ER Wait Times Put Patient Safety at Risk

Sitting in the Emergency Room, waiting to be seen, hour after hour, is an experience most of us have shared – repeatedly. It’s a dreadful nuisance, but worse than that, long

wait times in our ERs can endanger patient safety. Yet, government refuses to acknowledge this fact, so no action has been taken to redress the chronic understaffing of our ERs.

During question period last fall, I asked the Minister of Health if he would act to cut ER wait times in order to protect patient safety. He refused to acknowledge that patients are at risk. Instead, he chose to fixate on the need to keep people with minor health complaints out of the ER line-up.

This was akin to yelling squirrel at your dog to distract his attention. Those of us who bring our children to the ER with ear infections or show up with strep throat or urinary tract infections are not slowing down the treatment of more seriously ill or injured patients. We just wait and wait until those patients are treated, but they are not receiving timely treatment either.

ER doctors are beyond frustrated when they find themselves stretched far beyond their human capacity to handle the volume of people in their waiting rooms who need attention as soon as possible. And they know better than any, that understaffing in their ERs can have tragic consequences.

Our health system actually has targets for emergency services. One benchmark of a healthy emergency department is that no more than 4% of patients become frustrated and leave before they are seen. Most hospital emergency rooms across New Brunswick exceed that target by 2 to 3 times. Fully 10 to 12 percent of people waiting in our Emergency Departments leave before they are seen by a doctor.

People waiting to been seen in the ER are triaged. Forty percent of people coming through the emergency room doors are status 3 patients who absolutely must be seen by a doctor as soon as possible. The provincial target for those of us who fall into that category is that 80% should be seen within 30 minutes of arrival in the ER. In the face of chronic understaffing, ERs are missing this target by 4, 5, even 6 times. This is a serious patient safety issue and the Minister of Health needs to acknowledge it and take action.

In those one, two or three hours of waiting, the condition of level 3 patients can worsen, damage can be done; these consequences would be avoided if they were seen within the first half hour of their arrival, the target we should be hitting. Equally worrisome, some of the patients in this category are among the 10 to 12 percent of people who leave the hospital out of frustration, and can face catastrophic consequences. There are also people who fail to go to the ER when they really should because they can’t face hours of waiting to see the doctor. No statistics exist for this group.

Our emergency rooms desperately need more doctors, nurse practitioners, and physician assistants to ensure the safety of those sitting in the waiting room. This should be a front page issue. New Brunswickers have the expectation that if they need medical assistance they will get it in time when they go to the hospital. For some, this is not happening because staffing is inadequate.

An immediate solution would be for doctors to be given the authority to call in extra help when they determine that wait times may be putting patient safety at risk. ER doctors are already authorized to call in extra help when there is a crisis in the ER caused by something catastrophic such as a train wreck. Surely the definition of crisis should be expanded to include wait times that are putting patient safety at risk. Doctors need the authority to call in extra help to act in the best interest of their patients.

A permanent solution to prevent wait times from putting patient safety at risk is to increase the budget for our ERs, so they can increase their staffing levels to avoid this perilous situation in the first place. The provincial budget for 2017 will be released early next month. It must include additional money for the health authorities dedicated to resolving the wait times in our ERs. Sometimes, money is the solution.

David Coon is the Leader of the Green Party and the MLA for Fredericton-South.