As Sarah McLeod’s asthmatic son struggled to breathe on a recent trip to the Calgary emergency room, she looked up at the dashboard to see the 10-hour waiting time between her son and the care he needed.
When she entered, her son was stable. But he got worse, so McLeod talked to a nurse.
“The nurse inspected her system and again there were no free beds. She was obviously disappointed. He told me he could say the system was broken, “McLeod said.
The nurse was able to find a bed in another ward, and McLeod’s son was eventually able to get help. But the whole ordeal took about eight hours.
“When I left the room, there were still families there who were there when I started at three in the morning,” McLeod said.
The question is long the waiting time bothers the hospital emergency departments long before the COVID-19 pandemic. In Ontario, emergency room patients are treated with a record high waiting time to be admitted to the hospital.
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Health experts say there are a number of solutions that could ease the pressure. Some of these solutions will take some time to implement, but they say others can be put into practice now.
Dr. Lindy Samson, CHEO’s chief of staff (former Children’s Hospital of Eastern Ontario), said it was important for children and their development that the problem of waiting be addressed now, as the effect of full emergency wards was having an impact. of operations.
“Inpatient wards have been with or over 100 percent occupancy in the last few weeks. And when that happens, it slows down the ability of children in the emergency department who need to be admitted to the hospital to be able to leave the emergency department and go up to their hospital room, “said Samson, who is also a pediatrician. infectious diseases.
Sarah McLeod faced a 10-hour wait in the emergency room when she brought her son, who was battling an asthma attack. (Submitted by Sarah McLeod)
Mental health care outside the emergency department
Samson says CHEO sees respiratory viruses spreading and an increase in injuries and bone fractures that come with children playing outside in the summer.
She also says that there are a large number of children and teenagers with acute mental health distress. And this is where CHEO 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 room in the first place.
The hospital has set up a provincial-funded health team focused on children and young people, partnering with more than 60 organizations and providers working in the field of children’s health, such as family doctors, pediatricians, mental health organizations and home care providers. care.
Dr Lindy Samson, CHEO’s chief of staff, said it was important to address the issue of waiting time in the emergency department to prevent the downward effect of delayed operations. (CHEO)
This group is working together to create a program called One Call, One Click, which is a mental health service that allows easy access to information and sorting to find who can provide the best help as quickly as possible. time without stepping into an ambulance.
Samson says it all has to do with putting “children and their families and their needs at its center [building] system around it in an integrated way, instead of making people jump through hoops and go to different silos that they plan separately. “
And Samson says the general approach works.
“There are data from before Covid that show that this reduces their need to be admitted to the hospital, and I believe that the visits to the emergency department,” said Samson.
Quick assessment areas
Dr. David Petrie says reducing waiting times in the emergency department is complicated, but can be done by understanding how the hospital system as a whole works and where the problems lie.
Petri is an emergency physician in Halifax and has been working in emergency medicine for almost 30 years.
Halifax emergency physician Dr. David Petrie says rapid assessment areas can help reduce emergency waiting times. (CBC)
He says that in the emergency departments in Nova Scotia, the wait from registration to a visit to the doctor is on average about four hours, but can be up to eight hours.
One of the ways Petri suggests improving the system is by making better use of the beds that hospitals have.
“Ten, 15 years ago, an [emergency department] the bed was [emergency department] bed and the next patient came in, stayed in that bed until their examination was over … so there was a period of time until a decision could be made, and the patient was moved upstairs to their inpatient bed, or discharged, ”Petri said.
But Petri believes the rapid assessment zone could change that.
“You bring in someone, do a medical history and physics… then take them out of that bed where possible, move them to what might be called an internal waiting area, and move the next patient,” Petri said.
“So instead a bed can be occupied by one patient for four to five hours, you can move five, six, seven, eight patients through that single bed.”
Accountability and coordination
Petri also suggests improving accountability. He says that often different departments do not work together and solving their own problems will create problems for others.
For example, a hospital with a long queue may leave patients in the emergency department. But Petri says this can be addressed with health accountability.
‘Specifically’ some of the most effective impacts on [keeping people moving through the ER] have to do with holding people responsible for certain flow goals, ”Petri said.
“And it’s about the length of stay. It’s about the expected discharge time, a whole host of things that can make a difference.”
Both Petri and Samson agree that more collaboration and teamwork in all health departments can also help the current problem.
“We all need to be committed to our patients and the system, and we all need to work beyond those boundaries,” Petrie said. “That’s the only way to get out of this.”
Sarah McLeod’s recent trip to the Calgary Emergency Department took eight hours, but she said it could have been much worse. Doctors say online triage, rapid assessment areas and more accountability can help reduce waiting for emergency care. (Submitted by Sarah McLeod)
It was these differences that Sarah McLeod said she hoped to see, so if she had to take her son to the emergency room again, he would get help sooner.
“I think we, as citizens, as parents, deserve to know what hospital waiting times are and why they are so bad, and what can we do to fix them?” McLeod said.
“I hope to move on, I won’t have to go back unless it’s incredibly serious.”
Produced by Colleen Ross, Amina Zafar and Stephanie Dubois.
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