Ottawa Hospital’s sickest waiting longer
By Pauline Tam, The Ottawa Citizen
OTTAWA — The sickest patients at The Ottawa Hospital’s emergency room appear to be waiting longer for treatment than they were two years ago, when Eastern Ontario’s largest trauma centre started getting funding to fix the problem.
According to the most recent provincial data, The Ottawa Hospital has not seen a noticeable drop in how long their hardest-to-treat patients spend in the ER, despite receiving $5.8 million since 2008 to slash wait times.
At the Civic campus, where the problem is most serious, the wait actually increased between April 2008 and June 2010, from 20 to 21.5 hours.
Over the same period, the General campus saw its wait time dip slightly, to 14.8 from 15.5 hours.
Officials were quick to blame a sharp rise in emergency visits for the setback.
In contrast, the waits for the hospital’s easy-to-treat patients have fallen since 2008, from eight to six hours at the Civic; at the General, patients now wait a maximum of 6.2 hours, down from 7.2.
The progress was considered significant enough that the hospital was awarded an additional $612,000 in bonus funding.
The figures come as the Ontario government pledged another $100 million to improve the way emergency departments look after patients. Of that amount, $40 million is being set aside for an incentive fund to reward those hospitals that see a noticeable drop in how long their patients spend in the ER.
The latest cash infusion, aimed at the 71 hospitals with the longest waits, builds on the $190 million already spent provincewide. As part of the new funding, The Ottawa Hospital is getting another $1.7 million, while the Montfort Hospital will receive an additional $319,000.
In total, $5.8 million have been allocated to Eastern Ontario hospitals.
Under the “Pay for Results” program, hospitals that fail to cut their ER waits markedly risk having a portion of their funding clawed out of their budgets.
Despite the upward trend over the past two years, The Ottawa Hospital maintains its wait time for the sickest patients has improved between April 2009 and March 2010, the most recent period monitored by the government.
“This is what the ministry is basing on whether they are clawing back money or not,” said Denise Picard-Stencer, clinical director for emergency and critical care.
Eastern Ontario’s health authority, which has the power to claw back the hospital’s funding, said it has no intention of doing so. “Their numbers of patients have gone up and that sort of clouds the performance,” said Dr. Robert Cushman, chief executive of the Champlain Local Health Integration Network.
Cushman pointed to the hospital’s progress in driving down waits for easy-to-treat patients as evidence the funding has made a difference.
“Even with increasing visits, they’ve made some good progress there,” said Cushman. “It’s the delays to admitting the high-acuity patients that are the problem.”
In recent years, congestion at The Ottawa Hospital’s emergency department has worsened. The situation was particularly bad this winter. Compounding the problem was the high number of elderly patients who occupied hospital beds because there were no spaces for them in nursing homes.
Cushman said the hospital’s ER waits won’t drop dramatically until those bottlenecks are solved.
The situation is different at the Montfort Hospital, which once had the region’s longest ER waits. But since 2008, with $1.08 million in provincial funding, the hospital has slashed that wait from 24 to 14.4 hours.
Over the same period, the wait for easy-to-treat patients was cut in half, to 4.7 hours from 9.3. As a result, the hospital was awarded a $200,000 bonus.
Dr. Bernard Leduc, the Montfort’s chief executive, attributed the progress to ongoing efforts to streamline and reorganize how ER staff work. Since hospital-wide renovations were completed earlier this year, the Montfort has also benefited from more space, allowing it to hire more ER staff to treat and discharge patients quickly, said Leduc.
Among Eastern Ontario hospitals, Hawkesbury and District General Hospital made the most dramatic improvement in its ER wait times. Between 2008 and 2010, the sickest patients saw their wait cut in half, from 25 to 12 hours. As part of the new funding, the hospital is receiving $400,000 over the next year.
The region’s worst performer was the Cornwall Community Hospital, which saw its wait time for hard-to-treat patients creep up to 19.5 hours from 17.6 in 2008. The hospital is getting $799,900 over the next year.
Three other hospitals are receiving funding for the first time. They include:
n The Children’s Hospital of Eastern Ontario ($1 million)
n Queensway Carleton Hospital ($1 million)
n Pembroke Regional Hospital ($513,000)
