Overcrowding worries ER doctors

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Barb Sweet
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National report aims to reduce emergency wait times

The Newfoundland and Labra­dor Medical Association (NLMA) is endorsing a national position paper on emergency room overcrowding.

The entrance to the emergency department at the Health Sciences Centre in St. John’s.

But the first task in this province is to start measuring wait times, said NLMA president Dr. Yordan Karai­vanov.

“We don’t know what the current situation is. … No one is doing the first step, which is measuring,” Karaivanov said in a telephone interview while travelling Tuesday, adding the NLMA has told the province it is interested in seeing those waits measured.

Karaivanov is a family doctor at the Labrador Health Centre in Happy Valley-Goose Bay and knows from personal experience how ERs can clog up.

Once wait times are measured in the province’s hospitals, health officials will be in a better position to tackle the trouble, he said, adding the concern is that people may not be being seen in a timely manner.

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In a position paper, the Canadian Association of Emergency Physicians is calling for national benchmarks and public reporting of wait times as a way to tackle overcrowding in the ER and the jam it causes for patients accessing care and hospital beds.

The paper proposes that hospitals should strive for the target of a median ER wait of one hour before initial assessment by a doctor, and that 90 per cent of the patients would wait no more than three hours for that initial assessment by a doctor.

If the patient were being admitted, the median wait would be two hours for a bed and it would be no longer than eight hours for 90 per cent of the patients.

Today is National Emergency Medicine Day in Canada and the paper will be published in the November issue of the Canadian Journal of Emergency Medicine.

Health Minister Susan Sullivan, in a statement Tuesday, said the province has paid a lot of attention to improving the performance of emergency departments and received a copy of the position paper. Officials are currently reviewing it.

“We will review the statement closely to identify potential opportunities where we can make improvement in our province’s emergency departments in partnership with the four regional health authorities and appropriate health-care professionals,” Sullivan said.

Karaivanov said the NLMA supports government and health authorities reporting to the public what emergency wait times are.

“The public needs to be informed,” said Karaivanov, who recently did a president’s tour of the province and recently met with presidents of medical associations in the other provinces.

And he recognizes that ER waits are a struggle across the country and in other places, such as the U.K.

Karaivanov said a major contributer to ER congestion is the flow being obstructed, sometimes for days, with patients waiting in corridors on gurneys to be transfered to inpatient beds.

“This is not only a problem of convenience. This is also causing congestion that may lead to people with serious medical problems not being seen in a timely manner,” Karaivanov said.

“Across the country … this has been identified as probably the most significant obstacle towards quick flow through the emergency department.”

In Happy Valley-Goose Bay, two-thirds of the ER beds are occupied by people waiting to be transferred to a floor, he said.

And that chain reaction can be traced to patients waiting for home care or placements in long-term care beds, he said.

According to the national association, there is no excuse for continued inaction on emergency room congestion in the country.

“Emergency department overcrowding is defined as a situation where the demand for emergency services exceeds the ability of an emergency department to provide quality care within appropriate time frames,” the paper by five doctors concluded.

“Patient suffering, prolonged wait times, deteriorating levels of service, adverse patient outcomes and the ability to retain experienced staff in an (emergency department) are all ill effects of this ongoing problem.”

The national association also suggests financial incentives or pay-for-performance bonuses be examined for hospitals that achieve improvements in emergency room service.

 

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Organizations: Labrador Health Centre, Canadian Association, Emergency Physicians Canadian Journal of Emergency Medicine.Health Minister

Geographic location: Happy Valley, Goose Bay, Canada

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Recent comments

  • Graham Bursey
    November 20, 2013 - 09:47

    Well Dunderdale and Sullivan apparently don't see any problems. After all they cut millions in funding and hundreds of staff to "IMPROVE SERVICE"..What an absolute joke.

  • JACK
    November 20, 2013 - 05:17

    12 hour wait health science,need to do somthing!!