ER Wait Times – do you know what it is?

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“Woman dies in emergency waiting room.” – CBC News, Oct 11 2002

“We warned of ER deaths.” – The Vancouver Sun, Apr 27 2006

“Another death in … hospital waiting room.” – Winnipeg Free Press, Sept 26 2008

These are the headlines that the public is constantly bombarded with over the years with regards to ER wait times. If I didn’t know any better, I’d think that the emergency waiting room is the deadliest place on earth.

It is certainly tragic when we hear of these cases where the patients who needed emergent medical attention the most, were unable to get prompt access due to overcrowding. Some might say though, that these cases are far and wide between … or are they?

There is an increasing amount of published literature to suggest that patient morbidity and mortality are closely associated with hospital crowding. It is no surprise then, with such tremendous media attention, that the government has been trying desperately to tackle this issue – in Ontario, this has mainly taken the form of the Wait Times Strategy.

If you spend any amount of time to actually examine the various debates and discussions on the topic, you might quickly realize that “ER wait times” is a behemoth of a problem, with contributions from practically all corners of the healthcare system. This is why the host of “solutions” that have been proposed ranges from increasing primary care access, to expanding the number of community nursing home beds. Each individual suggestion may make sense from any one perspective – however the number of perspectives inevitably becomes overwhelming. Perhaps we should try and cut the issue down into more manageable chunks, and prioritize which to address first?

You see, the problem of wait times is different to different people. The 84-year old with a debilitating arthritic knee wants a shorter wait time for elective knee surgery so she can resume her independent living. The 28-year female in her first trimester of pregnancy suffering from new abdominal cramps and spotting wants a shorter wait time to find out if she is having a miscarriage. The family of a 89-year old male with severe dementia having fevers and hypoxia for several days, wants a shorter wait time to see an ER physician so antibiotics and resuscitation can begin as soon as possible.

This comment by Dr. Alan Drummond of the Canadian Medical Association tries to highlight the fact that not all wait times are equal – and that we should tackle the most serious and life-threatening ones first. Those patients with relatively minor and non-life threatening ailments may just have to wait longer, while we shift resources to help those who really need emergent care. Unfortunately, the public doesn’t always see that – each patient presents to the ER with a medical problem that he/she feels is an “emergency” to them, and their only measure of wait times is how long it takes to see a physician.

What does the problem of ER wait times mean to you?

Edmund Kwok

Edmund Kwok

Emergency Medicine. Quality Improvement. Patient Safety. Change Management. Healthcare Administration.

Frontdoor 2 Healthcare

Frontdoor2Healthcare, founded by Dr. Edmund Kwok in 2012, provides editorial and commentary on issues affecting Canadian healthcare from the emergency department’s “front door” perspective. Frontdoor posts allow for open sharing of the diverse opinions and perspectives of emergency physicians from across the country.

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