Emergency department wait-times remain well below the provincial average at Southlake Regional Health Centre in Newmarket.
On average, patients at the York Region hospital's emergency department waited 0.6 hours, or about 36 minutes, for their first assessment by a doctor, according to Ontario Health data from March.
This is the shortest wait-time in Ontario and well below the provincial average, which was 1.9 hours for the first assessment.
On average, the entire length of stay for low-urgency patients who aren't admitted is 2.2 hours, while the entire length of stay for high-urgency patients not admitted is 3.4 hours.
"We're really proud of being a place in the community where people can come to get care in our emergency department, but not just care in general but timely care and high-quality care," said Dr. Gaurav Puri, chief of emergency at Southlake.
He said the first step in a patient's journey when they come to the Southlake emergency department is pre-triage, when a nurse will identify if something is life-threatening or needs immediate attention.
"That's a really good thing to have because it allows a quick look from one of our experienced nurses to identify things that can wait and go through the usual triage process, or that need urgent attention," Puri said.
He said this is somewhat unique and he doesn't know many emergency departments that have a pre-triage nurse.
After that, patients are triaged and sorted by urgency using a number system and have their vital signs checked and then onto registration to have their demographic information confirmed.
From there, they are sent to the sub-acute or fastback areas with a chart and shortly thereafter, they're seen by a physician.
"At a lot of other institutions, once the patients have been triaged, they wait in the waiting room, the main waiting room, whereas we strive to bring every patient in as soon as they've been triaged. Now occasionally, it's not possible logistically, but I'd say 90 per cent of the time after they've been triaged, they're brought in," Puri said.
The clock starts right at that pre-triage time and from then it's just over half an hour on average to be seen for first assessment by a doctor, which is where that metric of 0.6 hours is from.
Another area that sets Southlake apart is the use of physician navigators. Puri said there are only one or two other hospitals that use this model, which sees a navigator assigned to each doctor to aid with paper work, let them know when patients are ready for assessment, and help with communication between nurses and other doctors.
"The navigator basically allows the physician to be more efficient while on shift," he said. "That's been the thing that's allowed us to get to the next level with respect to physician efficiency."
One area where Southlake has long wait times, however, is for patients who require admittance into the hospital. On average, the entire length of their stay in emergency prior to being admitted is 18.9 hours.
"That's something the emerg has little control over because those are patients who have been seen by an emergency physician, and they've been deemed too sick to go home, whether it's for a medical reason, a surgical reason or a mental health reason," Puri said.
He said the biggest issue is the lack of capacity in the hospital.
"That's one of our biggest challenge as an emergency department, because those patients stay there (in emergency). They still require care, and they take up a lot of space and resources. And they can't leave the department because there's no space in the hospital for them yet," he said.
Last year, Southlake's emergency department saw more than 115,000 visits, with an average of 320 unique patient visits per day.
Puri credits the experienced nurses, physicians and the navigators for providing high-quality care in a timely fashion.
