Patients stalled in HSC’s ER part of national crisis, Canadian Medical Association says

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This article was published 12/07/2022 (799 days ago), so information in it may no longer be current.

Patients sick enough to be admitted to hospital are waiting much longer in Manitoba’s largest ER than they were before the pandemic.

The Canadian Medical Association says the problem of patients being stalled in emergency rooms is a national crisis.

In May, the time it took for patients to be moved out of the Health Sciences Centre ER after they’d been assessed as needing a hospital bed was double the time it took in May 2019, according to median figures provided by Shared Health.

The median wait times at HSC’s adult emergency department worsened, while the wait appeared to improve slightly in the children’s ER. It took a median time of 6.83 hours after a decision was made to admit an adult ER patient to hospital for that patient to be moved to an in-patient unit. In May 2019, the median time was 3.58 hours.

In the children’s ER, young patients waited a median time of 2.86 hours for admission, compared with 3.05 hours in May 2019. Median times reflect the midpoint of the wait. The figures mean half of patients waited longer and half of patients waited less time.

The longer wait times are concerning but not unique, a Shared Health spokesperson said.

“Continuing patient-flow issues are causing longer wait times in emergency departments and urgent-care centres — not just for those waiting to be seen but also for those waiting for admission to an in-patient unit. These issues have been well-documented across the country and are not unique to this jurisdiction.”

Admitted patients taking up ER beds and relying on the care of ER nurses is the “crux” of patient-flow problems in the ER, which lead to longer waits for everyone, said Canadian Medical Association President Dr. Katharine Smart. Ideally, patients should be moved out of ERs in no more than three or four hours. But across Canada, the reality is far off that target.

“More and more, that number is being measured in days, not hours,” Smart said.

A dearth of data exists on per capita patient-flow figures, but Smart said the association hears from members that the same thing is happening in every province and territory.

“It’s having really substantial impacts on emergency departments’ ability to function, to keep seeing patients, and that’s partly why we’re seeing these really astronomical wait times for people to be assessed in (emergency). So it’s quite bleak,” she said.

Every hospital has been hit by staff shortages, and long-standing under-resourcing has only worsened during the pandemic. Last-resort moves such as temporarily closing ERs are now happening not only in remote parts of the country, but in urban centres.

“There’s not one place that I’m aware of where people aren’t really, deeply concerned about what’s going on. It’s literally every single place,” Smart said.

“We know that the rural and regional piece has always been challenging, but now we’re even starting to see these issues happening in big cities — major hospitals.”

The association is advocating at the national level for leaders to abandon political platitudes that are only aimed at assuring the public the health-care system will be there for them when they need it. That’s not true anymore, she said, suggesting political will is required to address root causes of burnout, moral injury and nurse exodus from the health-care system.

“The biggest challenge that we’re having is, I don’t think we’re seeing a recognition from any level of government about how dangerous the situation is or how in peril the health-care system is,” Smart said. “And I think the first step to solving this problem is for people to admit that there is a problem, and that it’s a problem we all collectively own.

“I think we should be scared, because the bottom line is there are going to be people that are harmed and lose their life because of this, and that’s already happening.”

At HSC, leaders asked for staff feedback and physician working groups were tasked with finding solutions to the patient-flow problems. Hospital CEO Shawn Young has said they are trying to make improvements at ERs, urgent-care centres and other health-care programs in Manitoba, along with Shared Health and WRHA, according to a Shared Health news release issued at the end of June.

They promised to create a staffing pool of nurses with previous ER experience, allow for nurses’ self-scheduling, hold daily huddles and better orientation for new nurses, as well as bolster home-care staffing on weekends to better support patients.

katie.may@winnipegfreepress.com