Toronto General Hospital is experiencing unprecedented demand in its emergency department (ED) and is implementing innovative strategies to alleviate pressure and enhance patient care.

Rising Patient Volumes Strain Resources

Toronto General Hospital, part of the University Health Network (UHN), is facing a significant increase in patient visits. The ED, originally designed for approximately 20,000 patients annually, now handles between 60,000 and 70,000 cases each year.

This surge, combined with the complex medical and social needs of patients – particularly those related to mental health and homelessness due to its downtown location – is straining resources and extending wait times.

Challenges Acknowledged by Hospital Leadership

Dr. Erin O’Connor, Head of the Department, stated that despite ongoing adjustments, demand sometimes exceeds the hospital’s capacity.

Collaborative ‘Care Pathways’ Implemented

To address the escalating pressure, Toronto General is actively building partnerships with other healthcare institutions through what they call ‘care pathways.’ These pathways aim to divert patients from the ED when appropriate and ensure timely follow-up care.

Current pathways include collaborations with Women’s College Hospital, a virtual ED, and Princess Margaret Urgent Care Clinic for imaging and bloodwork.

Focus on Mental Health and Substance Use

A new pathway, developed in collaboration with CAMH and the Ministry of Health, will focus on managing mental health and substance use challenges. This includes managing withdrawal symptoms, initiating medication-assisted treatment, and connecting patients with ongoing support.

Empowering Frontline Staff for Innovation

The hospital is also fostering a culture of innovation, encouraging frontline staff to propose and rapidly test new care delivery models.

Michael De Wit, Nurse Manager, emphasizes the importance of ‘failing fast’ and learning from both successes and setbacks, noting that many impactful ideas originate from nursing and medical teams.

The addition of advanced practice providers, such as nurse practitioners and physician assistants, is also helping to ease the burden.

Addressing Unmet Community Needs

Toronto General recognizes that the ED often serves as a safety net for unmet needs in the community, including primary care and social services. Strengthening relationships with external organizations is a core focus to ensure patients receive care in the most appropriate setting.

Nurse Practitioner Kathryn Grundy highlighted the team’s dedication to improving patient flow and maximizing efficiency.

Dr. O’Connor believes continued investment in staffing, resources, and partnerships is crucial for sustaining quality care. The hospital is committed to adapting to the changing healthcare landscape and the complex needs of its population. This information was reported by the CBC’s Talia Ricci.