The targets set out for cutting the waiting times of patients in Winnipeg's emergency rooms appear ambitious. The lack of a firm plan by the Winnipeg Regional Health Authority to hit the targets makes them seem doubly so. Relying on the efforts of all the professionals in the chain -- family physicians, nurses and specialists -- to gamely pull together will be frustrated if Winnipeggers have no other means of after-hours health care.

The opening of a stand-alone mental health crisis site near the Health Sciences Centre this spring will help take the pressure off emergency rooms, most immediately at the HSC itself. Patients with mental health issues can contribute significantly to the ER backlog as these cases are complicated and poorly served in an environment better suited to physical illness.

But the value of the crisis centre -- how much and how quickly it can contribute -- to cutting wait times remains to be seen; the WRHA has made 2015 the target date for when city ERs will treat and discharge 90 per cent of non-admitted patients within four hours. At present, Seven Oaks General Hospital performs best, with a wait time of about six hours. Slicing more than two hours from the total time that 90 per cent of patients spend in ERs in two years can be an enormous task.

In fact, while the proportion of ER patients who do not constitute an emergency has been falling in the last few years, the ability of emergency ward staff to usher them through in a timely fashion has flagged. In 2012, 51 per cent of non-admitted patients were treated and released in four hours, compared to 56 per cent in 2010.

Also by 2015, the off-load time for patients arriving by ambulance is to be dramatically cut and almost all patients needing to be admitted should be off the ER ward within eight hours. The WRHA wants to cut to 20 per cent from 45 per cent the proportion of non-emergency cases going to the ER -- hoping expanded access centres, clinics, more nurse practitioners and the off-hour service by family physicians will redirect or keep such cases at home.

Other provinces and health authorities, says the WRHA, have cut wait times by setting targets publicly and making them a priority. On that evidence, and based on some changes locally that show promise, it is sure it can be done here.

This shows how ambitious, seemingly hopeful, the targets are, but if the WRHA believes such system-wide progress can be made by sheer force of will, why wasn't it a priority years ago?

Republished from the Winnipeg Free Press print edition January 26, 2013 A14