While steadily increasing wait times are putting pressure on the health-care system and frustrating waiting patients, doctors say other very sick people are leaving the emergency room without ever being seen by a physician at all.
“It’s very concerning,” former provincial specialty lead for emergency medicine at Shared Health, Dr. Alecs Chochinov, told Global News.
“These wait times of nine and 10 hours really are unprecedented. They’re heartbreaking.”
The Winnipeg Regional Health Authority said median wait times are up, year over year, to 2.53 hours this past July. They were 1.68 hours in July of 2020.
According to the health authority’s latest stats, St. Boniface Hospital has the longest median wait time at 3.67 hours, while the lowest is the Children’s Hospital at 1.17 hours.
But Chochinov — also an emergency room physician at St. Boniface — said the situation is worse when you look at the 90th percentile measure, which shows the ER waits endured by the patients at the longest end of the spectrum.
At Health Sciences Centre in August, that meant 10 per cent of patients were waiting nearly 10 hours after registering at the front desk before they saw a doctor, according to data released by Shared Health.
“Wait times in emergency departments are just symptomatic of problems in the health-care system itself — and the health-care system, as we all know, is very complex,” he said.
There have, however, been many instances of much longer wait times — a month ago, an ER doctor told Global News about patients he had seen at St. Boniface who had waited up to 17 hours.
Winnipegger Alyson Shane told Global News that a head injury she suffered while cycling — one that eventually required seven stitches — left her in the waiting room at Health Sciences Centre for the better part of a day Wednesday.
“I was triaged. The nurse bandaged me up a little bit and then I sat in the waiting room for about 10 hours. That sucked,” Shane said.
“I was finally seen at about 2:30 in the morning. I think around there, time started to have no meaning. And honestly, once I was seen — once I was in a bed — I was in and out in 30 minutes.
“The doctors and nurses work super fast. They were great, but it was the waiting and being in that waiting room that was the really difficult part of that whole experience. ”
Shane said the wait was one of the most depressing and eye-opening experiences she’s had — watching people leave because they couldn’t wait any longer, watching patients struggle without getting any help.
“There were probably about half a dozen people at least who left who were there when I got there, who just left over the course of the night because they didn’t want to wait anymore,” she said.
1 in 4 leave without seeing doctor
In August 2018, HSC had a left without being seen rate of 8.7 per cent. By August 2021 that number had skyrocketed to 24.3 per cent, meaning nearly one in four patients who presented and were triaged in the emergency room left without being seen by a doctor.
“Breaks my heart,” Chochinov said. “I’ve never heard of anything like that in my career.”
The “left without being seen” rate is a number doctors and health officials track closely.
“The left without being seen rate is a very, very important measurement of how the emergency department is functioning and how we’re how we’re able to deal with with patients,” Chochinov said.
Chochinov said the standard that they aim to be at or the bar that was set was to have a left without being seen rate of two per cent. However, he said that percentage is not very achievable so hospitals aim for less than five per cent.
“When we started reaching eight or 10 per cent or more, we knew we had a problem,” he said. “Rates of 20 per cent are unfathomable.”
He said those percentages signify deep problems within the system and often end with deadly outcomes for patients.
“The result is increased morbidity and mortality. I don’t think that it would be an exaggeration to say that left without being seen rates at up 20 per cent are causing significant pain and suffering every day and causing unnecessary deaths every week,” he said.
Hearing about patients leaving emergency waiting rooms without getting treatment, Chochinov said, is a serious concern — as the majority of people visiting an ER are there for a serious medical problem.
“These are sick, sick people. And in the context of the pandemic, they’re often people who have been at home with medical illnesses and have worsened and finally they can’t wait anymore.
“So we’re not turning away people with a sprained ankle,” he said.
“We’re turning away sick people, people with heart conditions, with post-surgical complications, with trauma who may not manifest the complications of that trauma for a couple of days. So it is very concerning.”
A spokesperson for Shared Health acknowledged that wait times — especially for those with less urgent needs — are well above their normal levels, and that staffing concerns remain at busy hospitals like Health Sciences Centre.
“More than 18 months of pandemic response have impacted our work force and exacerbated staffing vacancies in some areas,” the spokesperson said.
“We are also seeing the return of patient flow challenges that existed before the pandemic. This happens when a patients’ length of stay is increased or when there are challenges in accessing appropriate services.
“Our inability to discharge has a significant impact on the (emergency departments), resulting in wait times that are well above our norm.”