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‘Long, hard summer’ looms in hospital ERs for exhausted staff, forced-to-wait patients: Doctor

Posted: July 13, 2022

(July 11, 2022)

By: Jonathan Juha, The London Free Press

 

Some hospitals in the London region are running some of Ontario’s shortest emergency room wait times, but lineups in London are roughly three times as long if not more, latest figures show.

The snapshot of the situation in emergency medicine comes from figures reported for April, two years after COVID-19 struck but amid what some say is shaping up to be a tough-slogging summer for many Ontario hospitals marked by some temporary rural ER shutdowns, record waits for many patients and staff shortages and burn-out from the pandemic.

 

On top of that, the arrival of COVID’s seventh wave fuelled by the fast-moving and highly transmissible BA.5 Omicron variant threatens to make the fallout even worse, some say.

 

“It is going to be a long, hard summer and it isn’t going to get any better unless we start stabilizing things,” said Dr. Atul Kapur, an emergency physician in Ottawa and co-chair of the public affairs committee with the Canadian Association of Emergency Physicians.

While emergency room waits have reached historic highs at many hospitals, some in the wider London region fared among the best in the province according to the April figures reported by Health Quality Ontario, a provincial agency that tracks health system performance.

 

St. Thomas-Elgin General Hospital led the pack among hospitals in the wider region, with patients admitted in April spending an average of 4.7 hours in the ER before admission.

 

That was the second-best mark in Ontario, whose average such hospital wait was 20.1 hours.

 

Hospitals in Woodstock (4.8 hours), Clinton (5.4), St. Marys (7) and Strathroy (7.1) were also among the Top 10 best times in Ontario for admitted patients, which includes the time patients spend waiting to be assessed by a doctor, receiving treatment and waiting for a bed to open.

By contrast, patients at London Health Sciences Centre’s Victoria Hospital waited an average of 15.1 hours in the ER. The wait time at LHSC’s University Hospital (UH) was 18.5 hours. Both were above the provincial average of 2.1 hours that Ontarians waited to be first assessed by a doctor, with Victoria’s average time clocking at 2.5 hours and UH’s at three hours.

 

The latest data comes at a time when many, if not all, Ontario hospitals are reporting staff shortages and burn-out while dealing with a sharp increase in demand for care from patients, many of whom have more complex needs than before the COVID-19 pandemic.

 

“London is no different than anywhere across the nation with wait times, and we’re doing everything within our capacity to ensure that our wait times are not as lengthy as they can be,” said Christie MacDonald, LHSC’s division chair chief of emergency medicine.

“It’s an unfortunate situation right now. However, each patient that is seen and registered in the (emergency department) does actually get seen by a physician and by our health care team. So although the wait times can be lengthy, each patient is seen, provided they do wait.”

 

The crunch is starting to affect even the hospitals that until recently were running some of the shortest wait time averages.

 

At the end of June, for instance, the St. Thomas hospital began warning the public of longer-than-usual waits for care, asking people to refrain from visiting the ER unless necessary.

 

More recently, the Huron Perth Healthcare Alliance, citing “continued health human resource shortages,” closed the emergency room Friday night at St. Marys Memorial Hospital, and it plans scheduled closings of the emergency rooms in its hospitals in Clinton and Seaforth.

“If this is the new norm, we’re in serious trouble,” said Peter Bergmanis, co-chair of the Ontario Health Coalition’s London chapter, adding “it was unheard of” for emergency rooms in Ontario to close due to lack of staff.

 

“This has been coming for quite some time,” he said. “We knew this kind of situation, with the constant under-resourcing of our hospitals, would happen and now the pandemic has exasperated everything because the staff are burning out.”

 

Matters could be made worse by the spectre of new COVID-19 cases sparked by more transmissible variants of the virus, including BA.5 Omicron. Already at LHSC, the number of hospital staff who’ve tested positive for COVID-19 has been rising, hitting a six-week high on Friday with 110 positive cases.

NDP Interim Leader Peter Tabuns has called on Premier Doug Ford’s Progressive Conservative government to do more to address the hospital crisis.

 

“We have reached a tipping point,” Tabuns said in a written statement. “Finding the doors to the closest ER locked is a terrifying thought. We need to recruit new health care staff, attract those who have left the profession, get qualified internationally trained workers into hospitals, and stop the exodus of doctors and nurses that is still happening right now, as we speak.”

 

MacDonald, the LHSC official, said the hospital network is reviewing its procedures in an attempt to reduce wait times. That includes looking at how patients are being triaged, making changes to the flow of patients – such as sending them back to the waiting room while they wait for bloodwork – and improving turnaround times for imaging tests such as X-rays.

But to Bergmanis, those steps amount to Band-Aid solutions. “If we want to get out of this crisis, we have to seriously look at rebuilding the capacity within the health system,” he said. “And that’s going to take money, and it’s going to take determination, and recruitment efforts like we’ve never seen before.”

 

Critics say the crunch facing hospitals is directly related to the pandemic, but that the COVID-19 crisis simply brought the issues into sharper focus.

 

Even before the pandemic, for example, Ontario had fewer beds per capita and a nursing shortage — a gap of 22,000 nurses less than needed, according to Registered Nurses Association of Ontario chief executive Doris Grinspun. Many more nurses left during the pandemic and Ontario is competing with jurisdictions around the world to replace them.

Many nurses on the job have been working short-staffed for years, are exhausted from the pandemic and the situation is getting worse. Grinspun said RNAO has long recommended solutions, but some will take time.

 

“The reality is, we are almost at the point of no return,” she said. “It is not about staffing shortages. It is about nursing shortages. I have been warning about this for years.”

 

Kapur said the Canadian Association of Emergency Physicians has long called on governments to do more to protect health workers from abuse and violence on the job — something that is driving people away, as is wage cap legislation Bill 124 in Ontario.

 

“We have lost staff. Anything you can do to bring them back by improving conditions and wages” would make a short-term difference, he said.

There have also been calls for the Ontario government to bring back mask mandates and expand fourth doses of vaccines, as well, to dampen the impact of the wave on already fragile hospitals.

 

“I am not sure what crisis the government is waiting for. The crisis is here,” Kapur said.

 

With files by Elizabeth Payne, Ottawa Citizen

 

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