ER Report Cards

The following are assessments of how your local Emergency Room is doing. Each is written by your local team of ER doctors based on their first-hand experience and expertise.

= Fail
= Fair
= Good

Click the name of your hospital below and find out how it’s doing.

Delta Hospital

Report Card for:
Fall/Winter 2012-13
Delta Hospital
5800 Mountain View Blvd,
Delta BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
At present at Delta ER, we have two ER physicians from 11:30 to 8 pm each day. The rest of the day there is a single ER physician working to see the ever-larger number of patients attending our ER. We need two ER physicians from 8 am to midnight because of the increasing volume of patients that we are seeing. To deliver prompt and safe assessment, we calculate our ER patients need this additional 7 hours of physician time each day. In other words, to meet current needs, it will take 2 more Emergency Docs to staff the additional 7 hours per day through the year. Our physician staffing level was set in 2010 based on seeing 26,581 patients a year. Since then, our ER patient visits have increased by 4313 to 30,894. More patients need more doctors. A smart system would plan a year ahead because it takes time to recruit new Emergency docs to the Delta area. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital for the Southern Lower Mainland. Our hospital is often overcapacity, although fortunately, for some reason, our ER is not as choked or blocked as other ERs.

However, if you are unlucky, and have to wait for a bed, Delta has by far the longest Emergency Department Length of Stay of all 12 Fraser Health Authority sites – over 36 hours on average. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. The plan is: you will have to wait. This is not good for our patients, nor for the ER.

The Fraser Health Authority administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.
Because of in-patient ward access block, ambulance patients wait frequently on stretchers prior to being seen by the triage nurse. Many face long waits in our back hallway before getting a stretcher in the ER where they can be seen by the doctor.

Eagle Ridge Hospital

Report Card for:
Fall/Winter 2012-13
Eagle Ridge Hospital
475 Guildford Way
Port Moody, B.C
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, we, the ER docs at Eagle Ridge Hospital (ERH) calculate our ER patients need 8 more hours of physician time each day than we currently have. We need one extra ER doc from 10 A.M. to 6 P.M. 365 days a year. In other words, to meet current needs, it will take 2 more Emergency Docs to staff a new 8 -hour shift all year. Our physician staffing level was set in 2010 based on seeing 46,593 patients a year. Since then, our ER patient visits have increased by 6,954 to 53,545 – a 15% increase!. We get a small amount of temporary extra staffing, but this is not enough. More patients need more doctors or ER patients wait too long. A smart system would plan a year ahead because it takes time to recruit new Emergency docs. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital for the Southern Lower Mainland. Our hospital is choked by over 100% capacity. Our ‘sister’ hospital, Royal Columbian, is also over 100% full. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. The plan is: you will have to wait. This is not good for our patients, nor for the ER.

The Fraser Health Authority administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.

Because of in-patient ward access block, ambulance patients wait frequently on stretchers prior to being seen by the triage nurse. Many face long waits in our back hallway before getting a stretcher in the ER.

Royal Columbian Hospital

Report Card for:
Fall/Winter 2012-13
Royal Columbian Hospital
330 East Columbia Street
New Westminster, BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, we, the ER docs at Royal Columbian Hospital (RCH) calculate our ER patients need 7 more hours of physician time each day than we currently have. We need one extra ER doc from 11 A.M. to 6 P.M. 365 days a year. In other words, to meet current needs, it will take 2 more Emergency Docs to staff a new 7 -hour shift all year. Our physician staffing level was set in 2010 based on seeing 68,048 patients a year. Since then, our ER patient visits have increased by 5,058 to 73,106 – a 7.5% increase!. We get a small amount of temporary extra staffing, but this is not enough. More patients need more doctors or ER patients wait too long. A smart system would plan a year ahead because it takes time to recruit new Emergency docs. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital for the Southern Lower Mainland. We are the second busiest Trauma Center in BC. Our hospital is choked by over 100% capacity. Our ‘sister’ hospital, Eagle Ridge, is also over 100% full. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. The plan is: you will have to wait. This is not good for our patients, nor for the ER.

The Fraser Health Authority administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.

Because of in-patient ward access block, ambulance patients wait frequently on stretchers prior to being seen by the triage nurse – second worst in BC. Many face long waits in our back hallway before getting a stretcher in the ER.

Royal Inland Hospital

Report Card for:
Fall/Winter 2012-13
Royal Inland Hospital
311 Columbia St. Kamloops BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
The Royal Inland Hospital is an alternate payment (APP) site that has seen an increase of 5000 patient visits since 2010 with zero increase in physician hours. Using the Provincial Workload Model (WLM) we calculate that due to our huge increase in patient volume, our patients require 3 more physicians to allow for prompt and safe assessment.

As of February 1st, 2013 we received funding for 2.45 extra physicians. This changes us from being critically short of staffing to being adequately staffed. However this contract ends March 31 2013 and its renewal is dependent on resolution of contract negotiations with the Ministry to pay for the 15 physicians already working. That contract to pay for the 15 physicians had expired in April 2012.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy tertiary care hospital for the Interior of BC and the fourth busiest trauma center in the province. Our hospital has been operating at or over 100% capacity since 2009 with peak times reaching up to 135%. The projected number of ED patient visits for this year is 57000, a 11000 increase in patient visits since 2009.

