Ottawa patients continue to face longer than average emergency waits

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Ottawa residents wait longer than most people in Ontario for emergency care, according to recent provincial statistics.

Waits to see a physician and get treatment are above the provincial average at every hospital in the city.

At Queensway Carleton Hospital, patients are waiting twice as long as the provincial average for an initial assessment by a doctor, according to recent provincial statistics.

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On average, Ontario residents wait two hours in emergency departments before receiving initial assessments by physicians, according to Health Quality Ontario, the agency that monitors the province’s health operations.

But that is far from the whole story.

Overall stays in emergency are much longer. On average, non-emergency patients spend a total of 3.2 hours in the emergency department and high-urgency patients spend an average of 4.7 hours in emergency.

Patients waiting to be admitted to hospital are there for significantly longer: an average of 19.2 hours, and just 27 per cent of them within the provincial target of eight hours.

Those patients are frequently waiting in hallways or cubicles on stretchers meant for short-term use, something that leading Ontario geriatrician Dr. Samir Sinha compared to torture, especially for the elderly who make up a high number of patients waiting to be admitted to hospitals.

At the General campus of The Ottawa Hospital, CHEO and the Montfort, patients wait an average of 2.7 hours for initial assessments by physicians. At the Civic campus of TOH, patients wait 2.8 hours for initial assessment, on average.

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At Queensway Carleton, the average wait for an initial assessment is four hours, or double the provincial average. That is the third-longest wait time across Ontario.

The longest wait times in the province — as of the end of August — were at Hawkesbury and District General Hospital, east of Ottawa.

In other measures, Queensway Carleton Hospital fares better compared to other Ottawa hospitals.

It takes longer for high-urgency patients to get treated at The Ottawa Hospital and Montfort, for example, and QCH, at 18.3 hours, is below the provincial average of 19.2 hours for patients to get admitted to hospital from emergency. The waits are longer at other Ottawa hospitals.

Those waits drew the attention of Premier Doug Ford this past week. During a news conference, Ford partially blamed the problem on too many patients going to emergency departments for non-emergency issues.

“The emergency department is for emergencies, not little Johnny cutting his leg or so on and so forth,” Ford was quoted as saying. He also said emergency doctors he talked to estimated that 50 per cent of people shouldn’t be in the emergency department.

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His comment drew immediate pushback from physicians and doctors’ organizations, who said they misrepresented the problem by blaming it on patients and could discourage some from seeking the medical care they needed.

The Ontario Medical Association called on the province to focus on increasing access to doctors, not limiting it.

“Ontario’s emergency departments are there to provide care when it’s needed most, and patients should never feel discouraged from seeking help when and where they need it,” the OMA said in a statement.

Perth emergency physician Dr. Alan Drummond was co-author of a position statement from the Canadian Association of Emergency Physicians that found, among other things, emergency department overcrowding was largely due to lack of access to hospital beds.

“Contrary to popular perceptions, ED overcrowding is not caused by inappropriate use of emergency departments or by high numbers of lower acuity patients presenting to the ED; the inability of admitted patients to access in-patient beds from the ED is the most significant factor causing emergency department overcrowding in Canadian hospitals,” the statement said.

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On Saturday, Drummond said It was frustrating to hear Ford focus blame patients after years of research that had shown hospital capacity was the main driver of crowded emergency departments, not patient overuse.

“There has been a lot of work internationally and in Ontario looking at the issue of crowding and it has been largely disproven,” Drummond said. “It is sad to see governments continue to focus on the myths and put all of their efforts into trying to blame and shame patients. Until we get our heads around the fact that we need to reduce hospital capacity to a safe occupancy level of 85 per cent, we will continue to deal with this.”

Ontario has the second-lowest rate of hospital beds per population in Canada.

Emergency department officials at Queensway Carleton acknowledged this past week that patients were waiting too long for care and said they were working on improving efficiency in the busy department to help reduce those wait times.

“There are many factors that cause our wait times to be long, too many to count,” said Dr. Adam Nicholson, chief and medical director of emergency services at the hospital. “In the end, unfortunately, our patients are waiting too long to be seen, they are the ones to suffer.”

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They urged patients to continue to come to the hospital when they needed to and emphasized that the sickest patients would get seen first.

“We understand how frustrating it can be for our patients and families,” said Paula Archambault, the hospital’s clinical director of critical care, emergency and mental health.

Archambault added: “If a patient feels they need to come to the emergency, they should come. We take their concerns seriously and are proud of Queensway Carleton Hospital and how much patient satisfaction we have recorded. It is a huge point of pride and we don’t want to see that change.”

She said the hospital had launched a project to significantly reduce the amount of time patients waited to be admitted to in-patient beds. That wait time has improved by 7.7 hours over last year, Archambault said.

The hospital is also working on projects to improve the amount of time until patients have initial assessments by changing the way patients flow through the emergency department.

Queensway Carleton has also seen a recent spike in the complexity and acuity of patients.

“Certainly that is a factor in the wait times,” Nicholson said. “When patients are more complex, it takes longer.”

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