By Katie Ryan
A new Health Quality Council survey suggests there is room for improvement in Saskatchewan’s hospital emergency departments.
While the majority, 82 per cent, of patients treated in emergency departments rated the overall quality of care they received as good, very good or excellent, the percentage of patients who rated their care experience as excellent sits at 22 per cent.
Prairie North Health Region participated in the survey, with two of the region’s emergency departments receiving ratings below the provincial average for excellent care from patients: Lloydminster Hospital sits at 10. 9 per cent and Battlefords Union Hospital at 19.5 per cent.
“There’s nothing like putting values like that on a piece of paper, in black and white, and also showing where you stand in comparison to other emergency departments. That certainly gets people’s attention,” said PNHR vice-president
of integrated health services Barbara Jiricka.  “Then you delve deeper into what people are saying and what their perception is of the emergency department, it becomes clear that there is work that we need to do.”
HQC conducted the survey between January and March 2011, in collaboration with regional health authorities. A random sample of 27,361 patients discharged from the participating 14 emergency departments were mailed survey packages, however, the results of the survey are based on the experiences of 4,132 patients who did not have an appointment for their emergency department visit.
Nicole Wohlgemuth, HQC emergency department survey program director, said the survey stemmed from the health regions’ interest in learning more from patients’ experiences in emergency departments.
“Really what we are doing is trying to set a stretch goal for the health system to try to aim for exceptional (ratings) all of the time,” said Wohlgemuth. “Across the entire health system, the patient’s voice and the patient’s experiences are key outcome measures that all health care providers should be looking at when trying to decide where to make things better.”
According to the survey, almost half, 44 per cent, of patients went to the emergency department because there were no other options available, and about 30 per cent reported said they went because they had an appointment there or were told to go there for follow-up care.
Results from the HQC survey were released earlier in November and during the Dec. 23 PNHR board of directors meeting, Jiricka presented not only the results but the actions being taken at Battlefords Union Hospital and Lloydminster Hospital to improve patients’ experiences.
“The results showed that the long waits were of concern to people,” she said, noting the need for family physicians in Lloydminster is also a factor in the survey results. “There is a problem with people being able to not only find a family physician, but sometimes even to get in to see a family physician that they regularly see within the time frame that they need to see the patient in.”
During the time the survey was done last year, Jiricka said the Lloydminster Hospital emergency department was under renovation. The construction noise and relocation of the waiting room was likely an  issue for patients as well, she continued.
“People were sitting on chairs, really in the hallway, while we were making renovations to the waiting area. So, we recognize that there was concern there,” Jiricka said. “Sometimes what happens as well is people who are waiting a long time in the emergency (department) will sometimes see other people going ahead of them and it could possibly be people who  had come in after them. What happens there, is that in their assessment by the triage nurse, they’ve been assigned a priority.
“Sometimes that’s difficult for people to understand,“she added, “because in most other circumstances it’s first come, first served. But that’s not the case in the emergency department.”
Emergency department physicians and staff learned of the results shortly after the report was released, said Jiricka, noting patients called for improved communication and more courteous interactions in the survey.
“It’s a stressful environment to not only be working in but also to be accessing if you need help. What we have initiated is a commitment on the part of the emergency department to try to improve that,” she said. “Nobody wants to wait for three or four hours or longer. As we go forward, we are going to be doing things like taking a look at how we monitor the wait room, for example. Over time, what will happen is we will be getting results from the ongoing service that will show us if we are making improvements.”
Jiricka said ongoing family physician and specialist recruitment will help address the issues raised by the survey. The health region will also receive quarterly information as to what is going on the emergency department from the clients’ perspective, she continued.
“We will use that information to know whether or not we are heading in the right direction or whether there is still additional work that would have to be done in a certain area,” Jiricka said.