HSC 10-hour wait time symptom of system in distress

Opinion

Hey there, time traveller!
This article was published 31/03/2022 (1000 days ago), so information in it may no longer be current.

Emergency room wait times at Manitoba’s largest hospital have hit double digits for the first time since health authorities began publishing the monthly statistics.

At Health Sciences Centre, the longest wait times for nine out of 10 patients seeking medical care hit 10 hours for the month of February — the highest since 2017, when the Winnipeg Regional Health Authority started posting such ER data. That’s up from 6.62 hours in January.

At St. Boniface Hospital, the February time was 7.63 hours, up from 7.55 in January.

It’s further evidence that as hospital staff — hundreds of whom were redeployed during the pandemic to treat COVID-19 patients — return to their regular jobs in areas such as surgery, medical wards are struggling more than ever to keep up with the influx of admitted patients.

The bulk of ER overcrowding occurs when demand for medical beds outstrips supply. When hospitals can’t accommodate the number of newly admitted patients, the system backs up in ERs.

Admitted patients — those sick or injured enough to require a hospital bed — often wait days in gurneys for space to open up on medical wards. The more admitted patients there are piled up in emergency wards, the longer it takes for busy ER doctors and nurses to see new patients.

It’s an age-old problem but it’s one that has worsened after the province consolidated acute care hospitals in Winnipeg between 2017 and 2019, including closing three ERs.

The longest wait time at all Winnipeg ERs and urgent care centres in February for nine out of 10 patients (called the 90th percentile wait time) was 6.87 hours — up from 6.62 hours in January.

Wait times are far longer than they were prior to consolidation. In October 2017, when the first phase of the hospital reform plan was implemented, that number was 3.9 hours.

The wait times measure how long it takes for a patient to see a doctor or nurse practitioner after registering at the triage desk.

The median wait time for all ERs and urgent care centres in Winnipeg was 2.18 hours in February. In October 2017, it was 1.35.

It’s not surprising a recent Probe Research poll found two-thirds of Manitobans believe hospitals are in worse shape since the Progressive Conservative government consolidated acute care services from six hospitals to three.

The promise of faster care and “the right care at the right time” promised under the consolidation plan has not worked. Patient flow through hospitals has not improved.

The most important gauge of that is the health of emergency departments, which become overflow stations for admitted patients when medical wards are full. That’s what hallway medicine is — and it’s getting worse.

It’s probably why the WRHA and the province no longer provide the public with regular updates on the progress of consolidation, as they did during the early years of implementation. The news isn’t good.

Emergency department overcrowding is not caused by low-acuity patients showing up at ERs when they could be treated elsewhere (like walk-in clinics). That’s a myth.

Study after study across Canada have shown long ER wait times are caused primarily by a lack of availability of hospital beds on medical wards. When hospitals are overcrowded, ERs are overcrowded. Most hospitals in Winnipeg operate with little to no surge capacity and can’t handle large influxes of new patients, even when surgical and other beds are used temporarily to accommodate medical patients.

It’s an inflexible, under-staffed and poorly resourced system.

The bad news is the situation could get worse if COVID-19 hospitalizations increase again, as they have in recent weeks in other provinces. Health officials in Manitoba have said they expect a rise in infections and hospitalizations after all public health measures, including mask use, were lifted March 15.

Now that Health Minister Audrey Gordon has approved a near-complete blackout of pandemic information, including the number of COVID-19 patients in hospital, the only way the public may be able to gauge whether conditions worsen again is through ER wait times.

It’s one of the few metrics left still made public.

tom.brodbeck@freepress.mb.ca