© Nathan Liewicki
Dr. Ziauddin Hassan looks up while he checking the pulse of a patient in the Moose Jaw Union Hospital's emergency department on Thursday. Head of emergency ward, Hassan is involved in the hiring process of nurse practitioners for the new Greenfield site that is set to open in early February.
Grassroots idea expected to open in February
The Moose Jaw Union Hospital is obligated to provide medical care for any person who comes to the emergency department.
With the new regional hospital set to open in spring 2015, that will continue. However, the Five Hills Health Region (FHHR) is getting a head start on providing an emergency room alternative to patients with non-life threatening illnesses or injuries.
Located on the 100 block of First Avenue Northeast, the Greenfield site will offer alternative care, along with other primary services.
“About 55 per cent of people show up in emergency for needs that have to be addressed, but maybe emergency care is not the place is that it should be delivered,” said FHHR executive director of primary health care Dianne Ferguson. “The Greenfield site was designed to look at how could we offer an alternate place to deliver services for folks for (who) need an unexpected health need cared for.”
The idea behind the Greenfield site, according to Ferguson, is to enhance team-based health care services for people in the community from the ground up.
The aptly-named Greenfield site will be built from the ground up.
“There isn’t anything in place, so we are really building it from the grassroots up,” she said. “We are using very much lean processes, lean tools and trying to really focus on high quality service, safe patients and timely access.”
The FHHR is aiming to have the site open to the public the first week of February. It will not be open seven days a week from the outset, but Ferguson said the plan is to do so eventually.
Instead of physicians working at the Greenfield site, nurse practitioners — qualified professionals with masters degrees and experience in the emergency department — will operate it.
“They can diagnose common medical illnesses. They can prescribe most medications. There are a few yet that they can’t, but that’s being worked on,” Ferguson said. “They can order labs and X-rays. For the most part they can probably do a fair share of what comes into a clinic.”
The nurse practitioners will be able to handle about 70 per cent of what a doctor looks at. If they have any questions or concerns, they can call one of the doctors in the hospital’s emergency room.
“We can give advice to them,” said Dr. Ziauddin Hassan, head of the Moose Jaw Union Hospital’s emergency department. “If they still have a concern, they can send the patient to the emergency department and we can look at the individual and decide if we need to do a further investigation.”
Some of the services nurse practitioners will provide include tending to colds, immunizations, fractures, ear pain, eye injuries, stitches, and minor burns. In addition, they will be able to draw blood and send it to laboratories for testing.
The Greenfield will allow emergency department physicians and nurses to have more time to deal with patients higher on the Canadian Triage and Acuity Scale (CTAS) system.
The five-point scale — where one is the highest and five is the lowest — prioritizes patient care requirements according to the type and severity of the signs and symptoms of their illness or injury. People who fall into levels four and five of the CTAS system are the ones the FHHR hopes will wind up at the Greenfield site.
Hassan, who is also overseeing the hiring process of nurse practitioners, said one of the more common things nurse practitioners will do at the Greenfield site is provide short-term prescription refills.
“I have seen quite a significant number of patients coming to the emergency department because they work a 9 a.m. to 5 p.m. job, or they aren’t able to go to the family physician to refill their prescriptions.”
About 55 per cent of people show up in emergency for needs that have to be addressed, but maybe emergency care is not the place is that it should be delivered. The Greenfield site was designed to look at how could we offer an alternate place to deliver services for folks for (who) need an unexpected health need cared for. Dianne Ferguson, FHHR
The real aim, however, is to have patients visit their physicians for prescription refills. Hassan told the Times-Herald this is because a patient’s physician might have something in mind he or she wants to change about an existing prescription.
Hassan added that patients seeking prescription refills at the Greenfield site will only receive ones lasting a maximum of one week.
“(Nurse practitioners) will be able to write the same prescription for a refill for a short period of time before the patient goes to the family physician to have it refilled again,” said Hassan.
The FHHR expects waiting times at the hospital’s emergency department to shrink as people use the new site.
“In emergency, we’ll definitely notice a decrease in the workload,” said Dr. Ziauddin Hassan, head of the Moose Jaw Union Hospital’s emergency department.
People who are in the Moose Jaw area to work for temporary periods would also to have access to the Greenfield site, even though their physician might reside elsewhere.
Operating hours of existing clinics are prohibitive toward many, said Ferguson. So the Greenfield site will be available to those people as an alternative to the hospital’s emergency room.
“We also believe that there’s still a population out there that doesn’t have a family physician, or a team of providers that they call their place to go for health needs,” said Ferguson. “We are working with some things we kind of don’t know for sure — some assumptions — but that’s the whole part of a Greenfield site.”
In addition, Ferguson noted the FHHR would learn from the Greenfield site and share what they learn with other locations across the province.
Electronic medical records (EMRs) will also play an important role at the site.
“We have an EMR system which we need to build up at the Greenfield site,” said Hassan. “The (nurse practitioners) can (electronically) transfer the patient’s data to the emergency department and the family physician’s office.”
By transferring a patient’s updated EMR to his or her physician, their physician is more aware of their medical history.
“The better informed your family physician is of all that’s happening with you, the better for your care,” said FHHR director of communications Kyle Matthies.
Although the undertaking of the Greenfield site will provide an alternative to the hospital emergency department, the FHHR is aware that educating the public about the services it offers is just as important.
“We need to educate the public so that they know we have a facility available for the types of things which they can utilize it for,” said Dr. Hassan.
“If you came in and you saw Dr. Hassan for a cold, once the appointment is done he could say, ‘In the future, for this kind of thing you could go to the Greenfield site,’” Matthies said.
And there will be no sending away of patients from the hospital’s emergency department if there are long waits for people coming in with, for example, ear pain.
“These are our customers. We don’t want to be sending them somewhere else to go,” said Hassan. “If they come to the emergency department we have to provide care for them.”
Nathan Liewicki can be reached at 306-691-1256 or follow him on Twitter @liewicks