Emergency room issues need more than stopgaps

Opinion

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This article was published 28/01/2025 (222 days ago), so information in it may no longer be current.

The Manitoba government says it has taken preliminary steps to improve services in emergency rooms after a 49-year-old patient died while waiting for care at Winnipeg’s Health Sciences Centre earlier this month.

Chad Giffin died on Jan. 7 at HSC after waiting about eight hours for care in the hospital’s ER. He was originally assessed as low-acuity, or less urgent. However, his condition deteriorated and he was pronounced dead shortly after staff noticed the change.

The ER was over capacity at the time, as it often is at Manitoba’s largest hospital. There were about 100 patients in the ER, around half of whom were in the waiting room.

On Friday, the provincial government said it has taken steps to improve care in the ER as it awaits the results of a critical incident investigation into the death.

“There are interim measures that have been taken in terms of making sure staffing is where it needs to be, and that all efforts are being made to ensure that the capacity that’s needed in order to ensure people are receiving the best care possible in our emergency departments is happening,” Health Minister Uzoma Asagwara told the Free Press.

Asagwara would not say exactly what those measures are. However, the Manitoba Nurses Union says it has heard from its members that the changes include adding a unit assistant to waiting rooms in ERs and urgent care centres to help monitor changes in patients’ conditions.

While that may be a useful measure, it does not address the core problem facing hospitals, namely that a shortage of staffed beds on medical wards is causing bottlenecks in ERs and urgent care centres. That in turn is causing long delays for patients seeking care.

Dr. Shawn Young, HSC’s chief operating officer, previously said that on the day of Giffin’s death, a backlog in the ER prevented admitted patients from being moved to a medical bed. It is a common occurrence that plays out at most Winnipeg hospitals. The more admitted patients there are in ERs waiting for a medical bed, the less time ER doctors and nurses have to see new patients. That in turn drives up wait times.

It’s a problem that has existed for several years that neither the previous Progressive Conservative government nor the NDP government has solved.

HSC had fewer licensed beds in 2023-24 at 781 than it did in 2020-21 at 791, according to Shared Health’s 2023-24 annual report. Bed occupancy during that period jumped from 83.45 per cent to 98.2 per cent. That means on average, there is very little additional capacity to absorb spikes in patient demand.

A shortage of personal care home beds and other long-term treatment options for patients is also contributing to the problem. Patients who require a PCH bed or other supports often languish in hospital for weeks waiting to be transferred to alternative care.

Together, bed shortages and delays in discharging long-term care patients contributes to hospital congestion and creates bottlenecks in ERs and urgent care centres.

While adding unit assistants to waiting rooms may be a valuable measure to provide more frequent re-assessments of patients like Giffin, it does not address the underlying problem.

The province must take steps to improve patient flow through hospitals by adding more staffed beds and increasing long-term care capacity to relieve pressure on ERs and urgent care centres.

Doing so is critical to bringing down dangerously long wait times and reducing the risk of more tragic deaths like Giffin’s.