Grand River Hospital cracks top 10 best list as ER handles more, sicker patients than it's designed for

Grand River Hospital has climbed into the province's top 10 best emergency departments, according to Ontario Health, and did so while handling more patients than it was designed for who are sicker than before the pandemic. 

The hospital's emergency department was built to handle about 170 visits a day, president and CEO Ron Gagnon told CBC News. 

"Our average over the last three months has been 219 with a peak day of over 290," said Gagnon. "Over the last two years, we've seen a 30 per cent growth in our overall visits to our emergency room. 

"And people are sicker. We are seeing more people getting admitted."

The ranked list is internal and refers to January, February and March. It's a health system performance reporting tool and a metric for the Pay for Results program. It's based on six benchmarks, which include length of stay for minor or complex conditions; how long it took a patient to see a doctor; and how long someone was hospitalized. 

Three years ago, Grand River Hospital found itself near the bottom of that list. It's spent time in the 40s and 60s — of 74, a hospital spokesperson said. 

Gagnon credits creative staff within his hospital, and external partnerships, for the turnaround.

For example, he said, the emergency room staff looked at the flow of patients over the course of a day, and changed physician and nurse shifts to better match when people were most often flowing into the department. They also looked at how to better use the space they had, he said. 

"We looked at spaces that really sit idle after four or five o'clock every day. And we started using that space for people who come with lower-acuity triage," said Gagnon. "That's akin to visits that could otherwise be in our urgent care department — but they're in the emergency department — and the team created a way to use that space." 

As for external partnerships, Gagnon pointed to a nuclear medicine agreement with St. Mary's General Hospital as one example. St. Mary's has long had the more-established department, but more than two years ago, Grand River's satellite nuclear medicine department was shut down as space was made for a new MRI machine at Grand River. 

"[The satellite department] was sitting in the space where the new MRI needed to go," said Dr. Rick Dubeau, medical director of the regional nuclear medicine program. "The impact is we no longer have the Grand River site so patients have been coming to the St. Mary's site for their procedures.

"That's an inconvenience if you have to be brought to the neighbouring hospital, but we've managed that well and we've worked into the evenings, dealing with those demands ... and we've been quite successful at getting them dealt with," he said. 

Gagnon said construction has been slower than he'd like, citing supply chain delays and labour challenges. He said he expects to have nuclear imaging and the new MRI machine up and running within the year.