People leaving Winnipeg ERs without being seen by doctor

A growing number of people are opting to leave the emergency rooms of Winnipeg's two largest hospitals before they have been seen by a doctor, CBC News has learned.

Some patients complain of long emergency room waits

A growing number of people are opting to leave the emergency rooms of Winnipeg's two largest hospitals before they have been seen by a doctor, CBC News has learned.

In the past year, 10.7 per cent of patients who sought care at the Health Sciences Centre's emergency room left without being seen — up 23 per cent from 2009-10 — according to numbers from the Winnipeg Regional Health Authority (WRHA).

About 8.8 per cent of people left St. Boniface General Hospital's emergency room without seeing a doctor in 2011-12. That's up 44 per cent from 2009-10, when it was 6.1 per cent.

CBC News obtained the figures from the health authority through an access to information request.

The WRHA defines "left without being seen" as people who register with a nurse at the reception desk, but who thereafter leave without being seen by a physician.

"We're certainly concerned about those who would leave before they are seen, particularly those whose health would be at further risk when they do that," said Lori Lamont, the WRHA's chief nursing officer.

Lamont added that a certain percentage of those who leave end up going someplace else, such as a medical clinic.   The WRHA says a call centre run by the provincial government's Health Links telephone service attempts to reach those who leave emergency rooms within 24 hours to see if their health issues have been resolved.

Frustrated with waiting

Some Winnipeggers who have left emergency rooms without being seen by a doctor say they are just too frustrated with what they describe as long waits.

Bob Kury said two months ago, he left the Misericordia Health Centre's emergency room after waiting in pain for several hours.

Kury described his pain at the time as a "12 out of 10," adding that he had trouble urinating.

"I wasn't going to die in an emergency room like Brian Sinclair," he told CBC News on Thursday.

"If I was going to die, I'll die at home."

Brian Sinclair, a double-amputee with a speech problem, was found dead in his wheelchair after spending 34 hours in the waiting room of the Health Sciences Centre's emergency department in 2008.

Since then, the Health Sciences Centre has introduced changes to ensure everyone who seeks care at its emergency room is directed by a security officer to a triage nurse who can assess their needs.

Sinclair's death has also prompted a public inquiry, in an effort to ensure others don't wait for care in vain.

In Kury's case, he said he never saw a doctor at the Misericordia or at the Victoria General Hospital, where he went the next day, but he did note that a nurse at the latter hospital did put in a catheter.

'Slight correlation'

Lamont said there is a "slight correlation" between the drop-out rate and the wait time in an emergency department.

"If the wait time is longer, we know that people are more likely to become frustrated and leave," she said.

The WRHA's biggest priority is to reduce wait times, Lamont said, but she added that its priority is to see the most serious cases.

"We know that … people who have truly emergency kinds of needs are seen really quite quickly," she said.

Lamont said the WRHA continues to develop ways to care for people with "less urgent needs" outside the emergency room.

Those ways include a series of "quick care clinics" and a "fast-track" system that uses nurse practitioners instead of doctors.

Still, Lamont said more and more patients are coming to the emergency rooms at Health Sciences Centre and St. Boniface Hospital every year.

The health authority monitors wait times each day. On Wednesday, the average wait time to see a doctor at the region's six hospitals was two hours, although on any given day the wait can be much longer.

Related document

The following is the Winnipeg Regional Health Authority's figures on the number of people who left hospital emergency rooms without been seen by a physician over the past three years: