Sunnybrook Magazine - Fall 2020

ED One Team fights ‘hallway medicine’

Members of the ED One Team (from left): Will Thomas-Boaz, Lisa Chang, Val Soper, Judith Keen-Bingham, Anne Moorhouse, Nadine Narain, Solmaz Dehghan, Faith Gallant, Belinda Wagner, Jasmine Segal.

On Thanksgiving weekend in 2019, a senior arrived at Sunnybrook’s emergency department with rib fractures after suffering a fall. She was in stable condition, but needed a new walker to get around. So, the woman was admitted.

The problem? No available beds.

“She spent the whole weekend with us in our hallway in emergency,” remembers Will Thomas-Boaz, advanced practice nurse for Sunnybrook’s emergency department and trauma program.

Fortunately, change was already in the works to address this all-too-common problem. Sunnybrook had begun developing a new team of emergency department healthcare workers with one main goal: helping seniors avoid long stays in the hospital by giving them the supports they need to go back home to the community safely.

On October 28, 2019, Sunnybrook launched the ED One Team. In its first five months, the team showed a decrease of 323 admissions, or 2.1 per day, compared to the same time period the previous year, says Thomas-Boaz, who develops quality improvement initiatives with ED One.

The ED One Team consists of both a hospital and community social worker, geriatric emergency medicine nurse, physiotherapist, occupational therapist, community care coordinator, psychogeriatric case manager, a community mental health specialist and staff from home-care service agencies. After a daily huddle to discuss cases, they usually work with an average of eight to 10 patients a day.

To further support seniors care, the ED One Team works together with the Slaight Senior Care Navigation Pilot, a project supported by the Slaight Family Foundation Seniors Fund. The pilot places a trained navigator from SPRINT Senior Care in Sunnybrook to help facilitate safe discharges into the community.

Natalie Coyle, the ED One Team coordinator, says using a holistic, team-based approach to patient care makes all the difference. She pulls up a letter from one patient, Terry, a senior living alone who arrived in emergency with a hip fracture. ED One Team members ordered his new walker, helped him learn how to use it, made sure he could easily return to his home in community housing and scheduled a home cleaning, too.

“I’m a very proud person and I’ve never accepted this kind of help before, but she really made me feel safe and was always pleasant and professional,” he wrote of his experiences with the ED One psychogeriatric case manager.

With a high number of seniors in the community, the ED One Team will be kept busy, but that’s precisely the point.

“Now that we have [ED One], I can’t imagine not having it,” says Coyle.