Overcrowding in Canada's emergency rooms is so severe that physicians and ER nurses have taken the unusual step of joining forces to demand reforms.
Dr. Douglas Sinclair, head of the 1400-member Canadian Association of Emergency Physicians, says the shortage of long-term-care beds has elderly patients lining emergency department corridors across the country. “It's a terrible way to deliver care,” says Sinclair, head of emergency medicine at the Queen Elizabeth II Hospital in Halifax.
“It's very noisy and there are lights on all the time,” adds Ann Cessford, head of the 1185-member National Emergency Nurses Affiliation. “The patients are exhausted by the atmosphere” and nurses experience “overwhelming anxiety.”
The 2 professional organizations responded with a joint position statement asking governments to recognize ER overcrowding as a high-priority concern. The joint statement says that overcrowding is “a symptom of system failure and solutions will require more community care options for the elderly and chronically ill, better access to diagnostic, surgical and acute care services, and improved hospital efficiency.”
They also want Canada-wide standards for ER triage, databases to monitor use and pilot projects to enhance care. Most important, says Sinclair, is the need to target spending on research-based outcomes. “We waste a lot of money in health care, no one would question that. We need to be smarter.”
Although the shortage of hospital beds is the primary cause of overcrowding, the statement says the problem is made worse by a “near collapse of primary care” that has resulted in orphan patients, a shortage of nurses and physicians, and large numbers of patients arriving with nonurgent problems.