Rapid Assessment Zone reduces emergency department wait times at Aberdeen Hospital

The Rapid Assessment Zone (RAZ) at Aberdeen Hospital in New Glasgow is reducing patient wait times and improving emergency department (ED) flow. Stacy MacDonald, the emergency department’s first nurse practitioner, leads this initiative.

MacDonald's expertise and 27 years of emergency and transport nursing experience are pivotal to the success of the RAZ.

“It’s amazing to see the huge decrease in the number of patients who leave without being seen. This means patients get the care they need faster and allows me to diagnose serious conditions that may otherwise have gone undetected,” said MacDonald.

Since the RAZ’s launch in May, 31 per cent of emergency patients use this pathway on days the RAZ is open, with an average of 2.5 patients seen per hour.

The RAZ operates as a designated area within the emergency department for patients with less critical conditions, allowing physicians to focus on more severely ill patients. MacDonald’s role in the RAZ is multifaceted; she performs a variety of procedures, including casting and suturing.

Continuity of care is another significant benefit of the RAZ. “I can bring patients back in a couple of days for a re-check. This is the same for ED physicians; if they see a patient who needs a follow-up, they send them to me in a few days for a reassessment. This is planned, so they don’t have to wait again,” said MacDonald. She also coordinates with the Ambulatory Treatment Clinic (ATC) upstairs for ED patients needing IV antibiotics and wound care. “Instead of having them re-register, move floors and wait again, I coordinate with the ATC group. This not only improves their care and healing but also reduces repeat visits,” she said.

Living in Pictou, MacDonald feels a strong connection to the community and is committed to addressing local healthcare needs. “We don’t have as many walk-in clinics, and many patients don’t have a primary care provider. The RAZ helps bridge that gap,” she said. “The community is happy because they're able to see a provider. We often hear that they are loving the way things flow now, and they feel wait times are much better.”

Collaboration is key to the success of the RAZ. She works closely with licensed practical nurse Candace Brown to ensure a smooth flow of patients. "Candace and I work as a team. We both don’t like to sit still and love the fast pace," said MacDonald.

MacDonald’s integration into the team has been smooth, thanks to strong support from physicians and leadership. “I’m grateful for the continuous support and the ‘What do you need?’ mentality from our leadership,” she said. “This is where I’m meant to be and am grateful for this opportunity.”

Lisa MacDonald is Chair of the Aberdeen Health Foundation, which provided funding for the setup of the dedicated space and equipment for the RAZ. “The RAZ represents a true enhancement to patient care in Pictou County and fits the bill for the types of initiatives the Aberdeen Health Foundation is keen to get behind,” she said. “It’s incredibly pleasing to see an investment have an instant positive impact on patient access in the ED, and we imagine this boosts staff morale too.”

The site looks forward to continued improvements and the positive impact on the community. “We’re already seeing great results, and plans are underway to expand to a seven-day-a-week model,” said Jennifer Sutherland, site lead, Aberdeen Hospital. “I’m proud of the teamwork among our staff and physicians, and the positive feedback from the community truly reflects their efforts and dedication. A heartfelt thank you to the Aberdeen Health Foundation for making this important space possible.”

As part of the Emergency Care Plan announced in January 2023, the Rapid Assessment Zone (RAZ) model has been implemented in six emergency departments across the province, transforming the delivery of emergency care in Nova Scotia. 

Photo of RAZ team members Stacey MacDonald, nurse practitioner and Candace Brown, licensed practical nurse.