WRHA unable to make progress on ER waits

WINNIPEG – The Winnipeg Regional Health Authority admits it has failed to make any measurable progress over the past 12 months in meeting a series of performance targets for city hospital emergency rooms.

A year ago, WRHA president and CEO Arlene Wilgosh (pictured) unveiled new goals for ER wait times and ambulance off-load waits in a speech to the Winnipeg Chamber of Commerce.

By 2015, she said, the WRHA wanted to be able to treat and discharge 90 percent of emergency room patients (those not admitted to hospital) within four hours and to ensure nobody sat in an ER for longer than 24 hours. If an ER patient needed to be admitted to hospital, she said, a bed should be found for that person within eight hours 90 percent of the time.

Also by 2015, she announced, the region wanted to be able to unload all ambulances at city hospitals within 60 minutes. And the WRHA sought to lower the number of non-emergency patients seeking treatment at ERs to 20 percent or less.

In an interview with the Winnipeg Free Press, Wilgosh released statistics that show the region has made little or no progress in achieving these goals in the past year. In a couple of areas, it lost ground slightly. “The numbers are what I call flat,” the WRHA boss said.

Wilgosh likened the effort it will take to reach the region’s ER targets to turning around the Titanic.

The WRHA and the province have several new initiatives in the works or already under way to reduce ER and hospital admission waits and to try to steer non-emergency patients away from hospital emergency departments.

Included among these is the creation of QuickCare clinics – designed to treat less serious injuries and illnesses – staffed by nurses and nurse practitioners. There are two such clinics in the city right now and two more are expected to be opened this year.

There is an ongoing advertising campaign and website – myrightcare.ca – encouraging patients who don’t need emergency treatment to seek quicker and more appropriate alternatives to a hospital emergency room.

The health authority is also looking at improvements in overall hospital practices that will ease the pressure on ERs. For example, hospitals sometimes keep patients longer than they need to because of delays in arranging needed supports once patients are discharged. One of the initiatives the region has launched is a more co-ordinated approach in which post-hospital discharge supports are assessed and put in place as the patient is admitted.

Wilgosh said there were some within the system who questioned the need for setting performance targets when she unveiled them at the business luncheon last January. But there has been better buy-in as the year has progressed, and the targets have “really motivated the system” to improve, she said.

Goals:

• 2015 goal: Treat and discharge 90 percent of non-admitted emergency room patients (those not admitted to hospital) within four hours.
• In 2012: 51 percent of non-admitted patients were treated and discharged within four hours.
• In 2013: 50 percent of non-admitted patients were treated and discharged within four hours.
• 2015 goal: Find a bed for 90 percent of emergency room patients who have been admitted to hospital within eight hours.
• In 2012: 33 percent of emergency room patients who needed to be admitted to hospital had been treated in the ER and admitted to a ward within eight hours.
• In 2013: 32 percent of emergency room patients who needed to be admitted to hospital had been treated in the ER and admitted to a ward within eight hours.
• 2015 goal: No patient, admitted to hospital or not, is to sit in an emergency department longer than 24 hours.
• In 2012: 95 percent of all emergency patients had been treated and discharged from the department within 24 hours.
• In 2013: 95 percent of all emergency patients had been treated and discharged from the department within 24 hours.
• 2015 goal: Ensure the number of non-emergency patients attending hospital emergency rooms does not exceed 20 percent.
• In 2012: Non-emergency patients accounted for 45 percent of all emergency department visits.
• In 2013: Non-emergency patients accounted for 43 percent of all emergency department visits.
• 2015 goal: All ambulances are able to unload patients at hospitals within 60 minutes.
• In 2012: 76 percent of all ambulances were able to unload patients within 60 minutes.
• In 2013: 74 percent of all ambulances were able to unload within 60 minutes.