Len's News, Notes, and Stuff

A Good System Sees Quickly & Talks Fast

Kingston is a leader. The City of Kingston, and the KFLA Public Health Unit have a system that sees quickly, talks fast, and heads off health problems faster than anyone else in Ontario. I’ve been dealing with flu assessment centres in Ontario these past few weeks, and Kingston was a leader all the way through.

When the pandemic H1N1 (pH1N1) virus and public awareness came front and center, the health system was inundated and overloaded. Primary care and hospitals saw people rushing to them like they do Walmart on Black Friday in the United States. Thankfully nobody was trampled, but the system took time to respond. It took time to set up flu assessment centers to take some of the surge in demand off the emergency departments and local doctors’ offices.

The question when a fire starts in your kitchen is not so much “will it be put out?” Of course it will be – either by you early on, or by the fire department after half your house has been scorched like a butter-coated marshmallow held over an industrial furnace. The really important question is “when will it be put out?”

So it is with health emergencies. Of course things will return to normal. Eventually. The question is when, and after how much cost and damage. Sooner is better than later – better for the system, better for the public, better for the taxpayer, and like it or not, better for politicians too.

I learned today that Kingston has something called the Syndromic Surveillance System. They see a spike in respiratory cases in the local Emergency Departments, or a spike in gastointestinal cases. Even before confirmed lab results come in, before the Province itself knows, they see patterns developing across the Kingston area.

They saw flu assessment demand go up before anyone else did. That’s why they set up and activated their flu assessment centres before anyone else did. In fact, they’ve peaked, gone back to normal, and have shut down their assessment centres even as other regions are still playing catchup and only now setting up their assessment centres.

Kingston came, saw, conquered, and left the playing field before the others even stepped onto the field.

And it wasn’t a one-time fluke. They did this with an E.coli outbreak some time ago too. They saw something happening, and like Bruce Lee, responded with lightning fast reflexes. They may even have made funny sounds and have had subtitles while doing so, I don’t know.

How do they do this? The see things quickly *and* they talk fast. Thanks to the Syndromic Surveillance System – which is a system of observation, reporting, and communication, not some technology package you can buy – they see patterns across hospitals and communicate ASAP with the local public health unit. They see what’s happening, and involve the people with the authority and pursestrings to develop an area-wide response.

You and I see things as individuals, yes. Unless you’re wearing superdark sunglasses at night and are listening to your iPod. But usually we see things. That’s kinda cool, but it’s not enough.

The system itself has to see. Not just one or two people. Not even a whole department. Emergency departments at hospitals have said, “We’ve been going nuts handling people with flu-like symptoms for 2 weeks before you guys even mentioned starting up assessment centres.” Well, why didn’t that message make it out beyond their walls?

You gotta see quickly, *and* you gotta talk fast. Seeing without talking quickly to the people who can do something for you is worth about as much as subtitles to an illiterate audience.

Think about the systems around you. Think about the systems you’re part of. Yeah, that includes your family and friends. How fast does the system see new developments? How quickly does one part of the system talk to another?

Think about it and do something about it before that fire starts in your kitchen, that emergency happens in your community, or that unspeakable horror called a Paris Hilton appearance happens.

I’ll bet dollars to donuts that Kingston would respond before Paris Hilton got within 250km of the city.