Interior Health Authority recognizes our ED congestion concerns. They have implemented overcrowding procedures and attempted to fund a utilization position. RIH administrators have daily and sometimes twice-daily bed meetings. We have tried a “bed team” to speed turnover time, and funded “Pathways to Home” beds to decrease patients who require placement to alternate care. Unfortunately these initiatives have done little to improve ED congestion. Because of ED congestion, ambulance patients frequently wait on stretchers in back hallways prior to being seen by the doctor

Lions Gate Hospital

Report Card for:
Fall/Winter 2012-13
Lions Gate Hospital
231 15th St E, North Vancouver, BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, we, the ER docs at Lions Gate Hospital (LGH) calculate our ER patients need 6 more hours of physician time each day than we currently have. We need one extra ER doc from 10 A.M. to 4 P.M. 365 days a year. In other words, to meet current needs, it will take 2 more Emergency Docs to staff a new 6 -hour shift all year.

The Lion’s Gate Hospital Emergency Department physicians are finding it increasingly difficult to see the large number of patients that present to our hospital each day. Our visits have increased by about 8.25% (or 4000/year) since our staffing levels were last established. The average acuity level (seriousness of illness) is also increasing. Our health authority and hospital have thankfully been able to increase the amount of physician coverage we have in a day through temporary funding. However, this increase will not meet our current or future demand. Patients will wait longer to be seen by a doctor until our staffing levels are addressed on a regular basis.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital for the Southern Lower Mainland. Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. The plan is: you will have to wait. This is not good for our patients, nor for the ER.

At Lion’s Gate, many of our emergency beds are filled with patients who are admitted to hospital. These patients should be on a medical or surgical floor, but our hospital does not have the nursing or physical capacity to care for them. This restricts our ER doctors’ ability to see people coming to the emergency room in a timely manner, or in a safe manner. We are often forced to see sick, contagious, elderly or mentally unstable patients in the waiting room or hallway. And none of these people can receive nursing care or lifesaving medications until they reach an emergency bed. Our hospital and health authority have initiated an “Overcapacity Protocol” in order to reduce ER congestion, but it has become ineffective as our visits increase.

Because of in-patient ward access block, ambulance patients wait frequently on stretchers prior to being seen by the triage nurse. Many face long waits in our back hallway before getting a stretcher in the ER.

Kelowna General Hospital

Report Card for:
Fall/Winter 2012-13
Kelowna General Hospital
2268 Pandosy Street
Kelowna, BC
Overcrowding

Access Block
Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are the referral centre for the interior of the province BC’s 5th busiest trauma center. Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. We have a new Hospital. It is “bigger”, but with bigger rooms, not more rooms. It was designed under the recent unrealistic government idea: that you design and staff hospitals based on 100% utilization of capacity: thus in spite of population growth our new hospital has the same number of rooms and staffing as the old.

Patients often wait more than 6 hours to see a physician or get a stretcher in the department. Our minor treatment and less acute areas are blocked by admitted patients and we don’t have room to treat simple medical problems. Elderly patient often wait the longest. This is unacceptable care for our family, loved ones and the citizens of British Columbia. We also have the longest ambulance wait times in the province.

The Interior Health Authority administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
As a Fee for Service Emergency Room, we have to see patients in order to be paid. Our schedule is staffed assuming flow of patients in, through and either home or upstairs to the wards. Now patients are waiting, but there is no safe place where we can examine them with dignity, where we can start treatment. The ER is blocked: all of its stretchers full of admitted patients.

In the last few months Access block/overcrowding has frozen flow to the extent that we ER Doctors see much fewer patients per shift. We are completely inefficient despite so many patients waiting. We have contemplated dropping a shift from the schedule because there is not enough work done on our shifts to justify a doctor’s time. More patients are arriving; more patients need more doctors, not fewer. Because less patients can seen because of boarding we are facing the possibility of less doctors: obviously, there needs to solutions to boarding. A smart system would ensure good flow of patients allowing for an increase in scheduled staffing. Our patients are still waiting for a place where we can see them. They can’t wait indefinitely to get timely care.

Prince George Hospital

Report Card for:
Fall/Winter 2012-13
Prince George Hospital
1475 Edmonton Street
Prince George, British Columbia
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
Our physician staffing level was set in 2010 based on seeing 44,000 patients a year. Since then, our ER patient visits have increased by 2,058 to 46,000– a 4 % increase. We expect to see 45-46000 patients this year – and our acuity has increased – we are seeing more older, sicker patients. Patients with potentially dangerous medical conditions on average wait more than 2 hours to see a physician (these patients should be seen within 30 minutes).

To deliver prompt and safe assessment, we, the ER docs at Prince George Regional Hospital (RCH) calculate our ER patients need 4 more hours of physician time each day to provide emergency waiting room assessment and care. We need one extra ER doc 365 days a year. In other words, to meet current needs, it will take 1 more Emergency Doc to staff a new 4 -hour shift all year. More patients, and more sicker patients need more doctors or ER patients wait too long.

For the first time ever we have recruited enough ER docs to cover the older, lower staffing level. A smart system would plan a year ahead because it takes time to recruit new Emergency docs, particularly to the North. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy regional and cancer care hospital for the North. We are a busy Trauma Center.
Our hospital runs at 110 % capacity. There is never an inpatient bed available. Our admission rate is unchanged from several years ago. Most admitted patients wait more than 14 hours to reach a bed. These patients are boarded in the emergency department where they receive less than ideal care. They also block all of the emergency beds on a regular basis.

Patients with potentially dangerous medical conditions wait more than 2 hours on average to see a physician.

