Higher ER targets set for 2015

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'...These waits in emergency are actually symptoms of an underperforming system' --Arlene Wilgosh, WRHA's president and CEO

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JOE BRYKSA / WINNIPEG FREE PRESS archives Emergency department at Health Sciences Centre.

Local health officials have set ambitious new performance targets for Winnipeg hospital emergency rooms that, if achieved, will slash average ER wait times by 2015.

Arlene Wilgosh, president and chief executive officer of the Winnipeg Regional Health Authority, announced the new targets at a Winnipeg Chamber of Commerce luncheon Tuesday.

She said achieving the new ER goals will require changes throughout the city's health-care system.

"While the emergency rooms themselves are often cited and targeted as the cause of extended waits, these waits in emergency are actually symptoms of an underperforming system," Wilgosh said.

For instance, she said, patients admitted to an ER may languish there for hours because the hospital is less efficient than it should be in treating patients and freeing beds.

Also, too many non-emergency patients are winding up at hospital ERs because there are not enough alternatives for them elsewhere. A survey released this week shows Manitoba ranks dead last in Canada in access to doctors after hours.

The WRHA wants to ensure 90 per cent of ER patients who do not require hospital admission are treated and discharged within four hours. Currently, the Seven Oaks General Hospital ER is the best-performing in the city. Its wait time for non-admitted patients is about six hours, Wilgosh said.

Another goal is to reduce the time it takes to unload ambulance patients at Winnipeg hospitals -- a source of friction between the city and province. The average wait to unload patients was 65 minutes in 2012. The WRHA pledged Tuesday to ensure all ambulances are able to unload patients within 60 minutes by 2015. Limited figures for 2012, released Tuesday, show that goal only occurred 77 per cent of the time.

The WRHA also wants to ensure no more than 20 per cent of patients attending hospital ERs are non-emergency. Last year, non-emergency patients accounted for 45 per cent of all ER visits.

Wilgosh said the city health-care system began work to meet the new targets last fall and will track progress monthly.

"Meeting these targets will require us to change, innovate and be accountable," she told business leaders Tuesday.

Later, she told reporters new efficiencies will not necessarily cost more money. She said the first priority is to do more within existing budgets.

Wilgosh said meeting the goals will require hospitals to be more efficient in dealing with patients on wards and how quickly they can free up beds.

It will also involve taking pressure off hospitals by providing more health services in the community. For instance, much of the intravenous antibiotic therapy that was once done in ERs is now done outside hospitals.

There are two Quick Care clinics, staffed by nurse practitioners, now opened in the city, and more are planned. Waits at these clinics range from 10 minutes to two hours -- far less than at an ER.

The WRHA and the province are also working with the city's 450 fee-for-service doctors to set up "virtual networks" in various parts of Winnipeg in which general practitioners would band together to provide on-call and after-hours services.

Winnipeg Coun. Russ Wyatt, who has been critical of long waits to unload ambulances, said the goal of not exceeding 60 minutes does not address the city's concerns. He would have preferred a target of 30 minutes, which would have been a "major step in the right direction. Sixty minutes is more of the status quo."

Chris Broughton, president of Manitoba Government and General Employees Union Local 911, which represents Winnipeg paramedics, said the 60-minute target is "achievable" and that he hopes the union will be part of the effort to improve wait times at hospitals. Broughton also noted that the new goal is substantially higher than the historical target of 30 minutes.

larry.kusch@freepress.mb.ca

Winnipeg Regional Health Authority targets

2015 goal: Treat and discharge 90 per cent of non-admitted emergency room patients within four hours.

In 2012: Thirty-three per cent of non-admitted patients were treated and discharged within four hours.

2015 goal: Find a bed for 90 per cent of emergency room patients who have been admitted to hospital within eight hours.

In 2012: Fifty-one per cent of emergency room patients who needed to be admitted to hospital had been treated in the ER and admitted to a ward within eight hours.

2015 goal: No patient, admitted to hospital or not, is to sit in an emergency department longer than 24 hours.

In 2012: Ninety-five per cent of all emergency patients had been treated and discharged from the department within 24 hours.

2015 goal: All ambulances are able to unload patients at hospitals within 60 minutes.

In 2012 (April-August): Seventy-seven per cent of all ambulances during this period were able to unload within 60 minutes.

2015 goal: Ensure the number of non-emergency patients attending hospital emergency rooms does not exceed 20 per cent.

In 2012: Non-emergency patients accounted for 45 per cent of all emergency department visits.

Republished from the Winnipeg Free Press print edition January 23, 2013 A3