Siobhan Mitchell, a resident of Toronto, recently experienced the dire state of emergency rooms firsthand as she waited an excruciating 48 hours in an urban emergency unit. Her ordeal highlights the crisis that healthcare professionals have been warning about—the severe overcrowding and strain on emergency rooms across the country.
Mitchell’s experience began in mid-August when she sought medical attention for an urgent gallbladder issue. However, despite her need for immediate care, there were no available beds for her in the hospital. Consequently, she found herself waiting for two days in a bed located in the hallway of the emergency unit. The situation was dire, with numerous patients in similar conditions lining the hallways.
She expressed her shock and dismay, stating, “Until you are in it, you don’t really understand how desperate and critical it is. Why everyone is not up in arms… that just is stunning. It’s unbelievable.”
Mitchell also acknowledged the dedication of the nurses and personal support workers who remained composed amidst the chaotic and overburdened environment.
While Mitchell eventually received the necessary surgery, she emphasized the need for the public to comprehend the gravity of what healthcare teams are conveying regarding overcrowding in emergency rooms. She urged for support and action to address this issue at the community level.
Healthcare Professionals Voice Concerns
Dr. James Worrall, an emergency specialist at The Ottawa Hospital and a professor at the University of Ottawa, emphasized the urgency of the situation. He stated, “We’ve normalized this dysfunction within our hospitals… We need to say that this is not acceptable.”
A new study based on data from British Columbia has shed light on the ongoing challenges faced by emergency rooms. The study reveals that even three years after the start of the pandemic, emergency rooms continue to experience “a sustained increase” in patient visits. While emergency visits initially dropped due to pandemic restrictions, they quickly rebounded, eventually exceeding pre-pandemic levels.
The study also noted that the growth in emergency department use has outpaced population growth, and more patients are being admitted to hospitals for serious illnesses. Dr. Catherine Varner, an ER doctor and deputy editor of the Canadian Medical Association Journal, commented on the situation, stating, “Across Canada, we’ve seen unprecedented (ER) crowding through the summer. We feel like we’re in a constant state of surge capacity and crisis management.”
The data from British Columbia also indicates that what were once seasonal surges in patients seeking ER care, often associated with flu season, have become more prolonged, stretching into weeks or even months. This extended period of overcrowding places an enormous burden on healthcare staff.
Hidden Harms of ER Overcrowding
Emergency units are designed to quickly assess, treat, and move patients to appropriate care areas, such as rehab, hospital beds, or home. However, the prolonged overcrowding in ERs has disrupted this workflow. Patients are now treated in unconventional spaces, including waiting room chairs and bathrooms.
Healthcare professionals have even resorted to providing care in driveways and closets due to the lack of available space. The increased patient-to-nurse ratios in overcrowded ERs have raised concerns about patient safety and the ability to provide quality care.
Earlier this year, some ER doctors in Alberta and B.C. issued warnings to patients, advising them not to come to the emergency department due to overcrowding. They expressed concerns that overcrowding could lead to medical errors and adverse outcomes. Tragically, some families have reported instances of harm or loss of life likely attributed to ER overcrowding.
Addressing the Crisis
Addressing the crisis in emergency rooms requires multifaceted solutions. While the COVID-19 pandemic exacerbated the situation, it is not the sole cause. The rising demand for emergency care is linked to an aging and growing population, as well as staffing shortages resulting from healthcare professionals leaving the field during the pandemic.
One critical solution is increasing the number of in-hospital beds, which currently lags behind other developed countries, as indicated by data from the OECD. Additionally, efforts should focus on retaining experienced healthcare staff who have faced burnout during the pandemic and its aftermath.
Redesigning inefficient hospital systems is also essential. While increased funding is welcome, it may not lead to meaningful change if the fundamental processes within the healthcare system remain unchanged.
The Canadian Association of Emergency Physicians is calling for a national forum to develop a comprehensive, cross-country plan to address the overcrowding issue swiftly. Healthcare professionals hope that these measures will prevent further harm and ensure that patients receive timely and adequate care.