As Sarah McLeod’s asthmatic son struggled to breathe on a recent trip to the Calgary emergency room, he looked at the blackboard to see a 10-hour waiting time between his son and the care he needed.
When he entered, his son was stable. But it got worse, so McLeod talked to a nurse.
“The nurse looked through her system and again there were no beds available. She was obviously frustrated. She told me she could tell the system was broken,” McLeod said.
The nurse was able to find a bed in another unit and McLeod’s son was finally able to get help. But the whole ordeal lasted about eight hours.
“When I left the room there were still families there when I started at three in the morning,” McLeod said.
The long theme Waiting times have been affecting hospital emergency services long before the COVID-19 pandemic. In Ontario, emergency room patients are being treated with record waiting times to be admitted to the hospital.
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Health experts say there are a number of solutions that could alleviate the accumulated pressure. Some of these solutions will take some time to implement, but they say others could be implemented now.
Dr. Lindy Samson, chief of staff of CHEO, (formerly Children’s Hospital of Eastern Ontario), says it is important for children and their development that the problem of waiting be resolved now, as the dripping effect of full emergency departments is having an impact. about surgeries.
“Hospitalization wards have been at or above 100% occupancy over the past few weeks. And when that happens, it delays the ability of children who are in the emergency department to be admitted to the hospital. to be able to get out. to the emergency department and go up to his hospital room, “said Samson, who is also a pediatric infectious disease doctor.
Sarah McLeod faced a 10-hour wait in the emergency room when she took her son, who was struggling with an asthma attack. (Submitted by Sarah McLeod)
Mental health care outside of emergencies
Samson says CHEO is seeing respiratory viruses and an increase in trauma and broken bones coming with children playing outside in the summer.
In addition, he says there are a large number of children and adolescents with acute mental illness. And this is where CHEO has started to make a difference.
Samson says CHEO is trying to reduce waiting times by eliminating the need for some children to even go to the emergency department in the first place.
The hospital started a child-centered health team that is funded by the province, which partners with more than 60 organizations and providers working in child health care, such as family physicians, pediatricians, organizations mental health and home care providers.
Dr. Lindy Samson, chief of staff of CHEO, says it is important to address the problem of ER waiting times to avoid the dripping effect of delayed surgeries. (CHEO)
This group has worked together to create a program called One Call, One Click, which is a mental health service that allows easy access to information and triage to find who can offer the best help in the shortest possible time, without stepping on it. the step. ER.
Samson says it’s about putting “children and their families and their needs at the center and [building] a system around that in an integrated way instead of people having to jump between hoops and go to different silos they plan separately. “
And Samson says the general approach works.
“There are pre-COVID data showing that this decreases their need to be admitted to the hospital and I think visits to the emergency department as well,” Samson said.
Areas of rapid evaluation
Dr. David Petrie says reducing emergency department waiting times is complex, but it can be done by understanding how a hospital system works in general and where the problems lie.
Petrie is an emergency physician in Halifax and has been working in emergency medicine for nearly 30 years.
Halifax emergency physician Dr. David Petrie says rapid assessment areas can help reduce ER wait times. (CBC)
He says in Nova Scotia’s emergency departments, the wait from enrollment to seeing a doctor is about four hours, but it can be as long as eight hours.
One of the ways Petrie suggests improving the system is by making better use of the beds that hospitals have.
“Ten, 15 years ago, one [emergency department] the bed was a [emergency department] He went to bed and the next patient, stayed in bed until his work was completed … so there was a period of time delay until a decision could be made, and the patient was transferred up in the hospital bed or discharged, “Petrie said.
But Petrie believes a quick assessment area could change that.
“You introduce someone, make your story and your physique … then take him out of bed where possible, move him to what could be called an internal waiting area and move the next patient,” he said. dir Petrie.
“So instead of occupying a bed for four to five hours for a patient, you could move five, six, seven, eight patients through that single bed.”
Responsibility and coordination
Petrie also suggests improving accountability. He says that often the different departments do not work together and by solving their own problems, they will create problems for others.
For example, a long-line hospitalization department may leave patients in the emergency department. But Petrie says this can be resolved responsibly across the health field.
“More specifically … some of the most effective impacts [keeping people moving through the ER] it has to do with people’s responsibility towards certain flow goals, ”Petrie said.
“And that has to do with the length of the stay. It has to do with the expected type of time of discharge, a whole lot of things that can make a difference.”
And both Petrie and Samson agree that more collaboration and teamwork across all health care departments can also help the ongoing problem.
“We all need to be committed to our patients and the system, and we all need to work beyond those limits,” Petrie said. “It’s the only way we’re going to get out of this.”
Sarah McLeod’s recent trip to a Calgary emergency room took more than eight hours, but she said it could have been much worse. Doctors say online triage, fast assessment areas, and more accountability could help reduce ER waits. (Submitted by Sarah McLeod)
These are the kind of differences Sarah McLeod said she hopes to see, so if she has to take her child back to the emergency room, she will get help sooner.
“I think we, as citizens, as parents, deserve to know what waiting times are in hospitals and why they are so bad and what can we do to fix them?” said McLeod.
“I hope I don’t have to go back forward unless it’s incredibly serious.”
Produced by Colleen Ross, Amina Zafar and Stephanie Dubois.