Emergency Wait Times

[lala.lahori]

Does anybody know why the wait times in Emergency are so high! I was with my sister and she had a large cut on her hand and went to the emergency last night. It took almost 4 hours for the doctor to see her. I saw other people in wheelchair some bleeding and still were waiting. I read somewhere the target for minor concerns is 4 hours, can't they do anything to reduce i.

[Lactic Folly]

http://www.waittimealliance.ca/waittimes/CAEP.pdf

[future_doc]

I guess it is manpower available vs no. of waiting patients

 

death can be an unfortunate byproduct of the existing system

 

Thank you Lactic Folly for that resource!

[Veritas et Utilitas]

Yeah emergency times can be horrible. It is chance in my opinion though. Just like future_doc said: physician/patient ratio. I passed out once. The ambulance was called and brought me (fully conscious) to Humber River Hospital. I was there for only 40-45 minutes until the physician saw me. So i guess it is like shopping - dont get sick on boxing day to avoid line-ups. I hope your sister feels better

[osteon]

Does anybody know why the wait times in Emergency are so high! I was with my sister and she had a large cut on her hand and went to the emergency last night. It took almost 4 hours for the doctor to see her. I saw other people in wheelchair some bleeding and still were waiting. I read somewhere the target for minor concerns is 4 hours, can't they do anything to reduce i.

 

For an emergency, there is no wait

[future_doc]

You mean coming in by ambulance, right?

[Veritas et Utilitas]

You mean coming in by ambulance, right?

 

If you were asking me - yes.

[future_doc]

if there is no triage for walk-ins, i.e., if it is take a number and wait, then emergency patients at the emergency dept. just wait - except for ambulance cases

[Renin]

if there is no triage for walk-ins, i.e., if it is take a number and wait, then emergency patients at the emergency dept. just wait - except for ambulance cases

 

False.

 

Everyone who comes in is triaged. Doesn't matter if you come by helicopter, ambulance, etc.

 

The trick is, usually the paramedics WON'T take you if they think it's not an emergency (vs. you driving yourself); so you have been triaged. Likewise, if you come in by LifeFlight, you have to be PRETTY sick to make it on that flight.

 

It's a common misconception that if you come in via ambulance you will be seen first.

[MarathonRunner]

False.

 

Everyone who comes in is triaged. Doesn't matter if you come by helicopter, ambulance, etc.

 

The trick is, usually the paramedics WON'T take you if they think it's not an emergency (vs. you driving yourself); so you have been triaged. Likewise, if you come in by LifeFlight, you have to be PRETTY sick to make it on that flight.

 

It's a common misconception that if you come in via ambulance you will be seen first.

 

+1. I was brought to the hospital once by ambulance when I fractured a vertebra in my back. I had to wait at the ER. And wait. And wait. So even though I was brought in, strapped to a back board, triage was performed and it was determined that I could wait.

 

And I waited a very, very long time. Long enough to have missed several meals so that I was starving. Long enough to have to use a bed pan, since they didn't want to risk me doing damage to my back in case it was something more serious. It sucked. Big time.

[Renin]

+1. I was brought to the hospital once by ambulance when I fractured a vertebra in my back. I had to wait at the ER. And wait. And wait. So even though I was brought in, strapped to a back board, triage was performed and it was determined that I could wait.

 

And I waited a very, very long time. Long enough to have missed several meals so that I was starving. Long enough to have to use a bed pan, since they didn't want to risk me doing damage to my back in case it was something more serious. It sucked. Big time.

 

Wow that seriously sucks; I'm sorry this happened to you. Did they unload you from backboard? Max at our hospitals is 15-20 min on a backboard.

[MarathonRunner]

Wow that seriously sucks; I'm sorry this happened to you. Did they unload you from backboard? Max at our hospitals is 15-20 min on a backboard.

 

Yeah, they did after a while, but they wouldn't let me move or anything. I guess I had the bad luck to break my back on a busy day. :| Oh well, it could have been worse. I'm just glad I didn't end up like Christopher Reeve.

[aaronjw]

Yeah, they did after a while, but they wouldn't let me move or anything. I guess I had the bad luck to break my back on a busy day. :| Oh well, it could have been worse. I'm just glad I didn't end up like Christopher Reeve.

 

I can say i almost ended up like him. In fact for a brief time i was where he is now lol.

 

Amazing how fast you're rolled through the system when there is somethimg really serious wrong. Makes me appreciate the wait the few times i've been toi emerg since then.

