Strains causing patient buildups in Chatham-Kent emergency

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While recently released data puts the wait times to see a doctor in Chatham-Kent’s emergency rooms close to the provincial average, the chief of emergency medicine for the local hospital group has said it doesn’t provide a full picture of the patient experience.

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The data from April, released by the province, revealed it took the average patient 2.2 hours for their first interaction with a physician in Chatham and 1.7 hours in Wallaceburg. The average across Ontario for that month was 1.9 hours.

Dr. Dax Biondi of the Chatham-Kent Health Alliance said some patients would be “quite pleased” with these wait times, “but I don’t think that’s the experience a lot of people are having.”

Biondi said the whole system has difficulty addressing a high number of registrations in the Chatham emergency department that usually occurs from about 10 a.m. until 9 p.m.

“What that means is every single hour that goes by, people are building up in the waiting room. We just can’t keep up with them,” he said.

Around 9 p.m. or 10 p.m., “the registrations start to drop off, but there are a huge number of people waiting because they’ve been building up,” he said.

The situation is similar in Wallaceburg, Biondi said, but the higher volume usually starts later in the day.

The doctor said reported issues about physician and nurse shortages are true, but they are not the only reasons for longer wait times.

“We do have uncovered nursing shifts. The nurses are running throughout their shifts and they are feeling a lot of stress,” he said.

“My sense is it is not about nurses and it’s not about physician hours. If you were to add more physicians or add more nurses, I don’t know if even that would solve the problem. It seems it’s the whole system. We just can’t keep up with the registrations.”

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Biondi said it seems every step – including getting patients to hospital beds, getting people through diagnostic imaging and labs running patient data – is under strain.

The actual footprint of the Chatham emergency department has also posed a challenge in seating registered patients, he said.

“Once those people are in the emergency department and they’re waiting, we lack capacity to bring new people in because … the physical floor space is occupied and their nurse is (also there) taking care of them,” Biondi said.

While Biondi said the health alliance made the right decision to implement a new digital information system in 2020 because it has helped with limiting errors, it seems to take longer for physicians to complete than the paper system.

Biondi said there are usually 100 to 110 patients in the Chatham emergency room every day. The data show there was an average of 94 per day in April.

“Prior to the pandemic, prior to our introduction to this new health information system, I would have said we felt we had the capacity to handle 100 to 110 visits a day in Chatham, and it just doesn’t feel like that’s the case anymore,” he said.

The longest wait time to see a doctor in the province was five hours at Windsor Regional Hospital’s Metropolitan Campus.

The health alliance has put out public service announcements this year asking people to consider other health-care providers if their condition is not an emergency due to these strains.

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Biondi said he recognizes he has a medical education and the benefit of hindsight once he sees a patient, but many people could have waited to see a primary-care doctor.

As an example, he saw 47 patients on a recent shift in Wallaceburg and “the vast majority of people didn’t need to be there,” he said.

Biondi said he often sees people who have a sore throat and think they need antibiotics, which usually aren’t used to treat viral infections.

He said most should only see a doctor for respiratory symptoms if they can’t take in fluids, if they struggle breathing or if they have a change in energy or behaviour that isn’t improving with ibuprofen or acetaminophen.

The data also showed patients at the Chatham site who needed a hospital bed waited 12.2 hours to be moved out of the emergency department. While this is lower than the province’s 20-hour average, just 43 per cent of these patients were admitted to a hospital bed within Ontario’s target time of eight hours.

The Chatham site has done better at meeting targets for discharging patients who did not need to be admitted to the hospital, with 75 per cent of low-urgency patients being released within four hours and 89 per cent of high-urgency patients released within eight hours.

Biondi said the situation hasn’t improved since April, and he expects these strains will worsen this summer.

“We tend to see a lot more trauma in the summer just because people are a lot more active right now – car accidents and multi-terrain vehicles, water-based sports,” he said.

“People seem to take more chances with drinking and driving, those sorts of things.”

Biondi asked people to consider the burnout a lot of physicians and nurses have been experiencing when being seen in the emergency departments.

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