Tuesday, June 19, 2012

Look at those times

Ontario ER patients waiting too long for hospital beds, says report



OTTAWA—A national report card on how long Canadians wait for medical treatment gave Ontario hospitals a failing grade for taking too long to move patients out of the emergency room and into beds.
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Ontario and Alberta are the only two provinces that publish how long it takes for a patient to move through the emergency department at any given hospital, from the moment they register to the moment they get admitted or go home.

A report card from the Wait Time Alliance — a coalition of national physician groups — issued on Tuesday shows Ontario is failing to meet its own wait-time benchmarks for getting people into beds.

The targeted wait time limits are from four to eight hours, depending on the level of distress the patient is in.

The average Ontario hospital misses the deadline for more than half of emergency department visitors who ultimately end up being admitted, which garnered the province an “F” grade for patients needing various degrees of urgent and non-urgent care.

“Clearly it takes a lot of bravery to report on these things, especially when you’re not doing very well, and we’ve always tipped the hat to Ontario for at least having an ‘F’ in those categories instead of a question mark,” said Dr. Chris Simpson, chair of the Wait Time Alliance and a cardiologist in Kingston, Ont.

Ontario did slightly better for patients requiring resuscitation, getting a “D” mark for moving between 50 and 59 per cent of them into beds within the 8-hour wait-time benchmark.

Ontario received straight “As” for emergency room visits that result in the patient being discharged, meaning 80 per cent or more of them are treated and released within the benchmarks.

A Toronto Star analysis shows that patients wait longest for a bed at Credit Valley Hospital at Eglinton Ave. W. and Erin Mills Pkwy., in Mississauga, which merged last year with the Trillium Health Centre and became The Credit Valley Hospital and Trillium Health Centre.

According to provincial health ministry data for January to March of this year, the average time patients had to wait for a bed after arriving at the emergency room was 34.4 hours.

Hospital officials say those numbers have improved over the past two months, with the average stay in the emergency room for an admitted patient down to 21.5 hours in May — a 38-per-cent shorter wait.

“That was probably a direct benefit of the merger,” Patti Cochrane, vice-president of patient services, quality and practice at the Trillium site said in an interview Tuesday.

Ontario Health Minister Deb Matthews said the provincial government is committed to increasing investments in home care and community services by an average of 4 per cent annually over the next three years, while denying increases to physician compensation and hospital-based budgets.

The goal is to keep seniors and others who really belong in long-term care facilities or at home with appropriate support services from taking up much needed space in expensive acute-care hospital beds.

“As we free up beds in the hospital by getting (those) patients the care they need outside of hospital, we’re starting to see a smoother flow through the emergency department,” Matthews said in an interview Tuesday.

The Ontario Medical Association, which represents some 25,000 doctors in the province, is currently fighting Matthews and the provincial Liberal government over its decision to impose $340 million in fee cuts in the middle of contract talks last month.

Members of that provincial body are also members of the Canadian Medical Association, which is one of the groups that make up the Wait Time Alliance.

Simpson does not see a link between the issue of physician compensation and more efficient emergency departments.

“Whenever we focus on the patient experience and on quality, the economics look after themselves,” said Simpson.

Data analysis by Andrew Bailey

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