A 2025 study by the C.D. Howe Institute found that Newfoundland and Labrador is among the worst in Canada in terms of access to health care. 

The shortage of family doctors in the province means a hospital is the only place many communities can receive medical care, which causes congestion and excessive wait times in emergency rooms.

That’s why Carbonear General Hospital worked to find a practical solution — and cut its wait times by 60 per cent.

Achieved results even though patient volume increased

Memorial University’s Dr. Christopher Patey was working at the hospital as the emergency room's clinical chief when he partnered with registered nurse Paul Norman to see if they could improve patient flow and mitigate patient surges that were overwhelming their ER.

What started as co-written sticky notes on a wall evolved into an efficient emergency room process they dubbed “SurgeCon,” so named by merging the phrases “patient surge” and “DEFCON.”

Between the years 2013 and 2017, Dr. Patey and Mr. Norman worked with staff to enact their SurgeCon protocols.

The results were extraordinary:

• The average wait times in Carbonear’s ER dropped from 104 minutes to 42 minutes (59.6 per cent)
• The total length of stay decreased by 65 minutes
• The number of patients who left without being seen went from 12.1 per cent to 4.6 per cent
• The results were achieved despite an overall 25 per cent increase in patient volume during SurgeCon's timeframe test

"Every minute SurgeCon gives back to hospital staff improves the quality of care we can give our patients,” said Dr. Patey. “We were able to treat patients sooner, but also better. By improving their experience in our ER, they’re more likely to seek medical attention as needed, which improves their long-term health.”

To use the SurgeCon software, emergency room staff enter data such as current patient numbers and available staff.

The software identifies which of five different surge levels the ER is experiencing.

When the emergency room moves from one surge level to the next, the program notifies key personnel and assigns them tasks to maintain order and quality of care.

Scaling up and across the country 

Having proved that the SurgeCon pilot project worked in Carbonear, Dr. Patey and his team subsequently received $5 million from the Canadian Institutes of Health Research and then collaborated with MOBIA Technology Innovations to improve SurgeCon protocols and software and to test it in four other hospitals.

While the COVID-19 pandemic and Eastern Health (now NL Health) cyber-attack interfered with its local implementation, SurgeCon is now surging on with great success.

“We continue to conduct our emergency flow training across the country and globally," Dr. Patey said. "We have reviewed and provided training to emergency departments in Nova Scotia, Alberta, PEI, B.C. and New Brunswick. Globally, we’ve worked with hospitals in South Africa, Switzerland and the United States and we continue to field inquiries from around the globe.”

As technology and AI improves, so will SurgeCon, he says.

“Our team continues to iterate the eHealth dashboard and we have a team working on the use of AI and integration into larger electronic medical record systems. There have been great changes in the IT environment since we began with SurgeCon. We are hoping to join that wave with SurgeCon 3.0.”

SurgeCon has become a signature example of the work being done by Memorial University’s Centre for Rural Health Studies in the Faculty of Medicine.

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Dr. Patey and Mr. Norman are available for interviews. To arrange a time or for more information, please contact Kelly Foss, communications advisor, Faculty of Medicine, at 709-864-6358 or kfoss@mun.ca