Penticton Hospital

Report Card for:
Fall/Winter 2012-13
Penticton Hospital
550 Carmi Ave, Penticton, British Columbia
Overcrowding

Access Block
Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy community hospital. Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER it is unlikely that there will be an open bed upstairs.

We have a very old Hospital. It was built when the local population was around 10,000; we now serve over 90,000 people.

Our minor treatment and less acute areas are blocked by admitted patients and we don’t have room to treat simple medical problems. We also have long ambulance wait times. This is unacceptable care for our family, loved ones and the citizens of British Columbia.

Our hospital administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. For example, they have created an Emergency overflow area for admitted patients in ER. These are unfunded beds, so the money comes from the regular hospital budget. An ambulatory care area was closed in order to create these beds.

From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretchers are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
Our Emergency doctors are not paid per patient. In order to increase efficiency in our department, we have restructured our physician staffing to allow for increased physician coverage at times of expected peak patient volumes.
Our schedule is staffed assuming flow of patients in, through and either home or upstairs to the wards. Now patients are waiting, but there is no safe place where we can examine them with dignity, where we can start treatment. The ER is blocked: all of its stretchers full of admitted patients.
In the last few months Access block/overcrowding has frozen flow to the extent that we ER Doctors struggle to find appropriate areas to properly assess and examine patients. It is not unusual for us to be doing primary assessments in the hallways. Obviously, there need to be solutions to boarding in ER.
A smart system would ensure good flow of patients allowing for an increase in scheduled staffing. Our patients can’t wait indefinitely to get timely care.

Abbotsford Regional Hospital

Report Card for:
Fall/Winter 2012-13
Abbotsford Regional Hospital
32900 Marshall Rd
Abbotsford, BC
Overcrowding

Access Block
Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a Regional Hospital and referral centre for the Fraser Valley and surrounding areas. ARHCC also serves as trauma centre. Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. We have a new Hospital. It is “bigger”, but was already too small the day it opened.

Patients often wait more than 4-6 hours to see a physician or get a stretcher in the department. Our minor treatment and less acute areas are blocked by admitted patients and we don’t have room to treat simple medical problems. Elderly patient often wait the longest. Cardiac patients are often treated in a chair because all monitored beds are full with admitted patients that belong in a medical ward. Patients suffering from terminal cancer spend their last days with family in an ER bed, surrounded by the noise and everything else that is going on in an ER. This is unacceptable care for our family, loved ones and the citizens of British Columbia. We also have long ambulance wait times in the province.

The Fraser Health Authority recognizes the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.
Not enough doctors

Waiting for a doctor…
Physician staffing deficiency
As a Fee for Service Emergency Room, we have to see patients in order to be paid. Our schedule is staffed assuming flow of patients in, through and either home or upstairs to the wards. Now patients are waiting, but there is no safe place where we can examine them with dignity, where we can start treatment. The ER is blocked: all of its stretchers full of admitted patients.

In the last few months Access block/overcrowding has frozen flow to the extent that we ER Doctors see fewer patients per shift. Physicians are waiting for hours to see patients because of the overcrowding of ER beds with admitted patients. We are completely inefficient despite so many patients waiting. A smart system would ensure good flow of patients allowing for an increase in scheduled staffing. Our patients are still waiting for a place where we can see them. They can’t wait indefinitely to get timely care.

BC Children’s Hospital (BCCH)

Report Card for:
Fall/Winter 2012-13
BC Children’s Hospital (BCCH)
4480 Oak Street
Vancouver, BC
Not enough doctors
Winter

Summer & Fall

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, particularly during the very busy winter months, we, the ER docs at BC Children’s Hospital (BCCH) calculate our ER patients need at least 7 more hours of physician time each day than we currently have during 6 months of the year (January – June). We need one extra ER doc from 11 A.M. to 6 P.M. 162 days a year. In other words, to meet current needs, it will take 2 more Emergency Docs to staff a new 7 -hour shift 6 months a year.

A good argument could be made that BCCH needs 3 more ER Pediatricians. Our physician staffing level was set in 2006 based on seeing 35,000 patients a year. Since then, our ER patient visits have increased by 8,100 to 43,106 – a 16% increase! We got a tiny amount of temporary extra staffing in 2010, and our Department of Pediatrics and PHSA are giving us emergency extra staffing on a month-to-month basis, but this is nowhere near enough. Our little patients can’t wait for up to 9 hours to get timely care.

More patients need more doctors or ER patients wait too long. A smart system would plan a year ahead because it takes time to recruit new Pediatric Emergency docs.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general pediatric hospital for the Southern Lower Mainland as well as the tertiary pediatric care hospital for BC. We are the only pediatric Trauma Center in BC. Our hospital is at times choked by over 100% capacity during in winter months.

The Provincial Health Services Authority (PHSA) administrators recognize the risk of in-patient ward access block. They have successfully implemented several new plans and procedures. Occasionally almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital, but this is a rare occurrence. The President of BCCH has insisted that once an ER patient is admitted it must go to a ward within 4 hours; he is informed of every “miss”, he holds those in charge accountable when ER patients wait indefinitely for in-patient care.

Accountability helps solve overcrowding and Access block!

Campbell River Hospital

Report Card for:
Fall/Winter 2012-13
Campbell River Hospital
Overcrowding

Access Block
Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
Campbell River has a busy community hospital serving the central and northern coast of Vancouver Island and the Northern Gulf Islands. Our hospital is often choked by over 100% capacity. That means when a new sick patient shows up in the ER there will not be an open bed upstairs.

