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ER back logs put patients at risk: Chief of Emergency

HALIFAX – Growing emergency room backlogs are harming patients, said the chief of emergency at Nova Scotia’s biggest emergency department.

“We do know that this back up of patients does them harm, we know that patients who wait longer for emergency care do worse,” said Dr. Sam Campbell, Chief of Emergency at the Halifax Infirmary. “We know that patients who wait in emergency for hospital beds do worse.”

In an interview Dr. Campbell said the emergency department is over capacity and busier than it has ever been. “Our volumes are up 30 per cent over the last two years, older, and the level of illness is more severe.”

Dr. Campbell said it isn’t a problem of too many patients coming to the emergency room, rather once they get there patients who need to be admitted are often waiting in the ER for more than 24 hours for a hospital bed. On average ten of the 36 emergency beds are taken up by patients who should already be in a hospital bed, said Dr. Campbell. That cuts the capacity of his emergency department by a third.

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The emergency department has been operating in “disaster mode on and off for months, and in the last month constantly,” said Dr. Campbell. “Everything that can be done to try and have people flowing through more efficiently has been done and we’ve run out of capacity to do anything else.”

The Health and Wellness Department said this isn’t a long term issue but rather the result of a rough winter. “It’s been a difficult year for the weather, its been a difficult year for illness, as well. So its a seasonal type of thing we see year after year.”

but pointing at the flu season or slip-and-falls doesn’t get at the whole problem, said Dr. Campbell, who characterized the overcapacity issues as “chronic” and “systemic.”

The lack of beds is having an impact on ambulances that need to offload new patients, resulting in a backlog.

Capacity was at its highest on Monday when more than 220 patients were admitted. Normally the ER sees fewer than 200 patients. Capital Health said it is working on a solution but adds that, in the meantime, patients can expect a longer wait if they head to the ER.

Meanwhile, members of Nova Scotia’s Progressive Conservative Party and NDP are criticizing the governing Liberals’ handling of the situation.

“The Liberals have created chaos and confusion in the system. Patients are the ones who are left to suffer,” said PC MLA Chris d’Entremont, who serves as the party’s health critic, in a press release. “People are going to the ER and they are unable to get the care and attention they need. They end up being forced to leave, before ever receiving treatment.”

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NDP MLA Dave Wilson said the government needs to devise a plan to deal with the overcrowding.

“This is a major concern. Health-care workers and doctors at the QEII need support right now from the government to mitigate what is a very challenging situation,” he said in a statement.

A quick fix isn’t the right fix in these circumstances said Dr. Campbell. “I think we as voting citizens, we and our leaders need to look at the system, and say ‘we’ve got a system that’s clearly not managing the load that is being thrust upon it.’ All of the tweaks and internal changes have been made, so now changes have to come from outside.”

– With files from Julia Wong and Patrick Odell 

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