ED wait times due to access block

The Canadian Association of Emergency Physicians (CAEP) released “A Snap Shot on Life in the Emergency Department” today, highlighting the current situation in Canadian Emergency Departments.

ED Wait Times due to Access Block is a major problem that was highlighted from the data they collected from Canadian hospitals. Average times to wait for admission ranged from 6.7 to 21.69 hours in urban hospitals and 7.2 to 10.74 hours in rural Hospitals*.

A major contributing factor at many hospitals is Occupied Alternate Level of Care (ALC) beds.  ALC patients occupied 16 per cent of all beds in some hospitals.  ALC patients are those who no longer require acute hospital care but cannot be transferred elsewhere due to a lack of beds and/or resources in the community.

“I think it is important to remember that this is a “snapshot”, and not a rigorous scientific study“, explains Dr. Andrew Affleck, co-chair of the CAEP Public Affairs Committee. “This is an accurate reflection of the issues that are currently affecting many busy Emergency Departments across Canada.  Many of which could be resolved by solutions outlined in CAEP’s recently released Position Statement on Emergency Department Overcrowding & Access Block.”

Since Canada has no national ED patient database, accurate data are not available for a similar reflective exercise. CAEP collected data from close to 100 Canadian Hospitals in conjunction with the release of that position statement in November 2013.  Some solutions highlighted within the paper include establishing national benchmarks for key intervals in the Emergency Department patient experience and reporting them publicly, linking ED length of stay (ED LOS) benchmarks to incentives and infrastructure investment, and mandating a national ED repository of visit data.

“Many of the solutions outlined within the position statement are not expensive options,” declares Dr. Andrew Affleck. “They require restructure and a change in the way hospitals do things.” Strategies to “equally share” overcapacity patients throughout hospitals and the health care system must be urgently implemented in the short term.  These short term cost-neutral strategies to relieve Access Block will enable EDs to resume the function for which they were intended, while longer term solutions are addressed.

The position statement can be found here. A summary of the collected data can be found here.

Affleck thanked all of the hospitals who provided data and encouraged Provincial Health Ministries to become partners with CAEP in helping develop solutions to provide Canadians with better healthcare. “We are all in this together. The hospitals, the physicians, the nurses and other health care providers, the politicians, we all want the same results. Rather than sidestepping the issue and/or laying blame we must work together to un-root the causes and produce practical short and long term solutions.

*Rural hospitals are designated to be in areas with a population of less than 30,000.

About the Canadian Association of Emergency Physicians

A leader in Canadian Health Care advocacy, the Canadian Association of Emergency Physicians (CAEP) is a member based association comprised of emergency physicians that have been advocating for emergency physicians and their patients since 1978.

The mission for CAEP and their 2100+ members is to promote the interests of emergency physicians and the specialty of emergency medicine in Canada by:

• Advocating for emergency physicians and their patients
• Connecting emergency physicians
• Providing leading emergency medicine education
• Providing a forum for research in emergency medicine