Accessibility/Mobile Features
Skip Navigation
Editorial News
Classified Sites

Brandon Sun - ONLINE EDITION

Cure for clogged ER unveiled

Transfer patients to wards, long-term care beds, physician tells inquest

A relative holds a photo of Brian Sinclair, who died while waiting for medical care.

WAYNE GLOWACKI / WINNIPEG FREE PRESS FILES Enlarge Image

A relative holds a photo of Brian Sinclair, who died while waiting for medical care.

A doctor who is an expert in emergency-room overcrowding has written a prescription to cure what ails the Health Sciences Centre's emergency department.

Dr. Grant Innes, an emergency room physician in Calgary, a professor at the University of Calgary and a member of the Canadian Association of Emergency Physicians, said the main reason for overcrowding in any emergency room is the inability to move critically ill patients from the area.

Innes, testifying at the inquest looking into the 2008 death of Brian Sinclair in the HSC emergency waiting room, said patients who have minor injuries don't clog emergency rooms.

"The overwhelming cause is blocked patients," he told provincial court Judge Tim Preston on Monday.

"Too many patients waiting too long in the wrong place."

The key to freeing up emergency-room beds is to transfer ER patients to wards where they can be treated and getting patients who don't need to be in hospital into long-term-care beds or discharging them, Innes said.

Pulling out a single sheet of paper, which was handed to the judge, Innes gave five recommendations that would solve overcrowding.

They are:

  • Creating a process of accountability for access and flow, which not only includes the hospital, but also community long-term care.
  • Having a demand-driven overcapacity protocol.
  • Matching capacity to demand, including having patient discharges seven days a week and having specialists available later in the day.
  • Implementing performance targets, including having a patient triaged within 10 minutes of entering the ER, and discharge or transfer times of four hours for the most critically ill patients or two hours for minor treatments.
  • Having better access to long-term and community care.
  • It's important because if the average hospital stay can be cut by three per cent -- or four hours -- that creates 161,000 emergency-room stretcher hours per year, he added.

Sinclair, 45, died in Sept. 2008, after waiting in the HSC emergency waiting room for 34 hours.

A coroner has testified Sinclair, a double amputee who used a wheelchair, may have died up to seven hours before he was noticed.

Sinclair had gone to the hospital because his urinary catheter was blocked. He died from a treatable bladder infection.

The inquest, which has been holding hearings on and off since last August, is in its final week.

Innes produced studies from North America and around the world that conclude if non-urgent patients are diverted to other places, it does little to free up ER access.

Creating more urgent-care facilities -- thinking it will get patients out of ERs -- is "a fundamental mistake," he said.

It would it do little to address problems in the ER.

If all patients with minor problems are diverted out of the ER, it could lead to physicians "sitting there doing nothing," he added.

"I hope the effort to do that isn't distracting them from dealing with the problem," he testified.

Innes criticized a move by the HSC to set up a pre-triage waiting area for patients, in which they would be seen before going to the regular waiting room.

"Enshrining a line to the triage process by creating a waiting area makes the hair on the back of my neck rise."

Earlier, Innes said the case of one patient -- who had a scratched cornea -- illustrates how blocking occurs because it took almost three hours for the patient to be seen and treated in the ER.

Innes said when he had a similar ailment and was seen by an ER doctor he knew, the treatment time was nine minutes.

He said the patient with the scratched cornea spent the rest of the time being repeatedly questioned by health-care staff who documented the ailment.

"This type of inefficiency shouldn't be allowed to exist."

Two more witnesses are to testify about ER overcrowding this week.

The inquest is to conclude Thursday after the Winnipeg Regional Health Authority, the Manitoba Nurses Union and the Sinclair family have made their recommendations.

kevin.rollason@freepress.mb.ca

History

Updated on Tuesday, June 10, 2014 at 9:31 AM CDT:
Adds photo, adds live blog

  • Rate this Rate This Star Icon
  • This article has not yet been rated.
  • We want you to tell us what you think of our articles. If the story moves you, compels you to act or tells you something you didn’t know, mark it high. If you thought it was well written, do the same. If it doesn’t meet your standards, mark it accordingly.

    You can also register and/or login to the site and join the conversation by leaving a comment.

    Rate it yourself by rolling over the stars and clicking when you reach your desired rating. We want you to tell us what you think of our articles. If the story moves you, compels you to act or tells you something you didn’t know, mark it high.

Sort by: Newest to Oldest | Oldest to Newest | Most Popular 0 Commentscomment icon

You can comment on most stories on brandonsun.com. You can also agree or disagree with other comments. All you need to do is register and/or login and you can join the conversation and give your feedback.

There are no comments at the moment. Be the first to post a comment below.

Post Your Commentcomment icon

Comment
  • You have characters left

The Brandon Sun does not necessarily endorse any of the views posted. Comments are moderated before publication. By submitting your comment, you agree to our Terms and Conditions. New to commenting? Check out our Frequently Asked Questions.

letters

Make text: Larger | Smaller

Brandon Sun Business Directory
Sudden Surge: Flood of 2014
Opportunity Magazine — The Bakken
Why Not Minot?
Welcome to Winnipeg

Social Media