Statistics can lie, Noel says 0
PRH CEO Pierre Noel
The Pembroke Regional Hospital’s president and CEO wants to set the record straight on wait times at its emergency department, which have spiked over the past 18 months.
Pierre Noel said while the hospital is facing some significant challenges in ensuring the smooth movement of people through the department, media reports suggesting patients are waiting in the ER for up to a day before treatment isn’t accurate.
“This is more about patients being placed in beds in the ER, where they are getting good care until beds in the medical ward become available, then are being moved there,” he said.
From the time people check in at the ER until they reach that ward bed or are discharged, the clock continues to tick, Mr. Noel said.
According to the latest statistics compiled by the Ministry of Health and Long Term Care, the PRH has the longest emergency room wait times in Eastern Ontario. Between April and June of this year, the maximum amount of time nine out of 10 high-acuity patients (the hardest to treat, needing more time and attention) spent in the PRH’s ER, whether it was receiving care, waiting for a transfer to another hospital or waiting for admission to a bed, was 23.5 hours. The provincial target is set at a maximum of eight hours.
(The MOHLTC calculates total time spent in the ER as the maximum time nine out of 10 Ontarians spend in the ER, and is measured from the time patients register or initially see a triage nurse until the time they leave the ER. The time patients leave the ER may be when they are sent home after being treated or when they are admitted to a hospital ward or inpatient bed, if medically necessary.)
In contrast, back in 2009 when the province started recording ER wait times, the PRH was listed at 14.6 hours for the months of July to September 2009.
The longer wait times may potentially jeopardize the hospital’s funding – the PRH was granted $521,700 to help it improve its wait times under the province’s Pay for Results program, aimed at Ontario’s busiest ERs. Since the grant recipients are held to strict annual performance targets, hospitals which fail to shorten their wait times risk seeing that funding clawed back.
Mr. Noel said the challenge isn’t in the number of folks coming to the ER, which has remained steady at some 30,000 visits a year, but in the admittance rate of acute medical cases, those patients with more complicated and serious medical issues.
For some reason, the PRH is getting a lot of patients who aren’t well enough to be discharged quickly, yet aren’t dealing with the sort of severe medical condition which would necessitate them being transferred to other hospitals, such as the Ottawa Heart Institute.
As a result, there has been a backlog of patients who are crowding the 48 beds in the ward, meaning others are being bedded and cared for within the ER until places in the ward are freed up.
Wait times for more serious medical issues which do not require being admitted to a bed is around five hours, Mr. Noel said.
“This is happening almost exclusively to the acute medicine program.”
The hospital president said there is no one specific reason why this is happening, except it is a recent trend beginning 18 months ago. It seems to be a multi-factional issue, he explained, a combination of an aging population, lack of family doctors and patients admitted to the wards staying longer than expected.
“For each day a patient stays in a bed, it prevents admission for another to that bed,” he said.
Mr. Noel said the hospital team will be working on ways to improve the flow through the ER which, while it may not directly address the high admittance rates of acute medical patients, will help ease the pressure on the overall department.
One thing they will be trying is a “see and treat” clinic for the less seriously ill, in order to have these patients examined and treated more quickly. This would help create a better flow in the ER department, he explained..
Stephen Uhler is a Daily Observer multimedia journalist