Reducing emergency room wait times: a matter of priority

Nobody likes to wait
When it comes to being in an emergency room, waiting can quickly make most patients quite impatient. Emergency department staff know this, and they do their best to see patients as quickly as possible. So why do we sometimes have to wait—and what is the LHIN doing about it?

In most cases, wait times are determined by the urgency of the situation. Hospitals triage incoming patients based on a “level” system that determines treatment priority. Level I is for patients with immediate life-threatening conditions such as cardiac or respiratory arrest or major trauma. Level II designates patients with a potential life-threatening condition such as drug overdose, head injury or severe trauma. There are three other levels that identify progressively descending levels of urgency. Where your condition places you on that scale determines the order in which you will be seen and treated.

The good news
The good news is that wait times are shortening, even for less urgent patients. That’s because we’ve assembled a variety of health care professionals to assist emergency physicians and nurses. These include, in some cases, physician assistants, nurse practitioners, triage nurses, Community Care Access Centre staff, hospital discharge staff, pharmacists and nurses who specialize in geriatric matters (GEMs). People with different levels of urgency are now directed to the practitioners best able to provide immediate care, making the flow-through more efficient. Busier hospitals may have additional triage nurses who can provide “see-and-treat” care or, in some cases, fast-track certain medical procedures such as X-rays or blood tests—even before the physician sees the patient. In busy hospitals, there may even be “front-of-process” doctors who directly participate in acute-case triage when faster intervention is required.
Dealing with “busy times”

Of course, wait times increase when the emergency department gets busy. Remember that patients are frequently being admitted through the back door by ambulances and, sometimes, helicopters. These are most often the Level I cases that demand immediate attention and that can lengthen wait times for others.

To improve the experience for those in the waiting room, many hospitals now have liaison nurses or volunteers who regularly provide information to patients about wait times, inform families on patient progress and respond to waiting patients whose condition may be deteriorating.

“People with different levels of urgency are now directed to the practitioners best able to provide immediate care, making the flow-through more efficient.”
–Laurie Zimmer, ED/ALC Manager, ESC LHIN

The availability of acute care beds
Wait times are also affected by the availability of acute care beds. When acute care emergency patients can’t be admitted to the hospital because rooms aren’t available, they have to be held in the emergency department.

That, in turn, can cause delays for less urgent cases in the waiting room. That’s why we’re focused on helping patients who are already occupying hospital beds to find appropriate alternative care. This could be in long-term or convalescent care facilities or, with the right supports, in the comfort of their own homes. These programs open up acute care beds and allow emergency room staff to see more patients more quickly.

What can you do to reduce wait times?
Ask yourself if your medical condition is a true emergency. Is your concern one that can be addressed more quickly and conveniently through your primary care giver or, perhaps, at a walk-in clinic? If we all make better use of alternative care options, we’ll all get faster treatment for ourselves and our families. It’s the best way to improve frustrating wait times in busy emergency departments.




DELIVERING RESULTS

The numbers are encouraging: based on the most recent data, our region’s wait times have been trending downward.

URGENT CARE #2 Among Ontario’s 14 LHINs

For urgent care patients awaiting admission to hospital, our wait times are now the second lowest in Ontario.

NON-URGENT CARE #6 Among Ontario’s 14 LHINs

For patients who are in need of less urgent care, we rank #6 out of 14 LHINs in reduced time to discharge.