[ploughboy]

For an emergency, there is no wait

 

The problem, and why ERs often get poor press, is that the public's perception of an "emergency" and the ER staff's definition of emergency are often two very different things. I feel very badly for the OP and his/her sister, and I'm not commenting on that specifically. It's gotta suck to have a big laceration and wait for hours to have it addressed. No question about that. I can only speculate on why she had to wait so long, but common reasons include:

 

- half the department being occupied by demented 90-year olds with "failure to cope" who have been admitted to a medical service, but are waiting in the ED until a bed becomes available on the ward. In the province where I'm training there has been a big emphasis on getting admitted patients out of the ED, but delays still happen and having admitted patients boarded in the ED takes up beds and takes away from the available nursing staff. It frustrates us, too!

 

- the ED staff dealing with real emergencies: eg the lady who came in VSA, the guy who unsuccessfully tried to decapitate himself, the kid in DKA with a pH of 6.9, the gal with the knife sticking out of her abdomen, the guy who didn't look quite right so his family drove him to the hospital and it turns out he was sat'ing 70% on room air and was in florid heart failure secondary to an ongoing STEMI, the "get drunk, fall down stairs, give yourself a subdural hematoma and a high c-spine fracture" gal, the "brought in by the police because he's acting weird and oh by the way, he has a temperature of 39.9 Celcius" guy, etc, etc, etc...

 

(All patients I've had to deal with during my residency, by the way, and most of them fairly recent. I really should have listened to my mother and become an accountant... )

 

I do not want to trivialize the OP's experience, and again I've got to say I feel badly that you had to wait so long where-ever it was that you were treated. To answer your question: emergency department wait times are a politically very sensitive issue which are being given a lot of attention and money coast-to-coast. We're getting better in general, but we're not there yet.

 

And just to be very clear about something that was said up-thread: it is definitely *not* "first come, first served" at the ED. Everybody gets triaged, whether they are walked in, carried in or flown in. Triage isn't perfect, but the triage nurses where I work generally do a pretty good job and the sicker you are the sooner you're seen.

[IamIDP]

Simple solution:

Open more seats for ER Physicians.

 

Not rocket science.

[Renin]

Simple solution:

Open more seats for ER Physicians.

 

Not rocket science.

 

Not really that easy. Where would they train? Where would they work? Can we afford (as a society) to pay for that many more ER doctors? Would it speed care to have more doctors without more support staff, equipment, labs, etc.

[seeking1]

Having volunteered in an ER department for a substantial period of time (6+ months), I can completely attest to the triage system and its effect on prioritizing patient wait times. There seems to be a belief in the media that emergency = seen right away, which is not how the system works in any pragmatic sense.

 

Wait times are useful knowledge, but they are definitely one of the worst things to obsess about if you want to improve the health care system. Thats because obsessing about the number of hours one waits to see the ER docs only tells you about how patients are feeling, not the level of care they are receiving.

 

There is documentation on the internet that suggests that speeding up ER wait times can be one of the most damaging things for emergency patient outcomes. I remember one that roughly said that heart patients saw more return visits for heart problems if they went through an ER that pushed them out quicker. The point here is, rushing ER doctors to a diagnosis is very bad. I will take a look through the internet to provide some of these papers in the future.

 

There is also the suggestion that six hour ER wait times in bustling, population-dense societies is actually the norm, and that there is little that can be done to impact the wait time. Again, I am just remembering this off the top of my head, and need to find actual documents that prove the point.

[aaronjw]

Its funny, as someone in/was in marketing it would be great to see ads that explain the process to the general public because most people go to ER when they could have waited and gone to their clinic or FM physician first.

 

A friend tore his ACL was in brutal pain and went to ER and sat and waited for about 6 hours and finally left cause he was sick of waiting. An ACL while painful (been there) is not like threatening therefore on the totum pole he's down near the bottom but people don't know that and they really dont do well at explaining it while in ER either.

 

It would be nice if triage staff Said upfront that a person may be waiting a while due to their symptoms not being considered life threatening or they could wait and see a family physician, something like that. Let people have the option of waiting or not but at least if they wait they know thy could be in for a long haul.

[seeking1]

I found something that this thread might like. Its a website by the name of EvidenceNetwork.ca. Its run by Canadian health experts from around the country, and answers a lot of the questions that are raised about health care in the media.

 

In particular, here is the section on wait times.

[Lactic Folly]

Its funny, as someone in/was in marketing it would be great to see ads that explain the process to the general public because most people go to ER when they could have waited and gone to their clinic or FM physician first.