If you headed to the emergency department at the Hawkesbury and District General Hospital (HGH) over the holidays and felt that you had a long wait, it was likely the case for several reasons.
“Wait times over the holidays are extremely long everywhere,” said HGH Chief of Staff, Dr. Julie Maranda.
There are various reasons for those longer wait times, according to Dr. Maranda. One is that the holiday season generally coincides with the peak season for colds, influenza, and gastro-intestinal viruses. Doctors’ offices are usually closed, or open for reduced hours over the holidays, which makes it more difficult for patients to get medical attention that way, so they go to the emergency department instead. More personnel are also away on vacation during the holiday season, which also leaves hospitals short of staff.
Dr. Maranda explained that the Physician Initial Assessment (PIA) formula the hospital uses to measure the amount of time it takes a patient to see a doctor from the time they arrive at the hospital is normally two to three hours at HGH but was four to six hours during the holidays.
Every patient who enters the emergency department is triaged. Those with more serious issues are attended to first.
“The patients waiting in the emergency room are still our patients,” said Dr. Maranda.
She said that the triage nurses routinely check the waiting area to see if patients’ conditions have changed and should be re-prioritized.
HGH Interim Chief Nursing Executive and Clinical Director of Inpatient Services Julie Milks said it is important that patients know that the triage nurse is checking the waiting area.
Milks and Dr. Maranda said that patients from Québec using the Hawkesbury hospital are not a factor in causing longer waiting times. Half of the emergency patients in Hawkesbury are usually from Québec and the hospital ensures that the department is staffed and budgeted according to the volume of patients regardless of which province they live in.
Dr. Maranda said having more medical offices and walk-in clinics open over the holidays would help reduce the number of people using emergency departments, but she noted that what people perceive as an emergency differs from person-to-person.
“A cough in one person is not the same as with another person,” she said.
HGH has been making efforts in the past three to four months to reduce emergency waiting times. Dr. Maranda said the ED Intensive Task Force’s efforts have led to “at least” a 50 per cent reduction in the time patients are waiting.
In order to reduce the wait times, the task force identified times when the department is generally busier, and more staff were added at those times. When conditions warrant, extra staff are called so that patients can be attended to more quickly.
Milks said the average wait time has gone from 7.4 hours to six. She added that the emergency department at HGH also has two physician assistants and a nurse practitioner was recently hired.
Another measure that Dr. Maranda explained HGH uses that many other hospitals do not use is a set of directives that allows emergency department nurses to order certain tests for patients in order to help the system move more quickly.
The efforts to further reduce emergency wait times will be ongoing. Milks said that will ensure HGH is better prepared for future peak viral seasons. She also said that any complaints they receive are taken seriously and are investigated.