A first time mom wakes up to her seven month-old coughing in her crib. It is a barking cough that sounds painful and is accompanied by a mild fever. The mom picks up her baby and comforts her. The baby starts coughing again, but appears to be in good spirits. Nonetheless, being a first-time mom, she is worried sick and calls Tele-Health. A Registered Nurse asks several questions, listens to the baby cough and breathe over the phone and advises the new mom to take the baby over to the emergency department (ED) to have her looked at. Frantically the new mom rushes out the door and heads to the nearest ED.
That new mom was me. Having never had a sick baby (fortunately), I was terrified and worried and emotional, par for the course, from what I hear. I arrived at the ED of my local hospital and my daughter was registered within ten minutes. I was told to sit in a chair and a triage nurse would be right with me – and she was. Within two minutes a nurse was checking my daughter and asking questions. Admittedly, I was a wreck and the nurse recognized that as well. She comforted me while I comforted my daughter.
The nurse told me she thought it was croup and that we would be called very soon. She reassured me that I was right bringing my daughter to the ED and said the cough sounded a lot worse than it was (for my daughter). I sat down in the waiting room wondering how I would keep her happy for what I was sure to be a long wait, and before I had a chance to settle in my seat, another nurse was calling the names of several patients, my daughter’s included. I couldn’t believe it. I hadn’t even been there for 20 minutes and I was already being brought into the room?
When the topic of health-care comes up, at least in my own experience, it inevitably leads to a discussion about wait times in EDs. I started as Editor here in 2007 and I remember fielding calls from angry health-care consumers, and receiving emails outlining a not-so-great experience with the system (most often in an ED). In most cases, I felt compelled to defend the health-care system, or at the very least try to help these individuals understand that while our system does have its flaws and inefficiencies, it does work well for most people and it saves lives every single day.
We are at our most vulnerable when we visit an emergency department – either sick ourselves, or worried about a sick loved one. People are in an agitated/emotional state – making it impossible to be patient – a recipe for disaster.
As our focus turns to emergency services once again, I realize that my inboxes are now very rarely a place for people to vent their frustration about waiting in an ED. Nor have I received any emails suggesting we cover emergency wait times to get to the bottom of this crisis.
In 2008 theOntariogovernment announced that one of its top two health-care priorities for the next four years would be reducing wait times in emergency departments. Since then, a number of programs have been put in place and hospitals must report their ED wait times. That information is made public and available at myhospitalcare.ca, a website that provides comprehensive data on over 40 hospital performance indicators to patients and their families in an easy to understand format (Ontario Hospital Association).
Ontario’s target ED wait times are 8 hours (high acuity) and 4 hours (low acuity). Since 2008 ED wait times have been reduced across the board for the most part. The provincial average is 12.1 for high acuity and 4.5 for low acuity. We have nearly reached our target for low acuity and I would suspect that the main reason we haven’t done as well with high acuity is the Alternate Level of Care patients having to remain the ED.
My experience at my local ED couldn’t have been better. Within two hours my daughter had seen a nurse, doctor, respiratory therapist, received a breathing treatment and was back home in her bed (with mom sleeping on the floor.)
Even more important to me that night than the lack of a long wait was the support I received from the nurses and doctors. They were reassuring, and provided us with a lot of information about croup, carefully answering our questions.
So I was pleasantly surprised to see that in addition to the ED wait time performance indicator, the Ontario Hospital Association also has three ED patient satisfaction indicators including overall rating of care, emotional support and information and education. While I don’t want to spend endless hours in an ED waiting to be seen by a doctor, I am just as concerned with the care, support and information I receive while I am there.
In the overall Rating of Care – Ontarians give our EDs an 84.6% – a pleasant surprise for many. For emotional support, a 64% and education and information a 63.4%. While there is room for improvement, I think many Ontarians should take comfort in these numbers. Our health-care system is showing marked progress in ED wait times and overall Ontarians give emergency care a strong A – that’s grade anyone can be proud of.