Ontario healthcare system on life support: why are ER wait times so long?

After 14 Ontario hospitals were forced to close their emergency rooms, beds or intensive care units this long weekend, some systemic shortcomings have led to a healthcare system on life support.

Staff on the front line say COVID-19 has stressed cracks in the foundation of a system already on the verge of collapse. After walking into Toronto’s Michael Garron Hospital in May, one woman said she waited more than an hour just to be registered as a patient.

“I didn’t expect it to be quick. It’s an emergency room,” Emma O’Neil said in an interview with CityNews. “As frustrating as it was, I felt really bad for the staff. They were completely overwhelmed.”

Wait times have never been longer.

The latest figures and data from Health Quality Ontario — an agency created by the government to connect and co-ordinate the healthcare system to ensure Ontarians receive the best possible care — show that in May, patients waited an average of 2.1 hours for a first assessment by an ER doctor.

The average wait time to get admitted to a hospital was 20.1 hours, the highest on record.

Health experts say COVID-19 has exacerbated low staffing levels

Last week, the Ontario Nurses’ Association (ONA) said it had heard from members about staffing shortages affecting more than a dozen hospitals in a variety of ways ahead of the long weekend.

“They’re either closures, reduction of beds, that they are redirecting patients, things like that,” association president Cathryn Hoy said in an interview on Friday.

Hoy said her union was “alarmed” about the impact a shortage of nurses is having on patient care in Ontario

Dr. David Carr, associate professor of emergency medicine at the University of Toronto, said sick people that need to be admitted to a hospital have nowhere to go.

“We don’t have people to take care of them, either,” Dr. Carr said.

Newly appointed health minister Sylvia Jones has yet to speak publicly. This prompted Ontario’s NDP to issue a statement with a single question: “Where is Sylvia Jones?”

A spokesperson for Jones tells CityNews that since the pandemic’s start, the government has added over 10,500 healthcare workers to address the challenge of maintaining the required staffing levels.

Dr. Carr said the problem predates the pandemic but has been exacerbated by COVID-19.

“Ontario has an incredibly low hospital and ICU beds per capita,” he said. “In hallway medicine, we’ve now moved towards ending waiting room medicine.”

Dr. Andrew Petrosoniak, an emergency physician at Toronto’s St. Michael’s Hospital, said this goes far beyond the waiting room.

“The emergency departments are in a crisis, but we’re sort of the canary in the coal mine,” Dr. Petrosoniak said, adding that he sees fewer patients every shift.

Healthcare workers say it’s increased the time and effort to care for each patient. Not to mention, COVID-19-related changes have made every task more time-consuming.

Dr. Petrosoniak cites another challenge: not having a unified electronic medical records system, often leading to repeated tests and procedures.

“Every patient takes a little bit longer, an extra two minutes. That adds up.”

Dr. Carr said that a delay in your care could be detrimental when every minute counts.

“Patients are being harmed by lengthy delays.”

Ontario’s patient ombudsman tells CityNews it has seen an increase in calls and written complaints about ER wait times and triage but still only makes up a small proportion of the office’s total complaints.

Rachel Muir, a registered nurse at the Ottawa Hospital and local bargaining unit president for the ONA told The Rob Snow Show on Tuesday, August 2 that the situation at the Ottawa Hospital has turned into a crisis mode. 

She noted the issue of staff shortage started happening even before the onset of the COVID-19 pandemic and since then, the situation has gotten worse. 

“The stress, added workload and disrespect shown to nurses by our government have all taken a toll,” she said. “Nurses are voicing their displeasure, and many of them are leaving the profession because you can only keep it up for so long before your physical and mental health as well as your family life start to suffer.”

Muir said there's no short-term fix, and the provincial government needs to repeal Bill 124 immediately, and find a way to bring back nurses who have left the profession while fast tracking nurses through nursing programs who are ready to work. 

“It will show nurses the respect they deserve and stop them from leaving,” said Muir. 

Listen to the full interview with Rachel Muir below:

With files from The Canadian Press and CityNews Ottawa.