Our Emergency Department is old, our layout is poor and our ability to hold overcapacity patients is extremely limited. While we usually get admitted patients to the ward in less than 10 hours, when admitted patients block our stretchers, we quickly lose room to see new patients. We adapt by seeing patients in chairs and in hallways, compromising patient privacy, dignity and patient and staff safety in order to care for our patients. This is unacceptable care for our family, loved ones and the citizens of British Columbia.

We suffer from an unrealistic government idea: that you design and staff hospitals based on 100% utilization of capacity. Thus in spite of population growth our new hospital will have essentially the same number of rooms and staffing as the old.
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
As a Fee for Service Emergency Room, we have to see patients in order to be paid. Our schedule is staffed assuming flow of patients in, through and either home or upstairs to the wards. Overcrowding makes recruiting and scheduling physicians more difficult. A smart system would ensure good flow of patients allowing for an increase in scheduled physician staffing. Our patients can’t wait indefinitely to get timely and appropriate care.

Burnaby General Hospital

Report Card for:
Fall/Winter 2012-13
Burnaby General Hospital
3935 Kincaid St,
Burnaby, BC
Overcrowding

Access Block
Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are one of BC’s busiest Emergency Room with over 70,000 patient visits each year. Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. We have an old Hospital. It has remained unchanged under the present unrealistic government idea: that you maintain and staff hospitals based on 100% utilization of capacity: thus in spite of population growth our hospital has the same number of rooms as a decade ago.

Patients often wait more than 4 hours to see a physician or get a stretcher in the department. Our minor less acute areas are often blocked by admitted patients. Elderly patients on stretchers often wait the longest. This is unacceptable care for our family, loved ones and the citizens of British Columbia. We frequently have long ambulance wait times with patients waiting in the hall on ambulance gurneys.

The Fraser Health Authority administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. It is unclear who is accountable when ER patients wait indefinitely for in-patient care.
Not enough doctors

Waiting for a doctor…
Physician staffing deficiency
As a Fee for Service Emergency Room, we have to see patients in order to be paid. Our schedule is staffed assuming flow of patients in, through and either home or upstairs to the wards. Now patients are waiting, but there is no safe place where we can examine them with dignity, where we can start treatment.

In the last few months Access block/overcrowding has frozen flow to the extent that we ER Doctors often see much fewer patients per shift. We are inefficient because of so many patients waiting. A smart system would ensure good flow of patients allowing for an increase in scheduled staffing. Our patients are still waiting for a place where we can see them. Even when seen, Nursing staffing levels do not take into account the excessive work load placed on ER RN’s managing admitted inpatients taking precious resources away from newly arrived patients. This compounds delays in care, further pushing the system into gridlock.

Richmond Hospital

Report Card for:
Fall/Winter 2012-13
Richmond Hospital
Richmond, BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, we, the ER docs at Richmond Hospital (RH) calculate our ER patients need 8 more hours of stable physician time each day than we currently have. We need one extra ER doc from 10 A.M. to 6 P.M. 365 days a year. In other words, to meet current needs, it will take 2 more Emergency Docs to staff a new 8 -hour shift all year. Our physician staffing level was set in 2010 based on seeing 45,036 patients a year. Since then, our ER patient visits have increased by over 2000 to over 47,000 – a 4.5% increase. We currently get some temporary extra staffing, but this is not enough and is not stable or dependable funding. More patients need more doctors or ER patients wait too long. A smart system would plan a year ahead because it takes time to recruit new Emergency docs. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital for the Southern Lower Mainland. Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. The plan is: you will have to wait. This is not good for our patients, nor for the ER.

The Vancouver Costal Health Authority (VCHA) administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.

Because of in-patient ward access block, ambulance patients wait frequently on stretchers prior to being seen by the triage nurse. Many face long waits in our back hallway before getting a stretcher in the ER. Emergency Physicians often must assess patients in the public space of the waiting room this is due to the lack of private and appropriate care spaces for evaluations in the department.

Chilliwack General Hospital

Report Card for:
Fall/Winter 2012-13
Chilliwack General Hospital
45600 Menholm,
Chilliwack, BC
Overcrowding

Access Block
Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are one of BC’s busiest Emergency Room with approximately 50,000 patient visits each year. Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. We have an old Hospital. It has remained unchanged under the present unrealistic government idea: that you maintain and staff hospitals based on 100% utilization of capacity: thus in spite of population growth our hospital has the same number of rooms as a decade ago.

Patients often wait more than 2 hours to see a physician or get a stretcher in the department. Our minor treatment and less acute areas are blocked by admitted patients and we often don’t have rooms to treat simple medical problems. Elderly patient often wait the longest. This is unacceptable care for our family, loved ones and the citizens of British Columbia.

The Fraser Health Authority administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time a high proportion of Emergency stretchers are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for a hospital bed.
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
The Emergency Room is staffed based on number of patient visits to the hospital. With little appropriate space to see patients, the wait times increase. Chilliwack has a new ER, with considerable space to see patients in a dignified, private manner. However, these spaces, designed to manage ER patients, are occupied by admitted, stable patients who no longer need the services of the ER. Yet, their prolonged stay in the ER deprives newly arriving patients from being seen in an appropriate stretcher. There is little use adding extra doctors, many times the ER doctors and nurses are doing everything they can to make space to fit more patients into a crowded dept. But with the best, and most appropriate spots to see patients already full, the new patients are left to be seen in hallways, chairs, and other makeshift spaces. Our patients are generally very flexible and understanding of the situation, but just because this practice continues to be accepted, it doesn’t mean that it represents the best situation that that could be offered our community.

