Hospital ER visits declining, but Windsor Regional Hospital seeing sicker patients 

Though Windsor Regional Hospital is seeing a steady decline in ER visits, hospital president and CEO David Musyj says his facility is seeing sicker patients come through the doors.

According to the hospital's 2018/19 annual report, Windsor Regional saw almost 5,500 fewer emergency department patients this year, compared to 2017/18.

"The decline has been steady. It has been [two to three per cent] per year," wrote Musyj, in an email. "However, at the same time the acuity … has increased."

Precisely 106,842 patients visited the emergency department in 2018/19, compared to 112,310 in 2017/18 — a figure that represents a 4.8 per cent decline between the two years. 

The most recent fiscal year also represents the fourth consecutive annual cycle that emergency department visits declined.

An increase in mental health and addiction visits

Musyj said that Windsor Regional Hospital has also seen an increase in patients with mental health and addiction needs. 

"What is troubling is mental health and addiction patients visits to the ER continue to rise and not decline," he said. 

"We need to continue to focus on adding community supports for mental health and addiction patients."

He added that the hospital regularly takes steps to attend to changing patient needs "in a more efficient manner."

"However, we have to balance acuity of patients attending the [emergency department], trying to avoid unneeded admissions and also trying to avoid re-admissions [and] attendances," said Musyj. 

ER visitation numbers across Erie St. Clair LHIN

Mark Ferrari is the executive director of the Windsor Family Health Team (WFHT) — a primary care centre part of the Erie St. Clair Local Health Integration Network (LHIN) that supports approximately 7,500 patients. 

He said that his facility has seen a similar decrease in emergency visits that Windsor Regional Hospital has noted.

"We've seen a decline across the entire Erie St. Clair LHIN," said Ferrari, adding that his facility's emergency visit decline is greater than that of other facilities part of the same network. 

Ferrari explained that his facility looks at a multitude of factors to ensure that patients visit them rather than hospital.

"If we need to offer more same day, next day appointments, if we need to be open different hours, if we just need to change our approach seeing people, we can be more responsive," he said. 

Ferrari added that he sees the decline in hospital emergency room visits as a good thing.

"It talks about the potential for an integrated system and how it could work better," he said. "In this case, the hospital and primary care working together is having significant impact … It tells us that it works and if we were done [on a] larger scale, it'd probably have even greater impact."

Still, Ferrari acknowledged that part of the reason why the WFHT is seeing lower emergency department visits has to do with with lower acuity patients choosing the facility, rather than going to hospital for less severe ailments. 

"I think that's part of our big success for our rate of [ER] visits for our patients, because they are in fact choosing us rather than the hospital," he said. 

Nonetheless, Ferrari echoed Musyj's concerns about patients with mental health and addiction needs.

"We unfortunately are seeing an increase in mental health and addictions showing up at a hospital," he said. "Now we know that we need to spend more time focusing on that."

Ferrari said that the WFHT plans on opening up an addictions recovery program through the facility's team care centre later in the fall to better address mental health and addiction.

"Hopefully through that we'll be able to get people into treatment so they're not showing up at emergency as often."

It's worth noting, however, that not all health service providers within the Erie St. Clair LHIN have reported a decrease in ER visits. 

Erie Shores Healthcare in Leamington actually noted an increase of 2,876 ER visits between 2018/19 and 2017/18.

Kristin Kennedy is the facility's vice president of patients services and the chief nursing executive.

She said that the collaboration between the Windsor-Essex EMS, Windsor Regional Hospital and Erie Shores Healthcare has allowed patients to access more timely care at these three facilities. 

Kennedy attributed the increase in ER visitation numbers to a growing population, as well as increased collaboration between the three area hospitals.