Holding out for Hope: Addressing Quebec’s Emergency Room Crisis and Aging Population

2024-04-19 04:00:00

Quebecers must be patient: waiting times are stagnating in the province’s bogged-down emergency rooms and the aging of the population will only make the situation worse in the coming years.

• Read also: “I was screaming: I need help, I need help!”: a Montrealer recounts her “horrible” visit to the emergency room

• Read also: Emergencies are overflowing in certain regions of Quebec

• Read also: Still so many waits at the emergency room in Quebec

“The population is aging. We can probably just limit the damage, but it won’t go well, summarizes Patrick Déry, specialized in the analysis of health policies. Many professionals will retire, the needs will increase more quickly.

“It is inevitable that there will be more elderly people in the emergency room, unless we take measures,” also believes Dr. Jacques Morin, president of the Association of Geriatricians of Quebec.

We almost reached the goal

Waiting in the emergency room has been a problem in Quebec for several decades. The last year (April 2023 to March 2024) is no exception to the rule, show data from the Ministry of Health and Social Services (MSSS).

On average, Quebecers waited 17.4 hours (h) on a stretcher before getting a bed upstairs, barely more than the objective, set at 5 p.m.

“Yay, we reached 5 p.m.,” quips Mr. Déry. But 5 p.m. doesn’t look like it!”

Average length of stay on stretcher

  • 2023-2024 17,4 h (target: 5 p.m.)
  • 2022-2023 18,1 h
  • 2021-2022 16,8 h
  • 2020-2021 15,9 h
  • 2019-2020 15,3 h

In the Montreal region, the majority of hospitals have exceeded 20 hours, or even 30 hours.

Worst stretcher stay averages

  • Albert-Prévost Mental Health Hospital 39 h 12
  • Royal Victoria Hospital (MUHC) 31 h 40
  • Anna-Laberge Hospital (Châteauguay) 31 h 00
  • Lakeshore Hospital (Pointe-Claire) 29 h 27
  • Suroît Hospital (Salaberry-de-Valleyfield) 28 h 01
  • Hull Hospital 26 h 18
  • Douglas Mental Health Institute 25 h 38
  • Sacred Heart 25 h 19
  • Saint-Jérôme 25 h 06
  • LaSalle Hospital 24 h 48
  • Montreal General Hospital (MUHC) 24 h 47
  • Lachute Hospital 24 h 21
  • Santa Cabrini 24 h 19
  • Our Lady 24 h 15
  • Gatineau Hospital 24 h 01
  • Papineau Hospital 23 h 27
  • St. Mary’s 23 h 16

Source: Ministry of Health and Social Services

“There has not been much improvement in the system this year,” admits Dr. Gilbert Boucher, president of the Association of Emergency Medicine Specialists of Quebec (ASMUQ).


Courtesy photo

Every week, patients come close to death because their condition has seriously deteriorated, notes the ASMUQ. When emergency rooms are very crowded, pressure is high on caregivers, who fear poor triage.

Patients have also died while waiting for treatment

• Read also: “She fell into my arms”: a woman dies in the Joliette emergency room after 17 hours of waiting without seeing a doctor

• Read also: Anna-Laberge Hospital: two patients died in the emergency room without seeing a doctor

Furthermore, many patients spend more than 24 hours on a stretcher (some of them several days), while the target is zero. For seniors, this wait causes all kinds of problems (loss of mobility, confusion, etc.).

Stays of 24 hours or more

  • Albert-Prévost Mental Health Institute 62%
  • Anna-Laberge (Châteauguay) 48%
  • Sacred Heart 44%
  • Royal Victoria (CUSM) 43%
  • Douglas Institute 43%
  • Hôpital Lakeshore 41%

MSSS objective: 0%

Stays of 48 hours or more

  • Albert-Prévost Mental Health Institute 31%
  • Anna-Laberge (Châteauguay) 22%
  • Royal Victoria (CUSM) 21%
  • Hôpital Lakeshore 20%
  • Suroît Hospital (Salaberry-de-Valleyfield) 19%

MSSS objective: 0%

Between 2021 and 2030, the population aged 65 and over will increase from 20.5% to 25%, according to the National Institute of Public Health of Quebec. It was 9% in 1980. Already, doctors are seeing that the increase is putting pressure on the system.

“Everything becomes more complicated”

“It’s inevitable, patients are getting heavier and heavier,” says Dr. Boucher. The elderly person who arrives a little mixed up in the emergency, after 24 hours, everything becomes more complicated.”



GEN-HOSPITAL-EMERGENCY

Photo Martin Alarie

According to many, it is imperative to treat as many people as possible outside of emergency departments (clinics, home care, etc.). On Tuesday, the MSSS announced the creation of two geriatric clinics.

“We must improve the fluidity of the system, otherwise the problem persists. It costs more not to take care of it,” summarizes Dr. Morin.

Despite the gloomy picture, Dr. Boucher notes that hospital management seems mobilized to relieve emergency room congestion.

“We see a real desire to improve. […] When CEOs decide to take their ship and steer it, there are usually results.”

The emergency response time to see a doctor was 2 hours 48 minutes in 2023-2024, so it almost reached the objective (2 hours 45 minutes). However, this target had been revised upwards. According to the MSSS strategic plan, a return to 90 minutes is planned in three years.

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