Emergency Rooms – Why the Wait?

November 6, 2014

(Strathroy, ON) – Reducing wait times in the Emergency Department is a top priority for the Middlesex Hospital Alliance at the Strathroy Middlesex General Hospital (SMGH) site. The organization is examining opportunities for how this can be accomplished on an ongoing basis.
‘To go to the Emergency Department or not’ is often a question we have when we’re feeling unwell at home. Our Hospital Emergency Departments are extremely busy and there may be a wait of several hours for patients who do not have a life-threatening condition.
If you are unsure as to whether to go to an Emergency Department, first call Telehealth Ontario at 1-866-797-0000, a toll-free telephone health advice line. Registered Nurses are there 24 hours a day to offer advice, after asking a battery of questions on your current health status. They will suggest you may be able to self-heal, can wait to make a doctor’s appointment, or advise you to go to an Emergency Department immediately. As well, many physicians’ offices prefer their patients contact them before going to an Emergency Department or walk-in clinic for after-hours care. Check with your physician to find out what after-hour services they provide.
Unlike other services, when you arrive at the Emergency Department, you will not be seen on a first come, first served basis. A triage nurse will see you first to determine the acuity or seriousness of your illness. Triage is a method used by both nurses and ambulance paramedics to determine how life-threatening a patient’s condition is. How soon you are seen by a doctor will depend on how sick or how badly injured you are, not by time of arrival. The sickest patients are seen first. If your condition worsens while you are waiting, it’s important to let the triage nurse know. Patients with non-urgent conditions should be prepared to wait. Dr. Gary Perkin, Chief of Staff said, “People often feel frustrated when they come to the Emergency Department because they aren’t aware that the most critical or seriously injured people must be treated first. In our busy departments, this can result in some people with minor conditions having to wait several hours to see a physician.”

The Length of Stay (LOS) commonly referred to as the “wait time” refers to the total time a patient spends in the ED, from the time of registration to the time of discharge, either home or to an inpatient bed. Our average wait time is within the expected provincial wait time targets and although we do our best to meet the target, the reality is that it is not always possible.

So why am I waiting when the department seems quiet? One primary reason is that the waiting room is outside of where all the activity is occurring. The treatment rooms could be full yet the waiting room is empty. Another structural reason is that the walk-in entrance is separate and distant from the ambulance entrance which is how most of our sicker patients arrive. A third and very important reason that most patients don’t realize is the fact that we have one physician working per shift. This means that the physician and nurses may be devoting their time and attention to stabilize one or more critically ill patients resulting in others waiting. Having a second physician would be a wonderful asset to our ED however SMGH currently does not meet the provincial guidelines to be funded for this. “When patients’ wait times increase, it affects the physicians and nurses in a manner similar to patients and is equally frustrating. To this effect, at SMGH ED, we have instituted “Green Zone” to help facilitate care for patients with non-urgent matters and as physicians and nurses we work extremely hard to attend to patients in the “green zone” as quickly as possible, while we simultaneously care for more critically ill patients. Most certainly, patients also have the choice to visit the local walk-in clinic to see a physician for less urgent matters, if they so choose,” stated Dr. Vikram Dalal Head of Emergency Services.
By being prepared, patients can take a proactive approach to managing their own health care which could help them either avoid an emergency visit completely, or greatly improve their experience if they do need emergency care over the holidays.
On behalf of the Middlesex Hospital Alliance and its Strathroy site, it