Bornais and Jamie Crawley.

Bornais said there’s limited existing research documenting why non-urgent patients go to emergency rooms.

“Is it because they don’t have a primary care provider, the location, the hours, the lack of understanding about what constitutes an emergency?” she asked. “There could be a whole variety of reasons. We need to understand who these people are and why they’re there so that we can introduce interventions to tackle this problem. We can’t adequately address this problem until we have some empirical evidence about why they’re there. The ultimate goal is to improve patient care.”

Dr. El-Masri said emergency departments have been misused as primary care facilities for non-urgent medical conditions, a practice that compromises the efficiency of services for emergency patients. The unnecessary crowdedness of emergency rooms can result in long waits and delays in treatment, diversion of ambulances to other hospitals, poor health outcomes for patients, and increased risk of death, he said.

However, all three researchers agreed that having non-urgent patients going to emergency rooms causes delays for urgent and non-urgent patients alike. Emergency departments are heavily utilized in the province of Ontario, with an estimated 5.4 million annual visits, or four visits for every 10 people, according to statistics they collected.

Recent data revealed that six out of every 100 Ontarians who visited the emergency department left without being seen by a physician. In the Erie St. Clair LHIN, 5.1 per cent of patients who visited emergency rooms in 2008 left without being seen by a doctor, according to the Ontario Health Quality Council.

Researchers will review data on all emergency department patient admissions at all seven community hospitals within the Erie-St. Clair LHIN’s region that took place between January 1, 2007, and December 31, 2011.

Dr. Crawley will do the qualitative analysis portion of the research and will conduct about 50 interviews with non-urgent patients to obtain a description of their experience and to determine why they visited the emergency room.

“We want to do something more than just count the numbers,” she said. “We need to really understand the essence of the problem.”

Theresa Morris, director of medicine in emergency services at Windsor Regional Hospital’s Metropolitan Campus, said she welcomes the opportunity to have the nursing team examine its data and looks forward to seeing the results, which should be complete by the end of next year.

“We’re always looking at ways to improve our efficiency and we believe this research could go a long way towards making sure that patients are getting improved quality of care from appropriate health care providers,” she said. 

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