Study sheds light on ER wait times in Ontario

Ontarians typically wait one to four hours in the province's emergency rooms, although wait times in larger cities can stretch past nine hours, a newly released study suggests.

Visits can range from 1 hour in small cities, to more than 9 in bigger ones

Ontarianstypically waited one tofour hours in the province'semergency rooms over a recent one-year period, although wait times in some largercities stretchedpast nine hours, according to a new study.

Half of visits to emergency rooms in small hospitals didn't last longer than 1.1 hours, indicates the study by the Canadian Institute for Health Information.

Half of visits to large hospitals, typically found in big urban centres, lasted between 2.8 and 3.6 hours, the study suggests.

In 10 per cent of cases, a visit to a small emergency room stretched out past 3.2 hours, while 10 per cent ofvisits to big emergency roomsdragged on beyond 9.3 hours.

The institute based its findings on data from April 2005 to April 2006 at nearly everyemergencyroomin Ontario —167 in total.

"I think one of the values of this report is that it gives people in Ontario a clear picture of how long people are waiting," researcher Greg Webster told CBC News Online on Thursday, a day after the release of the study.

He said the point of the study is not to judge hospitals or evaluate how their emergency rooms are doing. Instead, the study strives to provide a breakdown of numbers.

Here's how long ER visits lasted:

  • Large teaching hospitals: Half of ER visitswere over in 3.6 hours (10 per cent in9.3 hours).
  • Large community hospitals: Half over in 2.8 hours (10 per cent in7.5 hours).
  • Medium hospitals: Half over in 1.5 hours (10 per centin 4.2 hours).
  • Small hospitals: Half over in 1.1 hours (10 per centin3.2 hours).

Ontario's biggest hospitals — teaching hospitals that train medical students, and large community hospitals — typically handled more than 30,000 emergency room visits a year.The hospitalsare based in citiesincluding Toronto, Windsor, Ottawa, London and Hamilton.

The study looked at 68 big hospitals, which handled 70 per cent of all of Ontario's emergency room patients.

Ontario's medium-sized hospitals, in towns like Brockville, handled between 15,000 and 30,000 visits a year. Small hospitals, in places like Georgetown or Deep River, handled less than 15,000 visits annually.

The study looked at 99 small and medium hospitals.

Worst waits in Toronto, best in London

According to the study, Toronto had the worst times in Ontario, with half of people in and out of the ER in four hours, while 10 per cent waited more than 12 hours.

By comparison, in southwestern Ontario, which includes the big hospitals in London, half of patients were out in 1.7 hours, while only 10 per cent waited longer thanfive hours.

Webster pointed out that Toronto only has large hospitals, which have worst wait times, while southwestern Ontario has a mix of large and small.

The study did not look at reasons wait timeswereas long as they were, and Webster said there are plans for future studies to determine that.

Bed shortage to blame, doctors say

Other reports, as well as medical officials, have suggested that long wait times are due to a lack of acute beds in other hospital departments and nursing homes. This creates a crowding of patients in the ER.

Shortages of nurses, doctors and medical equipment add to the problem.

"Patients are waiting too long to be seen in emergency rooms because of overcrowding and backlogs elsewhere in the system," Dr. Tim Rutledge, of North York General Hospital in Toronto, told the Globe and Mail.

Dr. Howard Ovens ofMount Sinai Hospital in Toronto told CBC News that wait times are too long. However, he said that during long waits, patients are getting tests and consultations, and receiving treatment.

"The care process takes time and sometimes to do it better takes more time than to do it quickly," he said.

Doctors do initial assessment quickly

Patients might be stuck in the emergency room for many hours, but the wait for an initial assessment with a doctor is not as long, according to the CIHI study:

  • Teaching: Half of patients seen in 1.1 hours (10 per cent waited more than 3.3 hours).
  • Large: Half in 1.2 hours (10 per cent longer than 3.6 hours).
  • Medium: Half in just underone hour (10 per centlonger than2.3 hours).
  • Small: Half in 30 minutes (10 per centlonger 1.6 hours).

Webster said the good news is that people with urgent medical problems weren'twaiting long to be seen.

"It's reassuring that the data does confirm people with the most urgent conditions are treated first, in the shortest time frames," he said.

He hopes the information will be useful to people who run emergency rooms across Ontario.

"We're putting this information out so they can look at this data and see how well they're doing."

Smitherman wants innovative solutions

George Smitherman, Ontario's health minister, said much of the waiting can be attributed to a high number of elderly patients, who often have complex symptoms and cannot be treated easily or quickly.

He said Ontario will have to develop innovative waysto find solutions, like care forelderly patients in their own home.

The Canadian Institute for Health Information, with offices across Canada, collects information on health and health care in Canada and makesit available to the public.