CGH Seeks ER Expansion to Meet Care Needs
In the ER, a Little Privacy Goes a Long Way
When the Canmore General Hospital was built in the 1980s, the town was a much smaller community. While the community has grown in population and visitor numbers, the emergency department has not. The Canmore and Area Health Care Foundation is looking to renovate and expand the ER to improve patient care.
“A lot of the changes that the project would facilitate involve a better working area for the staff,” said Dr. Mike Wickham, Emergency Physician Lead, Canmore General Hospital.
Like an open-concept house, you can easily overhear conversations happening in other areas because of the design of the space.
“There’s no real private place in our department to talk about your issues,” said Dr. Wickham.
About two decades ago, Dr. Wickham became the hospital’s first certified emergency physician. Now, as Lead Physician, Dr. Wickham is setting higher standards for all staff in the emergency department.
“He has really raised the bar for the physicians to really have higher credentials,” said Robbie Berendt, a retired RN who worked at the hospital for 23 of her nearly four-decade long career.
That higher bar, she said, includes trying to get some of the physicians on staff certified as emergency doctors. Though, that’s only one component. Monthly sessions allow doctors, nurses and EMS personnel to further their education or to openly discuss a challenging case they saw in the emergency department.
Berendt, who retired in October 2015, said during her career at the hospital, she noticed changes in the emergency department.
“The patient acuity has gone up in such a way that we really need more space in the department,” said Berendt.
The number of patients who come through the ER has gone down over the past 10 years from a high of 18,780 visits in 2007-08. In 2018, there were 14,197 visits to the hospital’s emergency room, about 400 fewer visits than in 2017. AHS indicated that despite a drop in the number of people visiting the emergency room over the past decade, since 2010-11 the ER has seen an increase in the number of “high acuity patients” that require critical care from nurses and doctors. In 2010-11, there were 4,032 patients that required critical care because of the severity of their injuries. In 2017-18 that number jumped to 5,816 patients.
For Dr. Wickham, the numbers he sees at the hospital aren’t the full story. And while more beds provided by an expansion will help, the design of the department itself needs an upgrade to improve quality of care and efficiency. The department is 35-years-old. It doesn’t accommodate computers very well, bigger equipment, and family-centered care.
“We want to change … how the patients enter the system right from the beginning, right from the front doors of the hospital because if you are having a significant medical concern, I think the first person you should see is a nurse, not the front desk,” said Dr. Wickham.
Right now, a patient entering the emergency department must first check in with the front desk and fill out paperwork. Seeing a trained medical professional as your first point of entry would be a quick and safe way to identify the patients with the most urgent needs, who could then be triaged. It’s a simple change that renovations would facilitate, perhaps by moving the nurse station. That said, our registration staff do an excellent job sending patients directly to ER if they are even remotely concerned.
“We’re very lucky to have the public health care system that we have, but there are certain things that individual communities would benefit from that the government won’t support or can’t support,” said Dr. Wickham.
Those improvements have come from the Canmore and Area Health Care Foundation, such as the satellite cancer care unit and the obstetrics unit. There are also smaller things that have made a huge difference for patients and staff alike: stretchers that can be used with an X-ray machine, so that a very sick patient doesn’t have to be moved to the X-ray department, as well as a bedside ultrasound.
Based on design drafts, the ER expansion and renovations will cost $4.5-4.8 million – money the Canmore and Area Health Care Foundation will raise to bring the 1980s-era facility up-to-date with the demands of a steadily growing community.
While the changes are a long-term plan, the staff continues to work to improve care.
“More than the physical space, it’s people working there that are taking care of the patients that are the wheels of the machine,” said Berendt.
Dr. Mike Wickham, photographed in the Canmore General Hospital, welcomes the upcoming improvements to the emergency department, which has not been renovated since opening in 1984.
Retired nurse Robbie Berendt says the Canmore General Hospital's emergency department now sees a greater number of patients in more acute condition than when she first started at the hospital more than twenty years ago.