We are requesting your feedback on the results of the following study conducted in St. John’s, NL. The research team is particularly looking to hear from fee-for-service family physicians practicing full time in the St. John’s metro region.

Determinants Of Potentially Preventable Emergency Department Utilization – With A Focus On Family Physician Work Hours – By Adult Patients In St. John’s, Newfoundland & Labrador
[Jerome Siromani PhD(C), Brendan Barrett MD, Marshall Godwin MD, Holly Etchegary PhD, John Knight PhD, Zhiwei Gao PhD, Kris Aubrey-Bassler MD]

Wait-times in Emergency Departments in Newfoundland & Labrador are the second highest compared to the other provinces in Canada, with an approximately 39% likelihood that someone waits 4+ hours in an Emergency Department in this province before receiving any care.

One of the main reasons for long wait-times in Emergency Departments is overcrowding, which often occurs when patients who do not actually need emergency care present at an Emergency Department and which can then lead to resources being stretched and to adverse patient outcomes (note: about 60% of all patients who present at Emergency Departments in Canada have been shown to not need any emergency care or hospitalization).

In Newfoundland & Labrador (including the St. John’s Metro region), there are very few primary care options for patients outside of normal working hours (9 AM to 5 PM, Monday to Friday), which leaves Emergency Departments as the only options of care for most patients outside of normal working hours.

Objective:

To describe (within the Fiscal Year 2011 – Fiscal Year 2014 timeframe) the relationship between after-hours care provisions by Family Physicians who were practicing full-time in St. John’s and non-urgent (as per the Canadian Triage and Acuity Scale) Emergency Department visits made by adult patients from St. John’s who were patients of those Family Physicians.

Please click here to review the methods and key results of the study.

Conclusions:

  1. The model of care being followed by the Memorial University-affiliated Academic Family Physicians (which includes a medical resident being on-call at all times to provide telephonic advice and perform telephonic triage) appears to help reduce the numbers of non-urgent Emergency Department patient visits; so, this model of care could be explored further.
  2. The after-hours care provided by Fee-For-Service Family Physicians does not appear to make a difference, in terms of the non-urgent Emergency Department visits made by patients of said physicians; so, the reasons behind this finding should be better understood.
  3. Encouraging every individual to see just one Family Physician on a regular basis (whenever primary care is required) appears to be a worthwhile endeavor, in terms of preventing non-urgent Emergency Department patient visits.

Your Feedback:

Researchers would like to hear your feedback on the results presented above as it pertains to your family medicine practice in the St. John’s area. Specifically:

  1. Why do you think that the after-hours care provided by Fee-For-Service Family Physicians in St. John’s did not appear to impact the numbers of non-urgent Emergency Department visits by the patients of said physicians?
  2. Do you have any thoughts on why the Academic Physicians’ model of care appears to be making a positive impact, in terms of non-urgent Emergency Department visits by patients?
  3. Do you have any thoughts on the strengths and weaknesses of this particular study?

Click Here to Answer Questions