Cowichan District Hospital (CDH)

Report Card for:
Fall/Winter 2012-13
Cowichan District Hospital (CDH)
North Cowichan, BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, we, the ER docs at Cowichan District Hospital (CDH)
calculate our ER patients need 8 more hours of physician time each day than we currently have.

Our physician staffing level was set in 2010 based on seeing 30,103 patients a year. Since then, our ER patient visits have increased by 857 (2.85%)

What has happened, though, is that a large number of easy ER visits have been moved elsewhere; We still have the same number of yearly visits, so more patients are coming, and they are all much sicker.

We estimate that we need 1 extra ER docs from 1600 to 2400 P.M. 365 days a year. In other words, to meet current needs, it will take 2 more Emergency Docs to staff a new 8 -hour shift all year.

More patients (and the same number of much sicker patients) need more doctors or ER patients wait too long. A smart system would plan a year ahead because it takes time to recruit new Emergency docs. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital for the Cowichan Valley area on Vancouver Island. Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. The plan is: you will have to wait. This is not good for our patients, nor for the ER.

The Vancouver Island Health Authority (VIHA) administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.

Because of in-patient ward access block, ambulance patients wait frequently on stretchers prior to being seen by the triage nurse. Many face long waits in our back hallway before getting a stretcher in the ER. hallway before getting a stretcher in the ER.

Cranbrook Regional Hospital

Report Card for:
Fall/Winter 2012-13
Cranbrook Regional Hospital
13 - 24th Ave N,
Cranbrook BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, we, the ER docs at Cranbrook Regional Hospital (RRH) calculate our ER patients need 4 more hours of physician time each day than we currently have. We need one extra ER doc from 8 P.M. to Midnight 365 days a year. In other words, to meet current needs, it will take 1 more Emergency Docs to staff a new 4 -hour shift all year. Our physician staffing level was set in 2010 based on seeing 20,146 patients a year. Since then, our ER patient visits have increased by 2120/year to 22,265– a 10.5% increase!. We get no temporary extra staffing, like some sites do. More patients need more doctors or ER patients wait too long. A smart system would plan a year ahead because it takes time to recruit new Emergency docs. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital in a remote area of British Columbia. Between skiing and mountain biking we have a busy Trauma Center. Our hospital is choked by overcapacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. The plan is: you will have to wait. This is not good for our patients, nor for the ER.

The Interior Health Authority administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.
Because of in-patient ward access block, ambulance patients wait frequently on stretchers prior to being seen by the triage nurse. Many face long waits in our back hallway before getting a stretcher in the ER.

Langley Memorial Hospital

Report Card for:
Fall/Winter 2012-13
Langley Memorial Hospital
22051 Fraser Hwy
Langley, BC
Overcrowding

Access Block
Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a very busy Emergency Room with over 44,000 patient visits each year: each year our ER patient visits are between 3- 5% higher than the year before.

Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. We have an old Hospital. It has remained unchanged under the present unrealistic government idea: that you maintain and staff hospitals based on 100% utilization of capacity: thus in spite of population growth our hospital has the same number of rooms as a decade ago.

Patients often wait more than 6 hours to see a physician or get a stretcher in the department. Our minor treatment and less acute areas are blocked by admitted patients and we don’t have room to treat simple medical problems. Elderly patient often wait the longest. This is unacceptable care for our family, loved ones and the citizens of British Columbia. We also have long ambulance wait times.

The Fraser Health Authority (FHA) administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care. In fact, FHA has eliminated any on-call administration on site at Langley Memorial Hospital, so there is no one to call if there is a crisis on a weekend evening.
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
As a Fee for Service Emergency Room, we have to see patients in order to be paid. Our schedule is staffed assuming flow of patients in, through and either home or upstairs to the wards. Now patients are waiting, but there is no safe place where we can examine them with dignity, where we can start treatment. The ER is blocked: all of its stretchers full of admitted patients.

In the last few months Access block/overcrowding has frozen flow to the extent that we ER Doctors see much fewer patients per shift. We are inefficient despite so many patients waiting. A smart system would ensure good flow of patients allowing for an increase in scheduled staffing. Our patients are still waiting for a place where we can see them. They can’t wait indefinitely to get timely care.

Mt St Joseph’s Hospital

Report Card for:
Fall/Winter 2012-13
Mt St Joseph’s Hospital
3080 Prince Edward St,
Vancouver, BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, we, the ER docs at Mount Saint Joseph’s Hospital (MSJ) calculate our ER patients need at least 4 more hours of physician time each day than we currently have. In other words, to meet current needs, it will take more Emergency Docs to staff a new shift structure all year. Our physician staffing level was set in 2010 based on seeing 20,973 patients a year. Since then, our ER patient visits have increased by 2,169 to 23,142 – a 9% increase!. As a stop gap measure, our hospital’s administration, Providence Health, has temporary provided some funding to cover these 4 extra hours of physician coverage. However, we do not know how long they will be able to support us. More patients need more doctors or ER patients wait too long. A smart system would plan a year ahead because it takes time to recruit new Emergency docs. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital for the Southern Lower Mainland – our ER is open 8:00 a.am. to 8 p.m. .

Vancouver Coastal Health Authority administrators recognize that in-patient ward access block makes the ER not function. They have implemented several new plans and procedures. From the ER patient’s experience, this often has worked well. Most of the time some Emergency stretches are blocked by admitted patients waiting for a bed in the hospital, but this is manageable. Administrators are held accountable when ER patients wait indefinitely for in-patient care.

