Wait times force 1 in 3 patients to leave Winnipeg's largest ER without seeing doctor: Shared Health
'If anybody was waiting for the apocalypse to actually make changes, let them know it's here': ER doctor
While increasing wait times continue to put pressure on Manitoba's health-care system, doctors say very sick people are leaving the emergency room without being seen by a physician at all.
More than one in every three patients who recently sought medical care at the emergency department of Winnipeg's Health Sciences Centre ended up leaving without seeing a doctor, according to recent data supplied by Shared Health.
"That's upsetting," Doctors Manitoba president Dr. Michael Boroditsky said when shown the data. "Obviously concerning for me as a physician, and for the patients for sure even more so."
According to the data, 13.1 per cent of those seeking medical attention in 2019 left without being seen by a physician.
During the same time period in 2023, that number skyrocketed to 34.1 per cent, meaning nearly one in three patients who presented and were triaged in the emergency room left without being seen by a doctor.
Those same rates worsened significantly at every hospital in Winnipeg over the past five years due to staffing and patient flow.
At St. Boniface Hospital, patients are leaving without seeing a doctor nearly 2.5 times more often than in 2019. At the Grace Hospital, it's happening nearly four times as often.
"This is unprecedented. I actually never dreamed it would be this high. It's a nightmare," said St. Boniface ER physician Dr. Alecs Chochinov said. "If anybody was waiting for the apocalypse to actually make changes, let them know it's here."
A patient leaving an emergency waiting room without getting treatment could lead to a life-or-death situation, Boroditsky says.
"That would be my biggest concern — that someone who needed care didn't get it," he said. "We don't want to be an environment where people feel that they're rolling the dice whether they're going to be cared for."
Chochinov said patients may present with what may appear to be minor systems that turn out to be signs of significant health concerns.
"What's thought to be a minor headache can be a stroke or a bleed into one's head. The whole point of seeking care for new symptom is to have experts in the field look at you," he said.
The rate of patients who leave without getting care is a number doctors and health officials track closely, as it helps provide a sense of what is happening within the health-care system as a whole.
The current numbers show the health-care system is not functioning well, Chochinov said.
While two per cent would be ideal, anything below five per cent is good, he said, but numbers higher than 10 per cent present the risk of deadly outcomes.
"Numbers at 20 per cent and 30 per cent … they're a recipe for disaster and those disasters are happening right now.
Struggle for timely care
The Manitoba Nurses Union agrees the numbers are concerning, saying wait times continue to plague the system.
"Patients get angry and they just leave," said MNU president Darlene Jackson, adding long wait times can end in tragedy for patients who aren't seen fast enough.
Emergency department wait times as of 2:40 p.m. Friday:
In February, a patient died while waiting for treatment in the crowded emergency department at HSC, where nurses said they were so overwhelmed they simply couldn't keep an eye on everyone all the time.
The man, who had been assessed and triaged, was awaiting care in a hallway — all staffed beds were full. His condition worsened and he died shortly after.
Patients end up stuck in the emergency room because there are no beds available.
Jackson says it's also important to note that some people end up at hospitals because they have no where else to access health care.
"If you are an individual in the core area and don't have access to a vehicle to get to Victoria Hospital, you go to HSC emergency — that is where you go to be seen," Jackson said. "And if you're not emergent or urgent then you may wait hours and hours and hours to be seen."
A new treatment clinic for minor injuries opened at Winnipeg's Health Sciences Centre in August in an attempt to ease pressure on the emergency department and connect patients with less urgent needs to other sites at the hospital.
The $3-million project is expected to see 22,000 patients each year, which is about four to six per hour or 50 to 60 daily.
So far, 828 patients, or an average of about 15 patients a day, had been seen as of Oct.1.
Shared Health said the current average median wait time in the new unit is just over 2½ hours.
However, its operating hours have varied over its first two months, ranging from six to 12 hours a day because of staffing issues that Shared Health says it's working to scale up.
Critical staffing shortages
HSC chief operating officer Dr. Shawn Young says the health-care system is currently struggling and overwhelmed, and staffing continues to be the most critical issue.
He said the rate of patients leaving without seeing doctors is troublesome.
"We're struggling being able to get people the timely care that they need," Young said. "It's quite distressing for all of us, patients and our staff, to see so many patients leave without receiving care."
Young added it's possible the situation could get worse before it gets better.
"It's a place none of us want to be," Young said. "None of us want to see it get worse. This is quite distressing for all of us."
However, staffing issues are not isolated to Manitoba or even Canada.
Recruitment teams are being "very aggressive" within the country and outside the country but there is competition worldwide, Young said.
While there has been funding in place to open more beds for some time, there is no staff to be able to open them. Young says he could hire 500 nurses tomorrow if they were available.
Young says patient flow continues to be a challenge not only in the emergency departments but one that cascades throughout all areas of care.
It remains a challenge moving patients to other units in the hospital from the emergency department because beds are occupied by patients who are unable to get into alternate environments such as long term care, home care or other jurisdictions.
"Some pieces of this will be quicker to solve, but at the crux of this is the entire ladder of our health-care system is facing the worst staffing crisis it's ever faced," he said.
In a statement to CBC News, Health Minister Uzoma Asagwara said their NDP government "was elected with a mandate to deliver better health care, starting with a plan to fix the staffing shortage crisis."
The "system is in desperate need of help" after years under a Progressive Conservative government, Asagwara said, and "these alarming patient volumes are just one sign of how extensive the damage is."
The new health minister added they hope to "restore Manitobans' trust in our health-care system."
WATCH | Wait times force 1 in 3 patients to leave Winnipeg's largest ER without seeing doctor: Shared Health:
ABOUT THE AUTHOR
