We sat down with Susan Kwolek, Mackenzie Health’s EVP, CNE and COO, to answer some of the most commonly asked questions from patients and families about how the pressures we see in the Emergency Department (ED) affect wait times and access to this specialty care.
Why is the ED so busy?
We have many more people living in our community than just a few years ago, and we also care for patients from across York Region, Toronto and other parts of the Greater Toronto Area. On any given day, we often see more than 300 patients, and last year cared for 109,000 in an ED built to care for 80,000 patients annually. In the eight years since we opened our new ED, the local community has continued to grow and we have not been able to keep up with this extreme increase in demand for emergency services. We also know the community is expected to grow by another 40 per cent by 2031 and those people will also need health care.
Our ED has 70 treatment areas, including treatment rooms and stretchers, isolation rooms and treatment chairs. At any time, our staff could already be actively caring for up to 70 patients, including those who have arrived by ambulance.
What are you doing about wait times?
Last year, we opened an Urgent Care Centre (UCC) to provide an alternative to the ED for patients with non-urgent health concerns such as needing stitches, casting broken bones or sports injuries. In its first year, we saw more than 11,000 patients of all ages at the UCC which is helping to reduce the burden on the ED, providing faster care for patients with less urgent needs.
In the ED, we do our best to see everyone as quickly as possible and are always looking for opportunities to improve care. Recently, we increased space and enhanced privacy in the ambulatory area of the ED. We also recently began construction on the new Mackenzie Vaughan Hospital which will dramatically increase our ability to provide care when it is completed in 2020.
Who decides who is seen first?
Patients are not seen on a first-come, first-served basis. First the triage nurse asks standard questions about your condition such as symptoms; and severity — “When did your symptoms begin” — and when an illness or injury occurred in order to determine immediate care needs. The triage nurse also monitors all the other patients in the waiting room for any changes in their conditions.
If your symptoms change or worsen while waiting, you should inform the triage nurse so your condition or immediate needs can be reassessed.
Why am I waiting so long?
In the ED things change rapidly. Wait times fluctuate depending on what illnesses and injuries are being cared for. Often patients need immediate resuscitation or care for a life threatening injury. Providing immediate care to those who need it most sometimes delays care for those with less serious concerns.
I came to the hospital by ambulance, why am I not being seen first?
Arriving by ambulance does not always mean you will be cared for first. Each patient is seen and assessed upon arrival and cared for as quickly as possible. The team also continually monitors the conditions of all the other patients waiting for and receiving care. If anything changes requiring attention sooner, those patients will be seen more quickly.
Why do I need to pay ambulance fees?
In Ontario, ambulance transportation is charged based on a number of factors. Ontario residents with a valid Ontario health card who arrive at a hospital by ambulance and a physician determines that the ambulance was necessary are required to pay a fee of $45. The remaining portion of the fee for these patients is covered under the Ontario Health Insurance Act.
If the ambulance is not medically necessary or patients are not eligible for OHIP, ambulance transportation is not insured under the Ontario Health Insurance Act and the patient must pay the full ambulance fee of $240.
Why am I waiting in the ED to be transferred to an inpatient room?
On any given day, we have more patients waiting for care than inpatient beds available to treat them in the hospital and we do our best with the space we have. Whether a patient is cared for in the ED or in an inpatient room we strive to provide safe, quality care.
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