Our referral hospitals, Vancouver General Hospital (VGH) and St Paul’s Hospital (SPH) are very busy. VGH runs at over 100% capacity: it is always full; St Paul’s is often very busy. That means patients at Mt St Joseph’s who need to more aggressive treatment may wait many hours before transfer to VGH or St Paul’s. This is not good for our patients, nor for the Mt St Joseph’s ER Centre, nor, of course for the patients already at SPH & VGH ER.

Nanaimo Regional General Hospital

Report Card for:
Fall/Winter 2012-13
Nanaimo Regional General Hospital
1200 Dufferin Crescent,
Nanaimo, BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, we, the ER docs at Nanaimo Regional General Hospital (NRH) calculate our ER patients need 9 more hours of physician time each day than we currently have. We need one extra ER doc from 11 A.M. to 10 P.M. 365 days a year. In other words, to meet current needs, it will take 3 more Emergency Docs to staff a new 9 -hour shift all year. Our physician staffing level was set in 2010 based on seeing 53,534 patients a year. Since then, our ER patient visits have increased by 3.868 to 57,400 – a 7.3% increase!. We get a small amount of temporary extra staffing, but this is not enough. More patients need more doctors or ER patients wait too long. A smart system would plan a year ahead because it takes time to recruit new Emergency docs. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital for the Nanaimo and Parksville area on Vancouver Island. We are a very busy Trauma Center. Our hospital is choked by over 100% capacity. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. The plan is: you will have to wait. This is not good for our patients, nor for the ER.

The Vancouver Island Health Authority (VIHA) administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.

Because of in-patient ward access block, ambulance patients wait frequently on stretchers prior to being seen by the triage nurse. Many face long waits in our back hallway before getting a stretcher in the ER. hallway before getting a stretcher in the ER.

Saanich Peninsula Hospital

Report Card for:
Fall/Winter 2012-13
Saanich Peninsula Hospital
2166 Mt Newton Cross Rd,
Saanichton, BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
Our current Physician staffing levels are based upon data from 2005/06. We were due to have an increase in the number of Physician hours in 2010, based upon increasing patient volumes and acuity, however, this did not occur. Since 2005/06, our ER patient visits are up by over 1700 patients per year, or about 10%. Now, during our busiest times of the day, in order to deliver prompt and safe patient care, we, the ER docs at Saanich Peninsula Hospital, calculate that we need an additional 4 hours of Physician coverage each day. The Vancouver Island Health Authority (VIHA) recognizes the need for single coverage departments like ours to have a crisis volume/acuity mechanism in place for additional Physician staffing when required, and in 2011 we arranged such a contract with VIHA. However, the funding for this is covered by our own ED’s “Operational Budget”, and unfortunately more than half the time that we try to implement this call-in of a second Physician, no members of our relatively small group of Physicians (10) are available. This could be solved by more scheduled hours.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a small but busy community hospital which serves a local population of over 64,000, as well as an increasing number of people from Greater Victoria who travel to us, for what they hope will be quicker ER care than they would receive at the two larger hospitals in Victoria. However, our ER only has 14 beds, and is staffed with only one Physician, and 3-4 Nurses. As such, our resources and capacity are surpassed almost every day, so ER patients sometimes wait up to 2 hours to be triaged, and up to 8 hours for a stretcher or to see a nurse or the Physician. On average, half of our ER beds are continuously occupied by in-patients who are waiting for a ‘real’ bed on an in-patient ward. These patients wait, on average, 27 hours in our ER to be transferred to the ward - the longest wait in all of the Vancouver Island Health Authority. 18% of our ER patients are over the age of 80 (the highest elderly population in the Vancouver Island Health Authority), for whom such waits can be even more difficult and detrimental.

St Paul’s Hospital

Report Card for:
Fall/Winter 2012-13
St Paul’s Hospital
1081 Burrard St,
Vancouver, BC V6Z 1Y6
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver prompt and safe assessment, we, the ER docs at Saint Paul’s Hospital (SPH) calculate our ER patients need 14.5 more hours of physician time each day than we currently have. We need one extra ER doc from 10 A.M. to 0200 A.M. 365 days a year. In other words, to meet current needs, it will take 4 more Emergency Docs to staff two new seven-hour shifts all year. Our physician staffing level was set in 2010 based on seeing 64,000 patients a year. Since then, our ER patient visits have increased by 11,826 to 75,826– a 18% increase!. We get a small amount of temporary extra staffing, but this is not enough. More patients need more doctors or ER patients wait too long. A smart system would plan a year ahead because it takes time to recruit new Emergency docs. Our patients can’t wait for years to get timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital servicing Vancouver’s Downtown, East Side and the West End. We see many of the poorest, most malnourished and vulnerable patients in BC. Our hospital runs at a lower percentage of capacity than many others in the province. This means you will not have to wait as long, which is good. However, we still have little extra capacity on busier days. And we often will be forced to see new sick patient in the Waiting Room Area.

Vancouver Coastal Health Authority administrators recognize that in-patient ward access block prevents the ER from functioning well. Working with ER staff, they have implemented several new plans and procedures. This has led to better patient care, however, most of the time some ER stretches are still blocked with admitted patients waiting for in-patient beds. Administrators are held accountable when ER patients wait indefinitely for in-patient care.

