The Canadian Association of Emergency Physicians (CAEP) has released a position paper listing recommended national wait-time benchmarks for various stages of an emergency department visit. It also says hospital wait times for these benchmarks should be reported on a national basis, and performance linked to incentives and infrastructure investment.
The CAEP says the problem of ED overcrowding is getting worse despite efforts to deal with the situation and calls the situation a “public health crisis.” The position paper cites a number of international studies which indicate that patients run an increased risk of dying if they turn up at ED when it cannot cope with the traffic.
The CAEP wants 90 per cent of ED patients to have an initial physician assessment within three hours (median of one hour) and 90 per cent of admitted ED patients to be transferred to a hospital bed within eight hours (median of two hours).
The position paper also specifies ED lengths of stay for different levels of urgency.
The paper calls for a coordinated approach to dealing with the issue, saying overcrowded EDs lead to “access block” in the hospital with admitted patients not able to get a bed. The problem is exacerbated by elderly inpatients, ready for discharge, who are unnecessarily taking up a bed while waiting for a continuing care placement. This problem continues to increase every year, the CAEP says, and will get worse with an aging population and lengthening life expectancy.
The position paper is at http://caep.ca/sites/default/files/caep/PositionStatments/edoc_document_final_eng.pdf. Health Edition, Nov. 21, 1973
