jamcity Posted January 21, 2016 Posted January 21, 2016 via Hamilton Spectator - Jan 21, 2016Despite improvements, ER wait times still too long Hamilton Spectator By Joanna Frketich Wait times for Hamilton's adult emergency departments continue to be far above target despite having rapid assessment clinics like the one announced in Burlington. The sickest patients are in the emergency department for more than double the amount of time set as a target by the Ministry of Health at Juravinski, Hamilton General and Joseph Brant hospitals. It took around 22 hours at Juravinski and around 19 hours at Hamilton General and Joseph Brant for nine out of 10 patients to either be discharged or admitted in November. The target is eight hours. St. Joseph's Healthcare was also over target at around 12 hours. "This is something that has been an area of focus and attention," said Cheryl Williams, vice-president of patient services and chief nursing executive at Joseph Brant. "We've made investments … to try to address wait times." The province announced Wednesday it is giving up to $2.7 million over three years for a new General Internal Medicine Rapid Assessment Clinic at Joseph Brant in Burlington to reduce emergency department wait times. The clinics help avoid unnecessary hospital admissions by giving emergency room doctors a place to refer patients where they will be seen by the appropriate specialist within 24 to 72 hours. Freeing up beds is key to reducing wait times so the department can quickly admit patients to the hospital instead of having them languish in the emergency room. Hamilton Health Sciences has a similar clinic at McMaster University Medical Centre. It is looking at allowing family doctors to also refer to the clinic to avoid patients going unnecessarily to the emergency department in the first place, said Brenda Flaherty, chief operating officer at HHS. St. Joseph's Healthcare has two clinics — one at its Charlton Avenue hospital and another at its West 5th Street site. "They make a big difference in our ability to safely discharge from the emergency department," said Dr. Ian Preyra, chief of emergency medicine at St. Joseph's. "It's important we can get them seen promptly … Emergency physicians would not generally feel comfortable sending someone home if you don't know they will be followed appropriately." But despite having the clinics for a number of years, Hamilton hospitals continue to struggle with waits well above provincial average and target. Ontario-wide it takes about four hours for nine out of 10 patients with minor injuries to be discharged from hospital. In Hamilton and Burlington it takes adults between five and six-and-a-half hours. A big part of the issue is that more than one in 10 hospital beds in Hamilton and one in five in Burlington are blocked by patients who no longer need to be in hospital but can't leave because they are stuck waiting for other types of care such as long-term care, rehabilitation and home care. "The two are definitely related," said Williams about emergency room wait times and blocked beds. "You don't have the capacity to move the patient up to the floors." The effect the blocked beds — also known as alternative level of care — have on emergency departments is obvious when looking at the waits at McMaster Children's Hospital. It meets all targets for wait times in part because children require fewer hospital admissions and there are no ALC patients in pediatrics. [email protected] 905-526-3349 | @Jfrketich Joanna Frketich is a reporter with the Hamilton Spectator. Email: [email protected]. Twitter: @jfrketich. How long do patients wait? Total hours spent in the emergency department from arrival to discharge or admission in November. Average - Patients with serious and complex conditions Ontario: 5.3 Juravinski: 8.9 Joseph Brant: 8.3 Hamilton General: 7.6 St. Joseph's: 6.4 McMaster Children's: 4.0 - Patients with minor issues Ontario: 2.1 Juravinski: 3.6 Joseph Brant: 3.4 Hamilton General: 3 St. Joseph's: 2.9 McMaster Children's: 2.3 9 out of 10 patients - Patients with serious and complex conditions were discharged or admitted within: Ontario target: 8 Ontario actual: 9.8 Juravinski: 22.2 Joseph Brant: 19.1 Hamilton General: 18.9 St. Joseph's: 12.2 McMaster Children's: 8.0 - Patients with minor issues were discharged or admitted within: Ontario target: 4 Ontario actual: 4 Juravinski: 6.6 Joseph Brant: 6.1 Hamilton General: 5.4 St. Joseph's 5.2 McMaster 3.9END of Articlejamcity commentary I spent some time in Barton hospital less than five years ago as adult services were being moved away from McMaster's hospital.The place was a complete mess, as in it was filthy, plain dirty- without even getting into how cramped and improper everything else was.It reminds me of when I had to go to a nurse here for blood working during my immigration, the most memorable part of that experience was how dusty the place was. The examination room had cobwebs hanging down from the ceiling- it was a total dump.The last time I was admitted to McMaster hospital it took me almost 10 hours before I left. It was of course 9 hours before I saw a doctor, who had a very tenuous grasps on the English language. He struggled to communicate with us and eventually left us saying that I had a 'bone bend' no cast would be needed, no sling provided, and sent out the door.Shortly there after I went to a specialist in Michigan. I waited less than a couple minutes upon arriving. The entire process took no more than 20 minutes, perhaps 30 minutes the first time. They checked me out, after which the specialist was fully informed about my problem and was ready to help me. We did some sort of electrical/acupuncture work on my arm- I came back in a couple more times to continue the procedure and follow up.It is literally faster for me to drive back to Michigan and back whenever I need medical work done then use any of the services in my area.I want to add one little anecdote:The hospitals in Canada are not caring- at all. By that I don't mean the doctors don't have much concern for the patients and simply want to push them out as soon as possible- which might be true for some.No I mean that whenever I have gone to the hospital, as a foreign national, they have been nothing but rude and indignant to me.They refuse to make eye contact it seems until you show them you can pay! I am glad I have good health insurance because once I begin producing that the attitude is more than a little changed, and often I get better service than the Canadians. That should not be forgotten though. Too many people mistake what medical and health care are. It seems like they would refuse medical service to those deeply in need unless they are told they can.I am at least proud that in America it doesn't matter who you are you will get the emergency services needed- I'm not so sure these how much these "universal health care" plans actually help those worst off.
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