Sometimes what brings a person to the Emergency Department (ED) isn’t an emergency at all.
Sometimes it’s a person in need of a prescription refill but with no family physician to write the script, or someone scared and confused with dementia, but with no family to help. And sometimes, those patients come back to the emergency department time and time again with non-emergency medical concerns.
That’s why Niagara Health (NH) has created the Familiar Faces program. It is for patients who frequently visit the ED, most commonly with medical concerns better suited to other forms of healthcare.
“We want to give the right care, to the right person, at the right time, and to provide excellence in care,” says Dr. Shira Brown, Familiar Faces Program Chair and the Physician Lead for the new South Niagara Hospital project.
Familiar Faces is a patient-focused program designed to reduce ED wait times by focusing on returning patients. Staff use technology to track the top 200 patients most frequently visiting EDs. Identifying those patients allows NH staff and physicians to search for a current, or create a new, care plan for the patient.
The program is so pioneering that it has received recognition from the national Health Standards Organization and Accreditation Canada. It has been named a Leading Practice for its innovative and people-focused practices leading to a positive change related to safe, reliable, accessible and integrated care.
“The project team has been working on this initiative since 2021 and has done a fantastic job of designing and supporting the program,” says Debby Schaubel, Senior Project Manager, ePMO, Strategy and Communications.
NH emergency departments have seen more than 185,000 patient visits in the past year. In 2022, 3,700 of those patients visited an ED more than five times, representing approximately 25,000 patient visits.
“There are people frequently returning to our emergency departments who are not in an emergency situation,” says Schaubel. “Do they need care? Absolutely, that's undeniable. But some of these repeat patients have complex care requirements that the emergency department is simply not equipped to deal with.”
The goal of Familiar Faces since it began last fall is to enhance a person’s overall healthcare experience by collaborating with existing community service partners to assist with complex care needs. That includes community care resources such as primary care partners, community care clinics, and chronic disease management programs. There is significant evidence that this case-management approach, involving social workers within the ED, is most effective with this patient population.
“They tend to have different types of needs than a patient who comes in once a year to the emergency department,” says Dr. Brown. “We want to find a way to ensure those patients are getting continuity of care and the type of community-based care that would serve them better, while also alleviating some of the pressures from the emergency department.”
Moving forward, Schaubel says she’s hopeful the program will grow as it works to lighten the load of the emergency department physicians and nurses, ease wait times, and provide a holistic approach of care to Niagara’s patients with complex care needs.
“I hope everyone who has invested their time and energy in this patient-centered program can enjoy the wonderful external validation of the hard work we are doing every day,” she says.
In photo from left to right: Social Workers Breanna Elliotson, Diane Thompson, Andrea DiToro