Surrey Memorial Hospital

Report Card for:
Fall/Winter 2012-13
Surrey Memorial Hospital
13750 – 96th Avenue
Surrey, BC
Overcrowding

Access Block
Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are one of the primary referral centres for Fraser Health Authority and BC’s busiest ER with approximately 100,000patient visits/year. Our hospital is usually running near or over 100% capacity most of the time. Often when a new sick patient presents to the ER there is usually no beds to place them into. The situation has been even worse recently during the fall and winter months as the public is being plagued with the flu and suffering from an outbreak of viral gastroenteritis. This has led to an even more overcrowding in our ER to the point where sick patients requiring beds are instead being treated in chairs within the waiting room. Overcrowding also means that there are higher chances of spreading these infections to already sick patients and making them more ill.

Patients often wait more than 4 hours to see a physician or get a stretcher in the department. Our minor treatment area often gets blocked by admitted patients and we don’t have rooms to treat simple medical problems. Elderly patients are often seen and treated in chairs rather than beds. This is unacceptable care for our family, loved ones and the citizens of British Columbia.

The Fraser Health Authority recognizes the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. One of these protocols is an over-capacity protocol which is instituted when the ER reaches certain levels of overcrowding which is deemed unsafe. There are 33 protected stretchers under this plan. However, it has yet to be implemented. Even in the lead up to its launch, with wards trying to pull maximum numbers of admits, there are typically around 30 admits in the department. Sometimes this will surge to 50 admits. This means that patients are sent to already full wards to relieve some of the congestion in the ER. Often these patients are parked in hallways or rooms that normally do not function as regular patient’s rooms. Although these protocols are somewhat effective we feel that much more can be done.

In Oct 2013 we will be opening a new emergency room which has 3-5 times the capacity of the current ER. The current ER was only intended to treat 40,000 patients per year and we are treating approximately 100,000. We feel that with the rapidly increasing population of Surrey and continued demand for emergency services most of the beds in the new ER will become quickly occupied with admitted patients and overcrowding will again become a norm.
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
As a Fee for Service Emergency Room, we are paid for each patient seen. Our ability to schedule physicians appropriately is highly dependent on them being able to see patients. However, this has been hindered by the poor flow and lack of space to see patients. Because there is no safe place where we can examine them with dignity and begin their treatment, patients continue to wait inappropriately.

We have considered adding more physicians to our schedule. However, not only have we ran out of physical space to add more physicians to our schedule we also are experiencing short supply of ER trained physicians to hire from.

UBC Hospital

Report Card for:
Fall/Winter 2012-13
UBC Hospital
2211 Wesbrook Mall
Vancouver, BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
The UBC Urgent Care Centre is an Emergency Department staffed by Emergency Physicians that has had much of its backup acute care hospital removed.

To deliver prompt and safe assessment, we, calculate our allotment of physician time each day is about right for the number of patients we serve each year. Our physician staffing level was set in 2010 based on seeing 18,650 patients a year. Since then, our ER patient visits have not changed significantly. We get no temporary extra staffing, unlike some centers.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general Emergency Department and Acute Care clinic for the Southern Lower Mainland – our Urgent Care Centre is open 8:00 a.m. to 10 p.m. UBC Hospital Internists have 9 inpatient beds. We are tasked with seeing patients with minor illnesses and injuries as well as patients with more serious problems who often arrive and require acute treatment and stabilization. These sicker patients all require transfer to VGH as there is no subspecialty backup at UBC Hospital.

Our ‘sister’ hospital, Vancouver General Hospital (VGH). is the busiest Trauma Center in BC. VGH runs at over 100% capacity: it is always full. That means patients at UBC who need to more aggressive treatment may wait many hours before transfer to VGH. This is not good for our patients, nor for the UBC Urgent Care Centre, nor, of course for the patients already at VGH ER.

Vancouver Coastal Health Authority administrators recognize that in-patient ward access block at VGH makes that ER not function, and causes problems for our patients at UBC. They have implemented several new plans and procedures. Two administrators at VGH have made a difference by holding all in the system accountable. From the ER patient’s experience, this often has improved things somewhat. Still, much of the time most VGH Emergency stretches are blocked by admitted patients waiting for a bed in the hospital – and patients arriving at UBC Urgent Care with serious illnesses will add their transfer time to that wait.

Vancouver General Hospital

Report Card for:
Fall/Winter 2012-13
Vancouver General Hospital
2211 Wesbrook Mall
Vancouver, BC
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
To deliver safe assessment and prompt care, we, the ER Docs at Vancouver General Hospital (VGH) calculate our ER patients need 13 more hours of physician time each day than we currently have. We need one extra ER doc from 11 A.M. to 12 M.N., 365 days a year. In other words, to meet current needs, it will take 3.5 more Emergency Docs to be able to staff the additional 13 hours per day through the year. Our physician staffing level was set in 2010 based on seeing 75,450 patients a year. However, since that time our ER patient visits have increased to over 84,000 visits per year (more than an 11% increase) and continues to grow.

We receive a small but direly needed amount of unsecured, temporary extra staffing from our Health Authority, but this is not enough. More patients need more doctors otherwise ER patients wait too long. A smart system would plan at least one year ahead because it takes time to recruit new Emergency Docs. Our patients cannot and should not wait years for access to safe and timely care.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a busy general care hospital for Vancouver and the largest tertiary care referral centre for the Province. We are the busiest Trauma Center in BC. Our hospital is choked by over 100% capacity, being continually over 100% full. That means when a new sick patient shows up in the ER there will never be an open bed upstairs. The plan is: you will have to wait. This is not good for you, our patients.

