ED serving double the patients it was designed for

TORONTO – The emergency department chief at Michael Garron Hospital, in the city’s east end, said the department is seeing twice the number of patients each day the facility was originally designed for. It’s scrambling to find ways of meeting the demand for emergency medical services.

When the emergency department at Michael Garron Hospital was designed 30 years ago, it was built to care for about 150 patients a day, chief medical director Dr. Kyle Vojdani (pictured) told CBC News. But as the population has grown, he said it now sees more than 300 patients daily.

That amounted to about 107,000 patients last year in a space designed to see about 50,000 annually, he said.

“We’ve absorbed waiting room spaces. We’ve absorbed lounges. We’ve absorbed conference room spaces,” Vojdani said. “Most of these spaces were never designed for clinical care.”

Rooms surrounding the emergency department have been annexed to increase capacity, Dr. Vojdani said. A corridor of offices, for instance, is now used to receive pediatric patients, with the number of child patients has going up nearly 70 percent over the last five years, he said. The number of adults has gone up roughly 35 percent, he said.

While the extra space has helped, Dr. Vojdani said most of it was never designed for clinical care. That can pose a challenge, as about 95 percent of emergency visits are what Vojdani calls high-acuity cases, which include heart attacks, strokes, sepsis and broken limbs.

“It means that we’ve had to be creative in the way we deliver care to ensure that we’re able to provide the highest quality care to all our patients,” he said.

To increase efficiency and see more patients, staff have also been using technology like remote monitoring, wait-time clocks and artificial intelligence, said Dr. Carmine Simone, executive vice president of medical operations, partnerships and innovation at the hospital.

He said AI has already improved doctor efficiency by 10-15 percent by helping with bureaucratic work.

Still, officials have been in talks with the provincial government, Simone said, advocating for more resources and more space, as well as renovations to existing space.

“Some hospitals have seen a decrease [in patient volumes] since COVID,” he said. “We’ve seen year-over-year growth. And so, because of that, we’ve had very unique challenges.”

The province has increased funding for the Toronto East Health Network, of which Michael Garron Hospital is the anchor site, by 55 percent since 2018, a Ministry of Health spokesperson said in a statement.

“This is in addition to the $44 million we have invested in hospitals to reduce emergency department (ED) wait times and $10 million to upskill 1,000 nurses to work in emergency departments,” said Satnam Grewal in the statement.

The province included a four percent increase for hospital funding in its new budget presented last month. The Ontario Hospital Association’s president recently said costs in the sector are rising at a rate of six percent annually, in part because of Ontario’s growing, aging and more medically complex population.

Michael Garron Hospital is expected to serve an additional 50,000 residents in east Toronto in the next five years, according to Dr. Vojdani.