Winnipeg's Grace Hospital has worst ER wait times in Canada: study

Newly-released information confirms what many Winnipeggers have found out the hard way: waits to see a doctor in Winnipeg emergency rooms are too long. 

In a report released by the Canadian Institute for Health Information Thursday about hospital emergency department wait times across the country, Grace Hospital topped the list with the longest wait: 9.1 hours in the 90th percentile, that is, the maximum amount of time nine out of 10 patients waited to see a doctor.

• INTERACTIVE: Find your hospital or province's ER wait times to see a doctor
• Hospital ER times across Canada reveal some 'disturbing' waits

Grace’s emergency department wait time is three times longer than the three hours recommended by the Canadian Association of Emergency Physicians (CAEP).

“Nine hours is really a very troubling figure,” said Dr. Howard Ovens, co-author, of CAEP's Position Statement on ED [emergency department] Overcrowding. “The idea of actually waiting in an emergency room waiting room for 9.1 hours is disturbing.”

Victoria General Hospital was more than double the recommended wait time with 6.5 hours. Concordia Hospital’s wait time was 5.9 hours.

Both of Winnipeg's teaching hospitals, St. Boniface General Hospital and Health Sciences Centre scored below average.

St. Boniface had the longest wait times of all the teaching hospitals CIHI surveyed. 

CIHI data shows 90th percentile wait times have increased in all six WRHA hospitals since 2009. Grace Hospital made the biggest jump, going from 5.4 hours in 2009 - 2010 to 9.1 hours in 2012 - 2013.

WRHA reaction: 'We know wait times are too long'

"We were disappointed to see that our performance in emergency hasn't improved," said Lori Lamont, WHRA's Vice President of of Inter-Professional Practice.

"We weren't surprised. We hear from people here in the health region that when they receive care, they do let us know that the wait times are long at times and they do want us to address that. So we've made the flow in emergency our top priority.”

Manitoba Health Minister Erin Selby doesn't know why the wait times are so long but said she has told hospital officials to pull up their socks.

"I'm disappointed with these numbers. The WRHA has put some very ambitious target goals for themselves and I expect them to meet them," she said.

The province has already diverted 90,000 patients from the ER with quick care clinics, she said, adding she doesn’t know why that hasn't helped reduce wait times.

"The message was loud and clear in these numbers that we can do better. We should be doing better and Manitobans deserve to have better.  I have told the WRHA that I expect them to meet their target.  It's an ambitious target but I think they should meet it."

Even if WRHA ranks at the bottom for wait times, CAEP still thinks it deserves kudos. The health authority is the only one in Manitoba that participated in the study. 

"I would like to congratulate every hospital that reports its performance and really call out primarily those provinces and hospitals that don't report their data. We don't know how they're doing. They might be doing even worse, “ said Ovens. 

Transparency is key to improving health systems, according to Jeremy Veillard, CIHI's vice president of research and analysis.

“Canadians should feel very comforted by the fact this information is now in the public domain," said Veillard. “There is lots of evidence supporting the fact that when you publish info publicly, there will be a number of adjustments and action will be taken to improve performance.” 

Easy fixes won’t solve wait times, according to the Canadian Medical Association's Wait Time Alliance Chair, Dr. Chris Simpson. 

“It's a system-wide problem," he said. "The problem manifests in the ER department but it's really a barometer for what's going on in the rest of the health care system, which is pockets of under-capacity and under-funding,” said Simpson. 

CAEP blames ER waits on patients being forced to wait in the ER before being able to get into their own room. 

The WRHA's Lamont agreed that is a factor, adding WRHA hospitals see more people with more minor types of injuries and illnesses than hospitals in other cities. 

Lamont said improvements can't happen overnight. She pointed to making more family doctors available and streamlining diagnostics as some ways ER wait times can improve. 

“It takes time to work on those things and we're starting to see some significant improvements,” she said. 

Ovens said in spite of these findings, Canadians generally who are at the greatest risk are usually seen right away. 

"The [triage] nurse is very good at sorting out who needs to be seen immediately, so the great majority of people who have to wait, are at not at medical risk from [waiting].”

Lamont said Winnipeg hospitals do a good job from that perspective. 

“We compare very favourably” in cases of life and death, said Lamont. “For others whose need is less urgent, we know they wait too long. “

'Cross your fingers and hope for a slow day': Winnipeg patient

Winnipegger Paul Friesen lived through a long ER wait a few weeks ago when he went to St. Boniface Hospital for a strange discomfort in his chest and arm. He was also coughing up blood.

When he called Health Links, the province's telephone information service, the nurse told him to go to the hospital.

“You know that as soon as you go to an emergency [room], you're in there for the duration, probably," he said. "You still have your fingers crossed and hope it's a slow day,“ said Friesen. “I kept looking and they have this big screen there that shows the longest time that a person has been there. It would hover between something like seven and seven and a half hours. I just hoped I wouldn't beat the record.“

Friesen said at one point he was thinking about leaving. But he stayed, waiting six hours before he was diagnosed with a pulmonary embolism, a clogging of the arteries which can produce blood clots, that can be fatal. 

In Canada, the 90th percentile, that is nine patients out of 10, will see a doctor within three hours or less, according to the CIHI report.

Three small Ontario hospitals had wait times under an hour in 2012 - 2013; Smooth Rock Falls Hospital, the McCausland Hospital and Horne Pain Community Hospital. 

Friesen was stunned, and just about ready to pack his bags. 

“Wow, that puts thing into perspective in terms of you kind of just want to get on a plane and go to another place, another hospital.“ He believes staff at St. Boniface were doing their best but that there was not enough staff. 

As a country, experts said Canada emergency room wait times are among the longest among industrialized countries. 

Other key information about Manitoba from CIHI: 

• Manitoba’s rate of in-hospital sepsis was lower than the national average in 2012-2013. Relative to the other provinces, Manitoba had one of the lowest rates of in-hospital sepsis in the country, at 3.9 per 1,000 discharges. The national average was 4.4 per 1,000 discharges.
• Manitoba had one of the lowest percentages in the country of all patients who were readmitted to a hospital within 30 days, at 8.5% in 2012-2013, below the national average of 8.8%.
• Manitoba’s rate of hospitalized heart attacks improved: from 255 per 100,000 people in 2008-2009 to 217 per 100,000 people in 2012-2013. However, this rate still remained above the national average of 207 per 100,000 people.
• In 2011-2012, 9.7% of patients in Manitoba had had at least 3 repeat hospital stays for a mental illness in the past year. Manitoba’s rate was better than the national average of 11.1%.
• Manitoba had the lowest rate of hospital deaths within 30 days of major surgery in 2012-2013, with 1.5 deaths per 100 major surgical cases. The national average was 1.8 deaths per 100 major surgical cases.