Emergency department issues were a hot topic in three provinces this past week, coming on the heels of a warning in a recent position paper from the Canadian Association of Emergency Physicians (CAEP) that ED overcrowding is worsening and constitutes a “public health crisis.”
In Newfoundland and Labrador Tuesday, the St. John’s Telegram reported that hospitals in the city are falling short of their wait-time targets for 75 per cent of Level 3 ED patients. The situation is even worse (23 per cent) for Level 4 patients.
Questioned about this in the legislature Wednesday, Health Minister Susan Sullivan said the government has already made progress with its ED wait-time strategy. In fact, in response to a related question last Thursday, she said the government has acted on seven of the 11 needed action steps cited in the CAEP position paper.
Ms. Sullivan said that despite a 16 per cent increase in traffic, the time to initial physician assessment has decreased by 17 per cent and the total length of stay is down 11 per cent. She also said the number of patients who leave without being seen by a physician has decreased by 35 per cent.
In the Manitoba legislature Tuesday, Progressive Conservative Health Critic Cameron Friesen cited data from a freedom of information request that show 10 per cent of people who go to Winnipeg EDs leave before seeing a doctor. He said 28,000 “simply got up and walked out,” 5,000 more than the year before.
Over the past number of months, the Opposition in Manitoba has also criticized the government for patient off-load times at EDs and rotating ED closures at some rural hospitals.
Emergency department issues, while prevalent in many parts of the country, are a particular concern in Regina right now. As of this Thursday, one of the two EDs in the city is closed during the evening and overnight hours.
From 7:30 p.m. to 8:00 a.m., the Pasqua Hospital ED is closed, and a paramedic team is assessing patients who turn up at the ED and referring those who truly need emergency care to the General Hospital, about 10 minutes away. Others are being sent to a primary care centre across the street from the Pasqua which has agreed to stay open until midnight.
The problem is a shortage of resuscitation-capable physicians. The Regina Qu’Appelle health region needs 30 of these doctors to staff the two city EDs, but has only 20 despite aggressive recruiting efforts.
It is estimated that the General could end up seeing around 30 additional patients a night, and this has raised questions about how it will be able to cope. Tracy Zambory, the president of the nurses’ union, says the southern part of the province cannot function with only one ED in Regina.
“You can’t do it,” she told the Regina Leader-Post this week. “Patient safety is going to be put at risk and we can’t have that.”
Health Minister Dustin Duncan has blamed the situation on a global shortage of highly-trained emergency physicians, although the NDP Opposition says the government has been ignoring the looming issue for years.
In the legislature Wednesday, Mr. Duncan suggested that the situation may improve when a new contract is signed with physicians. He said the government hopes this will put the province in a competitive place with other provinces across Western Canada and “help fill some of the gaps in terms of coverage.” HE
