ER wait times show progress,but real test still to come

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This article was published 28/11/2019 (2245 days ago), so information in it may no longer be current.

There was plenty of good news for the Pallister government this week with the release of new Winnipeg emergency room wait-time statistics.

However, the Canadian Institute for Health Information (CIHI) data only includes wait times until March 31, 2019, so the real test of whether the province’s reforms are working won’t come for months, after the effects of the ER closures at Concordia and Seven Oaks hospitals are felt.

The longest wait times for nine out of 10 ER patients (called the 90th percentile) in Winnipeg was 4.4 hours in 2018-19, according to CIHI. That was unchanged from the previous year, but it’s an improvement over the 5.1 hours for 2016-17, the year before the Pallister government launched its hospital reform plans.

ER wait times are also getting closer to the national average of 3.9 hours — although that’s due in part to an increase in national numbers the past two years.

The amount of time patients are waiting in Winnipeg ERs to get a hospital bed has also improved. That’s an important metric because when hospitals get congested, admitted patients start to pile up in emergency departments, driving up wait times for everyone.

In Winnipeg, the longest wait time for nine out of 10 admitted ER patients was 32.5 hours in 2018-19; the national average was 35.5 hours.

Two years ago, it was 43.5 hours in Winnipeg. So progress has been made.

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But there’s a caveat. The numbers released this week were collected before the emergency departments at Concordia and Seven Oaks were converted to urgent care centres.

We already know from the Winnipeg Regional Health Authority’s own ER data that wait times have grown since then. According to the most recent numbers, ER wait times at Winnipeg hospitals were just over five hours in October, up from 4.2 hours for the same month in 2018.

The Pallister government has now reached the critical phase of its reform plans. All of the major changes in the hospital consolidation plan are now complete; the ER conversions at Concordia and Seven Oaks were the final steps. There will be some tweaks required going forward, but the stage has been set.

Winnipeggers will find out over the next year or two whether the reforms will produce the desired results of better care and shorter wait times.

Meanwhile, Manitoba, as a whole, still has a long way to go to catch up with the rest of Canada, according to the CIHI data.

Manitoba had the second-longest wait times in the country when it comes to how long patients spend in ERs, called “length of stay.” (The numbers apply to patients treated in ERs and released, as well as those waiting for a hospital bed.)

The length of stay in Manitoba for nine out of 10 patients was 13.4 hours in 2018-19, second only to Quebec. The Canadian average was 10.9 hours.

There’s a lot of data in CIHI reports. Observers can cherry-pick whatever statistics they want to argue the health-care system is getting better or worse. Government tends to focus on the data that highlights its successes; critics dwell on negative outcomes.

It’s tough to argue there’s been no progress: patients aren’t being warehoused in ERs as long as they were three or four years ago; the longest wait times for nine out of 10 patients have declined somewhat.

But there hasn’t been significant change. Wait times are longer at some facilities than others, and they’re climbing again. St. Boniface Hospital has been affected most by the hospital reform changes and its ER wait times have ballooned to 6.15 hours in October, compared to 4.42 hours for the same month last year.

If the revamped hospital system in Winnipeg does ultimately produce better results, the public probably won’t see it for some time. ER wait times always spike in the winter, which means they’ll likely grow over the next several months.

If the changes made in the past 2 1/2 years were the right ones, wait times should start to fall by this time next year. If they don’t, government will be hard-pressed to claim its reforms have been a success.

tom.brodbeck@freepress.mb.ca