Manitoba ER wait times hold steady, but still longer than Canadian average: report

Emergency room wait times at Winnipeg's hospitals held steady over the past fiscal year, according to the latest update from the Canadian Institute for Health Information — but waits at the now-shuttered ER at Concordia Hospital remained well above average.

The CIHI report shows ER wait times in Manitoba were consistent from 2017-18 to 2018-19, coming in at 4.4 hours in both years.

That compares to the Canadian average of 3.9 hours for 2018-19, according to the report.

At Concordia, waits were down to 5.5 hours in 2018-19 from 5.7 hours the year before. That was the second-worst ranking among reporting hospitals outside of Quebec — a province that includes 15 of the 20 hospitals with the longest wait times in the country.

This was the first year Quebec's hospitals were included in the CIHI report.

The 2018-19 numbers for Winnipeg include Concordia Hospital's emergency room, which was closed and converted to an urgent care centre in June, and the Health Sciences Centre, which moved from Winnipeg Regional Health Authority oversight to that of Shared Health in the spring.

CIHI's figures are expressed as "90th percentile times," which peg how long it takes 90 per cent of ER patients to receive an initial assessment by a physician.

The overall Canadian average ER wait of 3.9 hours was up from 3.2 hours in 2017-18.

That increase helped narrow the gap between Manitoba's score and the Canadian average, which were close enough that the health organization ranked Manitoba this year as "average" compared to the Canadian figure.

CIHI's report ranks provinces' performance on key indicators as "same as average," "below average" or "above average."

Krista Williams, chief nursing officer and chief health operations officer of the Winnipeg Regional Health Authority, said this year is the first since CIHI started reporting that Manitoba has reached the "same as average" ranking, rather than "below average."

"This is good news, and I want to recognize the people who have been doing work across our system to make improvements in wait times," Williams said at a technical briefing for media on Wednesday.

"But I also want to recognize that we've got room to improve."

Williams said she's confident the WRHA is on track to achieve its goal of meeting or improving upon the Canadian average by 2021.

How do the WRHA hospitals rank out of 230 reporting facilities for longest ER wait times?

• Concordia Hospital — 16th-longest wait.
• Grace Hospital — 32.
• St. Boniface General Hospital — 39.
• Seven Oaks General Hospital — 40.
• Health Sciences Centre — 56.

Oct. wait times up compared to 2018: WRHA

The WRHA also released its latest monthly emergency room and urgent care centre wait times Wednesday.

In October, the health authority reported a 90th-percentile wait time of roughly five hours.

That's an improvement on the 5.3 hour wait in September, but worse than the 4.18 hours reported in October 2018.

At St. Boniface Hospital, the 90th-percentile wait jumped to 6.15 hours in October, compared to 4.42 hours in the same time period last year.

The time was, however, once again an improvement over September 2019, when St. Boniface reported a 6.78 hour wait.

Williams said the increase in wait times Winnipeg hospitals saw earlier this year, compared to the numbers for the previous fiscal year, was likely due to nursing vacancies and major changes over the summer.

Those changes included the closure of the Seven Oaks and Concordia emergency rooms, which were both converted to urgent care centres.

"We have struggled with our wait times. I'm going to be honest with that," Williams said Wednesday.

"But we have the teams that are focused to make improvements, and I'm confident over the next several months that we are going to meet our target in 2021, and achieve or exceed the Canadian average for [emergency deprartment] wait times."

Here are the 90th-percentile wait times at Winnipeg hospitals in October 2019, according to the WRHA:

• Concordia Urgent Care Centre: 5.3 hours (down from 5.78 in October 2018).
• Grace Emergency Department: 4.87 hours (up from 4.53 in October 2018).
• Health Sciences Centre — Adult Emergency Department: 5.42 hours (up from 4.13 in October 2018).
• Health Sciences Centre — Children's Emergency Department: 3.53 hours (up from 3.1 in October 2018).
• Seven Oaks Urgent Care Centre: 4.53 hours (up from 3.88 in October 2018).
• St. Boniface Emergency Department: 6.15 hours (up from 4.42 in October 2018).
• Victoria Urgent Care Centre: 4.9 hours (up from 3.39 in October 2018).

The health authority also released up-to-date information on nursing vacancies in the system. The overall nursing vacancy rate at all Winnipeg hospitals (including HSC) was 15.7 per cent as of Nov. 17, the health authority said.

The vacancy rate at all Winnipeg emergency departments and urgent care centres (including HSC) is 17.2 per cent.

WRHA below average on 10 indicators

Manitoba Health Minister Cameron Friesen said the province has hired 200 new nurses since June.

He also argued that maintaining steady ER wait times from 2017-18 to 2018-19 is a win, in the context of increased visits to ERs.

Emergency rooms and urgent care centres in the WRHA saw more than 337,000 people in 2018-19 compared to 284,097 in 2017-18, according to the health authority's annual report for the past fiscal year.

"Clearly, there is evidence in this latest data that Manitoba continues to go in the right direction," he said. "We know there is much more work to do. We accept the challenge of doing that work."

NDP MLA Uzoma Asagwara said the numbers show there's been no improvement in Manitoba ER wait times.

"We're not seeing an improvement in those wait times, and that's disappointing and certainly concerning for those who are simply trying to access the best care possible in our emergency rooms," the Opposition health critic said.

Friesen said province has set targets for improvement on the 10 indicators measured by CIHI where Manitoba performed below the Canadian average. Those include a worse-than-average "hospital standardized mortality ratio."

The metric is used to track how successful hospitals are at reducing death. It compares the number of deaths in a hospital with the average Canadian experience after adjusting for factors including patient age, sex, diagnosis and length of stay.

Manitoba reported an ratio of 109. Hospitals in the WRHA reported an average hospital standardized death rate of 115, compared to the overall Canadian average of 97.

Winnipeg's Health Sciences Centre had the second-highest HSMR among all reporting hospitals at 131, and was one of only three hospitals that reported a ratio of over 130.

The WRHA also ranked below average on these indicators:

• Avoidable deaths from preventable causes: 147 per 100,000 people (Canadian average: 130 per 100,000).
• Avoidable deaths from treatable causes: 88 per 100,000 people (Canadian average: 68 per 100,000).
• Life expectancy at birth: 80.8 years (Canadian average: 82 years).
• Life expectancy at age 65: 20.2 years (Canadian average: 20.8 years).
• Improved physical function in long-term care: 29.9 per cent (Canadian average: 31.4 per cent).
• Falls in the last 30 days in long-term care: 17.5 per cent (Canadian average: 16.7 per cent).
• Experiencing pain in long-term care: 8.5 per cent (Canadian average: 6.7 per cent).
• Obstetric patients readmitted to hospital: 3.1 per cent (Canadian average: 2.2 per cent).
• Restraint use in long-term care: 10.1 per cent (Canadian average: 5.2 per cent).*

* The WRHA says Manitoba defines "restraints" more broadly than other jurisdictions, resulting in a higher provincial rate.