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This article was published 2/3/2017 (1535 days ago), so information in it may no longer be current.
A new study by the Manitoba Centre for Health Policy is challenging some long-held assumptions about the primary causes of lengthy emergency room waits in Winnipeg.
The report, released Thursday, concludes the time it takes to get results from medical tests in hospital ERs is a key factor in determining wait times.
A crowded waiting room does not necessarily mean a long wait, particularly for patients with serious illnesses, the study said. Similarly, the number of emergency room patients waiting for a hospital bed has only a moderate effect on ER waits for other patients.
"We found that the number and type of medical tests and scans done in the emergency department have a large effect on wait times," said Dr. Malcolm Doupe, associate professor in the U of M’s department of community health sciences and the study’s lead author.
"More than half of (emergency room) patients have an X-ray, urine test or other diagnostic test. From discussions with our stakeholders, we learned that it can be very time-consuming for patients to undergo tests, for medical professionals to interpret the results and for staff to take action based on the results," he said.
Doupe said the study suggests a need for more streamlined diagnostic testing in hospital emergency departments.
In 2003, there were about 550 ER visits a day in Winnipeg. By 2013, that increased to about 610 visits a day. Winnipeg has long had some of the longest hospital emergency room waits in the country, but the report concluded that patients with the most urgent medical needs never wait to see an ER doctor.
Doupe said the study shows that adding more ER treatment areas, or freeing up more hospital beds, may not be the most effective approach to reducing emergency room wait times for Winnipeggers. "Our results indicate that wait times are not just a matter of capacity, and that emergency department reform should focus on doing certain things differently, not on creating more space," he said.
Health Minister Kelvin Goertzen called the report "helpful," and said it would help inform a task force appointed by the Progressive Conservative government that is examining waits for various medical services.
Goertzen said it’s known that as many as 30 per cent of medical tests are unnecessary, and indicated other provinces have implemented standards spelling out when certain diagnostic procedures will be done. He said discussions are underway in Manitoba that would see tests done only when necessary.
He said based on recommendations of another study commissioned by the former NDP government, the health system is looking at a possible reduction to the number of hospital emergency rooms in Winnipeg. However, he gave no timeline Thursday as to when a decision would be made.
Some experts have noted that ER waits can be exacerbated by the fact not all city facilities are properly equipped to carry out a full range of diagnostic tests around the clock.
Dr. Alecs Chochinov, medical director of the Winnipeg Regional Health Authority’s emergency program, said one of the most important findings of the study is that ER patients with less urgent problems are not delaying care for people who are very seriously ill.
"That’s a very important message," he said.
Chochinov said in addressing ER efficiency in the past, administrators have focused a lot of attention on freeing up hospital beds for patients who need them, and on looking for ways to divert patients with less serious health problems to other facilities.
But comparatively little scrutiny has been devoted to the workings of emergency departments — which Chochinov likened to a "neglected middle child."
"Nobody’s paid attention to it. It’s extremely important and the processes we employ within the emergency department to look after patients on their route have to be looked at," he said.
He acknowledged that part of the solution is the need to develop "more unified standards" for when tests are ordered.
Larry Kusch didn’t know what he wanted to do with his life until he attended a high school newspaper editor’s workshop in Regina in the summer of 1969 and listened to a university student speak glowingly about the journalism program at Carleton University in Ottawa.