Friday, March 6, 2009

Alberta doctors to hear how UK cut wait times.

Alberta ER docs to hear about changes to U.K. wait times

Last Updated: Friday, March 6, 2009 | 1:34 PM MT

It is good that Alberta is seeking reform advice from experts outside the US. The US is not at all efficient and is very costly compared to most systems and also it is not universal as are Britain and most of the European systems. Personally I have never had to wait any significant length of time in an ER but I gather in some cities it is a real problem even in Winnipeg in Manitoba.

A British physician who advised former prime minister Tony Blair will speak to doctors in Edmonton on Friday about how Britain changed its health-care system so waits in emergency rooms are limited to four hours.

Dr. Matthew Cooke will talk about the "four-hour rule," whereby patients are either treated and sent home or admitted to a hospital bed within four hours of showing up at an emergency room, 98 per cent of the time.

In order for the change to occur, the country's National Health Service spent £600 million [roughly $1 billion Cdn] to create thousands of beds in nursing homes so that sick elderly patients could be moved out of hospitals, Cooke said Friday on CBC Radio's Edmonton AM.

"If we looked in 2001 in England, there were 7,000 of these people any day in a hospital bed. Now, it's about 1,500," Cooke said.

The change means beds are now available to ER patients that require admission to hospital.

"It was a big investment but the improvements have been obvious from that investment," Cooke said.

In Alberta, emergency room wait-times average six hours, and doctors are looking to see if British-style changes can be implemented in Alberta.

Doctors at the Emergency Department Integration Conference, at which Cooke is the keynote speaker, will look at the root of the problem and talk about best practices in Alberta and other jurisdictions.

"If you told Canadians that they were going to be in and out of the emergency department within four hours, they'd say that's the best health-care system in the world," said conference chair and Edmonton emergency physician Dr. Brian Rowe.

"And we know it can be done. It requires a lot of change and change is not easy but we know now that it can be done and it can be sustained."

Cooke said the situation in Canada today reminds him of how things used to be in British emergency rooms.

"All things I'm hearing are just what was happening in the U.K. seven and eight years ago," he said.

While the rule works well in general, wait times for some patients still exceed four hours.

A few weeks ago, Cooke said he and some other doctors at his hospital were unhappy because four or five patients had gone over the time limit. But then he realized the situation used to be much worse.

"Seven or eight years ago, we would have had 30 or 40 patients at least going over," he said.

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