Sinai Health

80,000 patients a year and reorganize care based on the best evidence� The redesign will be senior-friendly, with more washrooms and handrails, and more clocks and natural light to keep people oriented� The revitalized ED will have more isolation rooms for people with suspected cases of infectious disease like tuberculosis and even the flu� Hand sanitizers and hand-washing stations will be placed to encourage maximum use� Seven nursing stations (there are currently three) will be located to maximize the number of patients in the direct eyesight of staff� There will be a separate entrance for patients arriving by ambulance or police� And the department will have its own next-generation CT scanner and X-ray� The goal is for success stories like Helga's to become commonplace� But timely care isn't just a matter of convenience, says Dr� Howard Ovens, Chief of Emergency Medicine� Extensive research shows that longer wait times mean higher risks for hospital-acquired infection and accidents� Overstretched EDs are associated with more mistakes and worse health outcomes� "The philosophy is the right care at the right place at the right time," says Dr� Ovens, who is also the Ontario Provincial Expert Lead in Emergency Medicine� "Helga didn't need all the sophisticated diagnostic facilities of an acute care hospital, but she did need intensive rehabilitation, and she would get more of that at Bridgepoint, in a more home- like setting�" Timely care meant that she started physiotherapy on the day of her injury — not days or even weeks later� "The speed with which staff were able to transfer Helga to Bridgepoint is highly unusual for any hospital, probably anywhere in the world," Dr� Ovens says� Under normal procedures, "she would have been admitted to the hospital during the paperwork and application process, so there would be a stay of at least a few days that would add almost no value to her care�" Ambitious plans In less than a decade, the number of patients coming through one of the city's smallest emergency departments (EDs) has doubled� Staff responded with an array of evidence- based changes that cut wait times in half, to the shortest in the city� Still, walk into the ED on any given day and you'll see stretchers full of patients lining the hallways� To cope with this growth, Mount Sinai will soon see even bigger changes� The hospital is embarking on an ambitious expansion and renovation that will more than double its space, to 28,000 square feet, add new technology with the capacity to treat Terrified that she had broken her spine and would end up paralyzed, Helga managed to drag herself to the kitchen phone to call 911� It was an unfortunate moment for an independent woman who had enjoyed good health all her life� But Helga got lucky in one way — the ambulance took her to Mount Sinai Hospital's Schwartz/Reisman Emergency Centre� In a matter of hours, she was diagnosed with a fractured spine, treated by a geriatric emergency medicine nurse and settled into a comfortable room at Bridgepoint Active Healthcare� "It was such a relief, arriving at Bridgepoint," recalls Helga, now back in her apartment and steadily recovering her mobility� "I went from a little gurney in a hallway with lights flashing and things beeping and a lot of traumas going on, to a room with a pleasant view and friendly staff� I was so amazed; I couldn't believe it�" All too often, stories about the world of emergency medicine tell of events that go badly wrong� This is a story of everything that went right — when bureaucracy didn't get in the way, when staff were plugged into a network of resources and the right care was delivered at the right time� It's a glimpse into the kind of care that Sinai Health System is actively working toward, where emergency management is fully, deeply connected to the rest of the medical system, where diagnosis, treatment and transition are handled seamlessly� Social worker Rebecca Detje and Dr. Howard Ovens, Chief of Emergency Medicine Helga in her home

• Cover