Abstract

This article presents a case study involving patient flow in a healthcare facility in northeastern Ontario, Canada, during a time when hospital-based funding was frozen while community-based services increased. This resulted in a dire need to manage patient services to ensure they were being delivered in the right venue and in the most cost-effective manner to maintain access to care across the continuum. In the fall of 2012, North Bay Regional Health Center (NBRHC) was experiencing severe patient flow issues. Norms were 100% occupancy rates in most units, long wait times in the emergency department (ED) for admitted patients, and daily pressure to find beds to clear the ED and critical care unit for incoming patients. The surgery schedule was in jeopardy many days because no beds were available for patients after surgery. In addition, there was limited capacity available in the case of disease outbreaks or disaster. In 2013, NBRHC employed innovative strategies internally and externally (in partnership with local, district and regional partners) to facilitate patients being discharged to appropriate destinations with the required supports for a successful transition. NBRHC took the lead to assist other hospitals in the region to improve flow and access to enhance the performance of the overall North East Ontario health system. The article discusses the strategies employed, and discusses follow-up and key learnings.