CKHA Communication - Improving Emergency Care For Citizens of Chatham-Kent: Physician Leaders Address the Critical Issue of Quality and Patient Safety

CHATHAM-KENT: April 26, 2016 -- Today, the Medical Advisory Committee (MAC) of Chatham-Kent Health Alliance (CKHA) confirmed their unanimous support of the hospital's capital and operating plans. It is the responsibility of the Medical Advisory Committee to make recommendations to the Board based on the best clinical evidence available and its collective judgement on issues of quality and patient safety.

"Over the past few weeks, there has been considerable attention to CKHA's proposed plans for emergency services circulating in the public forum," stated Dr. Ranjith Chandrasena, Chief of Medical Staff, CKHA. "Unfortunately, information related to the delivery of clinical care has often been inaccurate and, at times, misleading."

At today's press conference, CKHA's Chief of Emergency Medicine, Dr. Indraneel Ghosh provided an overview of how emergency services are organized across the Chatham-Kent community. He explained that even without a financial imperative, there are systemic issues associated with the current structure and operations of emergency services that must be addressed in order to provide better and safer care across the Alliance. "I know that this is a very difficult and emotional issue for the community but it is our clinical judgement that there's a better way to provide emergency care at CKHA," explained Dr. Ghosh. "We have a responsibility to provide recommendations to improve patient safety and outcomes, particularly for those that need life-saving, life-sustaining interventions, for all citizens of Chatham-Kent."

Modern medicine is built on the principle that volume drives quality. Any critically ill patient in need of emergency care requires treatment by professionals with a high degree of training, skills and expertise. Critically ill patients also have better outcomes when taken care of in a system that treats this type of patient routinely and by a team of clinicians that have the specialized training and exposure. Furthermore, ready access to back-up resources - whether in the department or hospital - enhance the number of interventions available and the quality of patient outcomes when challenging cases present. This is an important consideration when examining the current delivery of emergency services in Chatham-Kent.

Today, the majority of patients using the Emergency Department (ED) at the Sydenham Campus require less-urgent or non-urgent care. This means that the vast majority of patients currently using the Sydenham ED can be better served by a different model of care. For the limited number of patients that need immediate and critical care, going directly to an ED with the appropriate support and resources offers the best opportunity for life-saving and life-enhancing care.

There are essentially two fundamental issues that the MAC considered in their support of changes to emergency services: the first being the ability to provide the best chance of survivability and outcomes for critically ill patients, achieved by consolidating high acuity visits to the Chatham Emergency Department; and the second, to improve everyone's access to urgent and primary care across Chatham-Kent.

For those who are critically ill, continuity of care and access to Specialists and inpatient units, given they are the most likely patient group to be from the ED, is key. For those who require less or non-urgent care, continuity of care with their primary care provider is essential in managing illness and preventing unnecessary visits to an ED for episodic care. In addition to enhancing the quality of care for all critically ill emergency patients, proposed changes address the demonstrated need for improved access to urgent and primary care across the region.

"We believe that the fundamental issue at stake is timely access to high quality care at the right time, in the right place and by the right team of providers for all citizens of Chatham-Kent," added Ghosh.

In a show of support, Drs. Ghosh and Chandrasena were joined by a panel of physician leaders who also provided their clinical expertise on issues of quality and patient safety related to the delivery of emergency services in Chatham-Kent. The panel included:

  • Dr. Dinesh Nethirasigamani, Chief of Anaesthesia, Interim Chief of Hospitalist Department & Senior Medical Director, Quality
  • Dr. Elizabeth Haddad, Chief of Surgery and Senior Medical Director, Performance & Utilization
  • Dr. Quoc Tran, Chief of Internal Medicine

"We understand that these decisions are ultimately in the hands of our directors as well as the government. Today's event was intended to ensure that the public dialogue, as it relates to the delivery of safe high quality care, is informed by those with the clinical expertise and experience to do so," concluded Chandrasena.

For more information please contact:
Dr. Ranjith Chandrasena
Chief of Medical Staff
519-352-6401 ext. 5744

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