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Urgent care gets boost

Casey Lessard
Northern News Services
Published Monday, February 6, 2012

Iqalummiut who have wasted hours in emergency for something that should take five minutes will be - and are, it seems - happy about the new rapid-access clinic at Qikiqtani General Hospital.

NNSL photo/graphic

Dr. Alison McCallum, the main physician in a pilot project rapid-access clinic at Iqaluit's Qikiqtani General Hospital, stages a mock examination with clerk-interpreter Maggie Ukaliannuk Feb. 2. - Casey Lessard/NNSL photo

"Your day-to-day illness is perfect for this clinic," said Dr. Alison McCallum, chief of outpatient services, suggesting it is ideal for prescription refills and to see if a sore throat is serious. "It's like a walk-in clinic in the south with a few more bells and whistles to fit the needs of patients here, such as two examination rooms, nursing care and assessment, and a translator available at the point of care."

The pilot project, funded by $100,000 from the federal Territorial Health Access Fund, started in early December in response to complaints that non-emergency cases were overwhelming the emergency department. Prior to the new clinic, non-emergency cases could only be seen by the limited number of same-day appointments or by appointment booked at the end of each month.

"There were six or seven same-day appointments available and I'd come in at 8:30 a.m., and it was like a third-world country," McCallum said. "You'd see people lined up outside waiting for the wicket to open so they could book an appointment for that day. It was crazy."

Faced with no other option, patients would go to the emergency department, where they would be considered low-priority and forced to wait for hours.

"People would sit in (emergency) sometimes for eight hours just to get a prescription for their birth-control pill, or something like that, refilled," she said. "I was saying there was no need for this. All we need is a rapid-access clinic and allow doctors to see a new patient every 10 minutes. They said it wasn't possible, but I did it all my life in Nova Scotia; I saw one every six minutes."

So far, the new system is working like a charm.

"You can go to (emergency), or come in at 8:30 a.m. and line up," said Darlene McPherson, director of clinical services. "The first six clients are given a number and told to sit down. The next six are given a number and told to come back the hour later. We see six an hour."

To maximize the time a patient has with the doctor, a licensed practical nurse takes each patient to one of two examining rooms and does a pre-screen before McCallum - for now, the trial's only physician - arrives.

"When the doc walks in, she just sees you for the problem," McPherson said. "They're seeing about 30 per day, so that takes 30 people out of the emergency department and gives 30 people an appointment they otherwise wouldn't get. You can come in in the morning and be seen."

The new system has greatly improved the mood of patients seeking care, said clerk-interpreter Maggie Ukaliannuk.

"It was very stressful before," she said. "The mood has changed. People are happier."

Each patient fills in a survey after they leave, and the results have been unanimously positive, she said. The clinic's funding needs to be renewed at the end of March, but so far the costs have been minimal. A second doctor is expected to be brought into rotation later this month, and the overwhelming success bodes well for the clinic's future.

"(Patients) all like the fact they can see a physician promptly and there's not too much of a waiting list. "This is a trial period, but I can't picture it going back," McCallum said.

The clinic is open in the hospital's old wing Monday to Friday from 8:30 a.m. to 5 p.m. One should still go to the emergency department if they need emergency care, have chest pain, or need stitches, X-rays, an electrocardiogram or blood tests. Those needing a narcotic prescription refill should see the prescribing doctor.

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