Long emergency waits increase risk to patients

A decade ago, emergency room doctor Grant Innes stopped and looked at the chaos. More than a dozen stretchers filled the waiting room. People were throwing up into garbage cans.

CALGARY — A decade ago, emergency room doctor Grant Innes stopped and looked at the chaos. More than a dozen stretchers filled the waiting room. People were throwing up into garbage cans.

“I had the closest thing I’ve ever had to a panic attack, and I thought, ‘I can’t do this, I can’t work like this, this is ridiculous,”’ he said Monday.

Innes now works as the head of the city’s three emergency departments. He’s one of more than 700 doctors who are meeting in Calgary this week, in part to discuss ways to cut down the hours patients wait in crowded emergency rooms to see a doctor.

“We have huge numbers of very sick patients essentially left behind in hallways and on ambulance stretchers for long periods of time,” said Innes.

How many hours patients lie on ambulance stretchers or curled up on waiting room chairs is becoming a political issue across the country.

“There’s no question patients are dying because of the wait times. We just don’t really know how many,” said Innes, pointing to research from Australia that showed mortality rates rose when emergency department wait times increased.

The issue was thrust into the spotlight last year when Brian Sinclair, 45, died in a Winnipeg emergency department after waiting for about 34 hours.

It’s impossible to talk about fixing emergency room wait times without addressing serious flaws in the health-care system as a whole, said several doctors attending the conference.

“It’s definitely the canary in the coal mine, so lots of problems elsewhere in the health system are reflected in the ER,” said Michael Schull, who works at Toronto’s Sunnybrook Health Sciences Centre.

About 15 to 20 per cent of patients in Ontario acute care beds could be moved to nursing homes or long-term care homes if there was room for them, or back into the community with the right supports, he said.

People also come to the emergency room when they can’t find a family doctor.

Solutions are also complex, said Schull, who worked on a study to be presented at the conference that looked at a pilot project aimed at improving the way patients move through an Ontario hospital, thereby freeing up ER space.

The project showed no change in wait times, but showed an improvement in how doctors and nurses perceived their work environment and ability to do their job, he said.

Innes said even if more funding for beds and staff isn’t provided, doctors and nurses need to be creative in finding solutions.

For example, a doctor could work in the waiting room, looking at patients before space is actually found to bring them into the emergency department.

He points to an emergency room in Toronto where no patients are left in a waiting room, but everyone is immediately brought into the department. Sometimes, if there’s no space, they’ll be left in chairs, but at least they’re being seen by medical staff.

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