A few months ago, a friend was telling me about an emergency room experience she’d had, and made an insightful comment about why it was so poor.  She is a pharmacist in the neo-natal unit at one of Toronto’s premier hospitals, so she is very familiar with hospital operations.

During her visit to the ER, she had a long wait (of course) and was appalled at the conditions once she was admitted.  She was lying in a bed in a hallway with many other patients and she ended up having to assist one of the elderly patients herself because there was no medical personnel available.  The ER facilities were old and outdated.

I expressed surprise because the hospital has such a good reputation and – I thought – was well funded by donors.  But she raised a great point: all the money that comes in is targeted for treatment of the more high profile conditions/diseases like cancer and heart disease (coincidentally, the Canadian Cancer Society and many of the more well-known cancer-related charities, as well as The Heart and Stroke Foundation, are Canada’s biggest charitable organization from a fundraising perspective).  So the oncology wards are probably state-of-art with hotel-room-like amenities and good staff-to-patient ratios.

But if you get hit by a car or have a seizure and need urgent care, good luck.

ER wait times have been on the agenda for several years in Ontario now and if you believe the press releases, the McGuinty government claims to have reduced wait times by over 4 hours for people requiring more complex medical care, and by over an hour for patients with minor conditions.  To their credit, they anted up more money for their Pay-for-Results program so that more hospitals could participate in this incentive program.  One of the other tactics they have invested in is a public awareness campaign educating Ontarians about alternatives to ERs, such as walk-in clinics, urgent care centres, of after-hour clinics, for example.

I would suggest this is probably one of the most effective ways to reduce wait times.  Like the awareness campaign around how to use 911, the objective is to filter out the non-emergency situations so that these individuals don’t go to ERs and clog up the system unnecessarily.  However, after having seen the ads that the government has been running, I cannot see how they effectively communicate the message – they’re too soft and tiptoe around the key message.  They need to be more blunt like the media campaign for 911: do not go to an ER unless you are experiencing something that requires urgent assessment and care.  The slogan on the “When to Call 911” website is: “It’s an emergency vehicle,  NOT A TAXI.  Save emergency vehicles for emergencies.”  ‘Nuff said.

Patient education is the first line of defense, especially in a province where new immigrants represent 28% of the population.  They need help with understanding the options available to them.  But equally important is addressing what constitutes an emergency: when is it prudent to make a visit to the ER and when is it best to go to the nearest walk-in.  In true emergency situations, every second counts, so making this decision could save a life.

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