Ontario to set 8-hour target for time spent in emergency rooms
Last Updated: Thursday, February 19, 2009 | 12:57 PM ET
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Ontario is aiming to be the first province in Canada to cut down on the amount of time patients spend in the emergency room by setting targets for hospitals across the province.
Health Minister David Caplan on Thursday unveiled the plan, which sets a cap of eight hours for patients with complex conditions and four hours for those with minor problems.
The clock starts when a patient registers or sees a triage nurse who gauges the urgency for treatment, and stops after they're discharged or admitted to a bed in another department.
Nine out of 10 patients with serious conditions that require more time to diagnose and treat spend a maximum of 13.5 hours in Ontario emergency rooms, according to the latest provincial figures, which date back to October.
Most patients with minor problems spend about 4.6 hours in the ER, the statistics showed.
The province also unveiled a website that posts wait times in ERs across the province, figures that will "open a lot of eyes," Caplan said.
All Toronto hospitals that reported wait times exceeded the provincial target, with one branch of the Humber River Regional Hospital clocking in at 22.8 hours for serious cases.
Northern hospitals fared better, with Notre-Dame Hospital in Hearst posting the longest time at 13.9 hours for serious cases.
Multibillion-dollar budget, persistent wait times
Ontario has struggled to reduce health-care wait times for years. Nearly half of every dollar spent by the provincial government goes into health care, a multibillion-dollar budget that dwarfs most federal portfolios.
"I think that we all have stories … personal anecdotes about time that we've spent either with ourselves or with loved ones in emergency departments," Caplan said.
"And that's why we're taking the next step in our plan, an ambitious move forward to be able to lower those wait times."
But those targets are "meaningless" when many Ontario hospitals are cutting beds and services to avoid illegal deficits, said Progressive Conservative health critic Elizabeth Witmer.
More than half — "probably 70 per cent" — of the province's hospitals are making cuts to balance their budgets for next year, said Tom Closson, president and CEO of the Ontario Hospital Association.
In addition to the financial crunch, hospitals are struggling to cope with an aging population that's putting more pressure on the system and taking up beds, Witmer said.
"You can set wait-time targets, but the problem's not the emergency room," said Witmer, who was health minister under the previous Tory government.
"The problem is that the other parts of the system can't accommodate the patients that need to be accommodated."
The pressure to meet those targets — which seem to have been plucked "out of the blue" — may also take away valuable resources from treating other diseases and conditions, said NDP health critic France Gelinas.
"I've never been a big fan of the wait-times strategy," she said.
"I think the health-care system should be looked at as a whole, and one human need should not have priority over another."
ER alternatives suggested
Caplan said there is no deadline for hospitals to meet the targets, but the government has a plan to help them reduce wait times.
The plan includes encouraging patients to seek alternatives like walk-in and nurse practitioner clinics and providing financial incentives and experts to help hospitals cut down on wait times.
The province is also looking at ways to move so-called "alternative level of care" patients — such as seniors who can be cared for at home or in a nursing home — more quickly out of hospital.
Those patients account for about 20 per cent of people currently occupying a hospital bed, according to the province.
It's the main culprit behind emergency room backlogs, because patients can't be admitted to hospital when there are no beds available, said Tom Closson, president and CEO of the Ontario Hospital Association.
One in 10 patients wait more than 35 hours to get into a hospital bed, he said.
"Setting targets on how long they should wait and actually providing financial incentives for hospitals to reduce how long people are waiting are all really positive steps, we believe, in trying to improve the situation," Closson said.
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