Ontario emergency departments under pressure


A hospital in Ottawa has recorded the longest emergency department wait times in the province for a third year in a row, according to an analysis of national health data.

In 2016, ten per cent of patients at Montfort Hospital’s emergency department would wait an average of nearly six hours before being assessed by a physician, almost twice as a long as the provincial average of three hours.

“We know we need to do better,” spokesperson Geneviéve Picard wrote in a statement.

Picard said the hospital, located along Montreal Rd. just east of Vanier, has made changes to ensure patients are seen quicker. The changes include hiring more nurses and adding physician hours to the emergency department.

The analysis looked at health data collected by the Canadian Institute for Health Information (CIHI) up to 2016.

A lack of available hospital beds has been putting “significant” pressure on emergency departments across the province, according to Dr. Paul Pageau, an emergency department physician at the Ottawa Civic Hospital and the President of the Canadian Association for Emergency Physicians.

Patients who are waiting to get transferred to long-term or community care facilities are often placed in emergency departments until those spaces become available, he said.

“To start off a morning where more than half of your available beds to see patients are occupied by non-emergency patients,” he said, “that’s going to delay that initial physician assessment.”

Ontario has cut the number of hospital beds by 18,000 since 1990 and has just 2.3 beds per 100,000 people, according to data collected by the Ontario Health Coalition. That’s one bed less than the national average.

Hundreds of hospital staff from across the province descended on the grounds of Montfort Hospital at the end of October calling on the government to end cuts and create 3,000 permanent hospital beds. Days before the protest, Health Minister Eric Hoskins had announced the province would make 2,000 beds available within the year.

The time it takes to see an emergency department phyisician is only one part of what CIHI Analyst Nicole Loreti calls a “complex issue”.

A report from the institute found the length of stay for emergency department visits is up by 17 per cent across the country compared to 5 years ago. In the past year, one in ten emergency department visits lasted longer than 32 hours.

“If they see a doctor quickly and then still have to wait for 33 hours to get into a bed, from the patient perspective that’s what they’ll remember,” Loreti said.

She also noted that while patients at Montfort might wait longer to see a doctor in the emergency department, their total length of stay is shorter than national and provincial averages. One in ten patients would be in the department for longer than 21 hours, according to the most recent data.

A lack of available beds has contributed to what the Ontario Hospital Association calls a “crisis” of overcrowding. Nearly half the province’s hospitals exceed 100 per cent capacity, with some as high as 140 per cent.

Ontario’s Auditor General report noted that, in some cases, patients were being kept on uncomfortable stretchers or gurneys in hallways never intended for care.

A lack of available hospital beds has been putting “significant” pressure on emergency departments across the province, said Dr. Paul Pageau, physician at Ottawa Civic Hospital. Source: Jordan Omstead.

“I can’t remember the last time we were under 100 per cent capacity,” Pageau said in a cafe at the civic hospital, as nurses and doctors on their morning break filed in and out of line for coffee.

“We all got into emergency medicine to help people,” he said, “but it can beat you down after fighting for things for so long.”

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