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The Challenge:

The pandemic has had detrimental effects on the population of people who use substances and has caused an increased and more dangerous substance use pattern. This, coupled with the existing opiate epidemic, resulted in a 6 month increase of 153% substance related visits to the emergency department (ED). The Thunder Bay Regional Health Sciences Centre (TBRHSC) had reduced their ED capacity by 40% as a pandemic response measure, forcing the immediate need to divert and support addictions care to community withdrawal management services.

The Solution:

St. John's Care Group (SJCG) and TBRHSC have secured 4 beds (overall increase of 3 beds) to facilitate more rapid response and transition to Balmoral Centre to offload the ED.

  • Stronger working relationships between crisis areas of both organizations and an increased understanding of
    the pressures to unilaterally respond effectively to ongoing opiate crisis and global pandemic.
  • Expansion of community withdrawal management beds ensures more timely access while strengthening service coordination via direct referral by the Emergency Medical Services (EMS), Thunder Bay Police Department (TBPD) and ED.
  • 6-month financial commitment to support an additional Registered Practical Nurse and Security
  • Costs for community withdrawal management is approximately $177.00/day versus the cost per ED visit for those presenting with substance use needs is $342.
  • On average 36 admissions per month using the defined pathways to designated beds.
  • Builds upon current multi-sectoral community initiatives, including enhanced pathways to RAAM Clinics and other integrated addictions services

The Process:

  1. Canadian Triage and Acuity Scale (CTAS) 4&5 substance-related visit in ED
  2. Communication for bed availability for potential transfer
  3. Liaise with receiving nurse regarding care, complete transfer documentation
  4. Confirm time and method for transfer
  5. Transfer the client with belongings and medications

For more information on Community Pathways, please contact: Nancy Black,

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