Improving Access to Equitable Care for Patients Living with Sickle Cell Disease in the Emergency Department

Vaso-occlusive episodes (VOE) are the most common reason for emergency department (ED) visits by patients with sickle cell disease (SCD). Despite guidelines recommending opioid administration within 30 minutes of triage, Toronto General Hospital ED's median time to opioids in 2023 was 101 minutes, with only 8.8 per cent of VOE patients receiving timely care. Interventions including workflow standardization, sublingual fentanyl adoption, and staff education increased timely opioid administration to 42.9 per cent, halving median time to 40 minutes, with no adverse safety events.