• I am writing in regards to a visit my wife and I had at your emergency ward. As everyone else that was there that day, we did not want to be there. We came in to the emergency because my wife was showing signs of what could have been a stroke – and she is only 46.

    The triage was quick and efficient. And from that point on, your staff worked in such a way that we felt as though we were the only ones at the hospital.

  • Everyone demonstrated great professionalism – taking the time to explain what was happening and why, all the while being warm and compassionate to my wife and I.

    While my wife was being prepped for a possible move, an ambulance delivered a 73-year old in cardiac arrest to the next bed. It was amazing to see the Montfort staff at work. Your staff went from compassionate nurses and doctors to the most well-oiled machine I have seen. No panic, no stress, just a high speed efficient ballet of life-savers.

  • They spent the next 30 minutes reviving this apparently homeless senior, having to restart several times as he would go into cardiac arrest more than once after being revived.

    The dedication to their job was a reflection of great compassion – one that they are apparently able to lock up when they need to focus and save a life – and then turn back on when they came to check on my wife after reviving the other patient. Amazing.

  • Satisfied that the scan did not show a problem, the neurologist discharged my wife and then followed up by arranging an MRI a few days later, taking charge to book the MRI instead of letting the responsibility fall on us in our personal panic.

    We can say without hesitation that we could not have been in better hands than at the Montfort.

  • Please pass on our deepest gratitude to the team that worked the ER that Friday morning. Outstanding professionals each and everyone of them.

     

It goes without saying that people
who end up in Emergency
would rather not be there.

With this in mind, over the last year the team at Montfort’s Emergency has put a lot of effort into improving patient experience. The team’s actions were guided by best practices, but also by the suggestions of patient-partners and comments made during patient, employee and physician rounds.

Every day, Emergency Manager Marie Parish and Care Facilitator Jannick Langlais take the time to sit with at least 10 Emergency patients or their loved ones. “People are surprised that we’re asking for their immediate feedback, but this is what allows me to better manage complaints and often bring an immediate solution,” explains Marie.

By adjusting schedules to better manage peak periods; by extending to midnight the presence of a nurse practitioner in the green zone to look after less urgent cases; by installing a new CT scanner in Emergency; and by refining all of the stages in the process, the waiting time before initial assessment by a physician or nurse practitioner has been reduced an average of two hours in the last 18 months and our patients have spent 30 minutes less time in Emergency.

These improvements in efficiency translated into our busiest year in the Emergency.

“That’s 30 minutes less in parking fees, 30 minutes less in childcare expenses, and, above all, 30 minutes less time worrying about the prognosis.”

Sophie Parisien
Clinical Director for the Emergency, Montfort

The number of patients who leave the Emergency before being seen by a physician has decreased, which partly explains the increased number of visitors.

The team has also changed its process in order to improve pain management as soon as the patient arrives. Nurses now have the authority needed to offer certain medications to people who need them. Once again, the comments of a patient in Emergency—himself a physician in another hospital—inspired this improvement.

The profile of those who come to Montfort’s Emergency has also changed.

In the last year, the number of patients with opioid intoxication has increased by 70%
30% of patients in Emergency have several chronic diseases (multimorbidity)
Some patients have to manage up to 12 diseases

In many cases, patients’ physical pain is accompanied by mental health problems. We must adjust our care and services to meet their needs.

A lot of work has been done for patients who come into Emergency with a mental health problem. Peer support workers affiliated with the Mental Health Program come to Emergency to sit and talk with patients. Opening new temporary beds in mental health has also helped enormously in reducing Emergency overcrowding.

“The Emergency Department is not the best place for a mental health patient.”

Annie Boisvert
Director of the Mental Health Program, Montfort

Montfort’s Emergency is also working more closely with paramedics and other hospitals in the region. For example, paramedics came to train nurses and volunteers so that they could go help patients elsewhere on the hospital grounds, if patients are unable to get around on their own. And in January 2018, Montfort was the first hospital to participate in a regional dashboard project with paramedics.

“You can see your transfer time in real time in all emergency rooms in the city.”

Dr. Shaun Visser
Chief of the Emergency Department, Montfort

To reduce waiting time, access to a hospital bed is essential if a patient needs to be hospitalized. On this issue, Sophie praises the multidisciplinary team managing patient flow, which has put a lot of effort into standardizing the transfer and discharge process throughout the hospital, including evenings and weekends. “There has been a real change in the culture to ensure that an empty bed doesn’t stay that way,” explains Sophie.

With the signing of the Alternate Funding Plan, we have been able look toward the future and develop new initiatives worthy of an academic teaching hospital. Consequently, each day one physician can now devote one shift to training new emergency physicians and nurses; while research projects are also starting to bear fruit.

All of these person-centred improvements in Emergency have been implemented “with and for you.”

The work carried out by Sophie, Marie, Dr. Visser and the entire family at Emergency has enabled us to establish the foundations we need to “become a recognized Clinical Centre of Excellence in multimorbidity,” one of our major strategic orientations.