The Vancouver Coastal Health Authority administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures, and several outstanding administrators have taken personal accountability for ensuring that admitted patients are more promptly moved upstairs. From the ER patient’s experience, however, nothing has worked consistently well. At times almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. We often have 20 – 30 admitted patients in our ER (practically all of our Acute care beds), waiting for in-patient beds upstairs on hospital wards.

Our provincial government has not made the requisite commitment of overall accountability and resources needed to ensure that you, our ER patients, do not wait indefinitely for in-patient care.

Because of in-patient ward access block, ambulance patients wait frequently on stretchers prior to being seen by the triage nurse. Many of you face long waits in our hallways and waiting room before getting a stretcher in the ER. You deserve better.

Vernon Hospital

Report Card for:
Fall/Winter 2012-13
Vernon Hospital
2211 Wesbrook Mall
Vancouver, BC

Overcrowding

Access Block
Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
We are a referral centre for the interior of the province and a busy trauma center. Our hospital is choked by over 100% capacity.

Patients often wait more than 6 hours to see a physician or get a stretcher in the department. Our minor treatment and less acute areas are blocked by admitted patients and we often don’t have room to treat simple medical problems. Elderly patient often wait the longest. This is unacceptable care for our family, loved ones and the citizens of British Columbia. We also have long ambulance wait times.

The Interior Health Authority administrators recognize the permanent in-patient ward access block experienced by our ER. They have implemented several new plans and procedures. From the ER patient’s experience, however, nothing has worked well. Most of the time almost all Emergency stretches are blocked by admitted patients waiting for a bed in the hospital. No one is held accountable when ER patients wait indefinitely for in-patient care.
Not enough doctors

Waiting for a doctor
Physician staffing deficiency
As a Fee for Service Emergency Room, we have to see patients in order to be paid. Our schedule is staffed assuming flow of patients in, through and either home or upstairs to the wards. Now patients are waiting, but there is no safe place where we can examine them with dignity, where we can start treatment. The ER is blocked: all of its stretchers full of admitted patients.
There are many times when the physician is waiting on a bed or nursing staff to be able to see patients.

However, this has not impaired our flow to the point that we are considering dropping a shift per day. We are still able to see the same number of patients as before.

In fact, we are seeing slightly higher numbers per shift because our RAZ and MTA area is much larger and more efficient than our prior ER. We also have about 10% have more patients registering per month than 1 year ago. Our major issues to patient flow include understaffed nursing and unit clerk positions and the classic bed blocking due to long term care patients.

St Joseph's General Hospital (Comox)

Report Card for:
Fall/Winter 2012-13
St Joseph's General Hospital (Comox)
2137 Comox Avenue,
Comox, BC

Not enough doctors

Waiting for a doctor
Physician staffing deficiency
St. Joseph’s Hospital provides for all emergency medical care for the 70 000 people living from Black Creek to North Qualicum. This includes the communities of Comox, Courtenay and Cumberland and unincorporated regional districts. We have one of the oldest demographic populations in Canada and the acute medical needs of these patients are accelerating. Our ER admission rate has gone up by 26% in the last 3 years. Due to inpatient bed shortages the number of patient days spent in the ER by admitted patients has gone up by over 100%. Our 9 dedicated emergency room physicians are currently only funded to 8.22 full time equivalents. This is only part of what the government agreed to as an adequate workload model in 2010, with no allowances made for increased patient volumes and complexity in the last two years. The result is that we currently have only 6 hours of double coverage daily- meaning that for most of the day, one ER doc works in isolation dealing with all medical, surgical, trauma and pediatric ER needs for the community, focusing on the sickest patients for treatments and admission. The single ER physician on duty is also the sole physician responsible for responding to code blue cardiac arrest calls within the hospital after hours. Without dedicated trauma services and other resources afforded larger hospitals, our department becomes backed up with many patients who are waiting to be seen. More funded hours of physician time would allow us to extend our double coverage through more of the busy hours in our department so that all patients could receive timely care in the emergency department.
Overcrowding

Waiting for a bed…
Waiting for a stretcher…
Waiting for a nurse…
Waiting for triage (with ambulance)
Due to a growing and aging population, our 100 year old hospital is increasingly feeling the strain of too many patients and not enough space or staff to care for them. St. Joseph’s Hospital runs at overcapacity (at greater than 100% occupancy) for most days each month. This has resulted in patients regularly spending the first 24 to 48 hours of their admission (or longer) in the ER as there are no available beds in the hospital to be admitted to. Evidence shows that this directly compromises the ability of the doctors and nurses in ER to provide quality ER care as they care for these admitted patients in addition to the ER patients. This number of admitted patients in the ER has doubled since 2010. To counter this, the administration of this hospital has made great strides in efficiency such as maximizing capacity for outpatient day surgery. Further resources were put into establishing a transitional care unit to cohort and provide better care for patients needing to rehab from acute care or transition to complex care facilities. However despite these efforts we currently have almost 30% of all acute care beds occupied by patients who do not require acute care services but have no access to complex care beds in our community and are unable to live independently. The rate of increase of this frail population occupying acute care beds, if continued unchecked at current rates, will result in 100% of acute care access being blocked by 2017. The ongoing and worsening problem of non acute care patients occupying acute care beds is the single biggest threat to emergency care at St. Joseph’s hospital. We are unable to provide high quality emergency care if our ER stretchers are consistently occupied by admitted patients.
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