Clinical Access Service enables patients to avoid Emergency Department
Access to testing, diagnosis and treatment at the JGH is now faster and easier, thanks to a newly launched service that allows patients with certain medical conditions to be seen promptly in an outpatient setting.
The Clinical Access Service , in operation since August, handles referrals from family doctors who feel that their patients have problems that require attention with minimal delay.
Specifically, the clinic sees pregnant women with vaginal bleeding during the first trimester; patients who are suspected of having a deep vein thrombosis (blood clot); and patients whose temporary symptoms suggest that they may have had a warning stroke or mini-stroke at least 48 hours earlier.
The service, which is available on weekdays from 8:00 a.m. to 4:00 p.m., is based in the Medical Day Hospital in room 101 on the main floor (level S1) of Pavilion K. It’s a nurse‑led initiative, in partnership with Dr. Jed Lipes, Dr. Jeffrey Minuk, Dr. Stephanie Klam, Dr. Vicky Tagalakis, Dr. Maral Koolian and other JGH physicians.
“Previously, the family physician might see a patient who had no life-threatening symptoms, but could potentially be in a life-threatening situation,” says Dominic Labranche, Associate Director of Nursing for Ambulatory Services. “This meant that the patient could not be sent home and had to go to the Emergency Department. With the launch of the Clinical Access Service, those particular patients can now be seen with only a short delay that does not affect their safety.”
However, Suzette Chung, Head Nurse of the Medical Day Hospital, notes that if the family doctor believes an emergency is really occurring, the patient can and should still be sent to the Emergency Department.
The Clinical Access Service sees individuals on the day of their referral or early the next working day. It also arranges for them to be tested with ultrasound or other types of imaging, and to consult with an appropriate JGH specialist from Thrombosis, Obstetrics/Gynecology or Neurology.
Ms. Chung explains that the nurses in the clinic provide care by following a set of detailed instructions related to each of the three conditions. These guidelines help them determine, for example, whether the patient should be given a blood test, undergo imaging or be seen by a specialist.
“If the results of our tests are positive—for instance, if a deep vein thrombosis is detected—the patient is seen by the specialist. All of the the information is then sent back to the family doctor in a timely manner, so that she or he can keep track of the patient’s results.
Another logistical feature is that time slots for imaging and other tests have been negotiated with Radiology, the Vascular Lab and Neurophysiology, says Shoshana Breiner, a Care Counsellor Nurse. This means that someone who is referred to the Clinical Access Service is almost certain to receive the required test on the day of the referral or the day after the referral.
“What we have here is a new corridor and a new point of entry for rapid access, says Ms. Breiner, “but promptness doesn’t mean we sacrifice the human touch.
“The nurses meet with each patient to walk them through the process and make sure that everything happens in the right sequence and in a timely manner. That kind of individualized care and guidance is what patients need during their clinic visit.”