Leaked report finds ER stays on rise in Mississauga, Brampton, Hamilton and rest of Ontario

A newly leaked report from Ontario Health paints an increasingly grim picture of the state of Ontario’s healthcare system, highlighting increasing stay times at emergency departments across the province. 

Earlier this week, Dr. Adil Shamji, MPP for Don Valley East and Ontario Liberal Health critic, unveiled a report that shows  emergency department stays increased by 17.1 per cent in September 2022 compared to September 2021. According to the report, the average length of stay in an emergency department was 12 hours for nine out of 10 patients. 

The report also says the daily average number of patients waiting for an inpatient bed during September increased from 883.8 to 945.9. 

The report, which provides historical data up to September 2022, also shows that patients requiring admission are staying in emergency departments longer. According to the report, the length of ER stays for such patients has increased by 40.5 per cent, with  patients staying up to 45.2 hours before getting a hospital bed.

“This new report from Ontario Health reveals a stark and unsettling picture of our emergency departments and hospitals,” Shamji said in a statement. 

“The data shows unequivocally that, as (Ontario Premier) Doug Ford and (Ontario Health Minister) Sylvia Jones stand by and watch, our healthcare system is plummeting in real time.”

As far as regional times go, the report notes that the areas with the longest ER stays include the Toronto Central and Hamilton Niagara Haldimand Brant sub-regions. While stays aren’t quite as long in the province’s southwest and northeast sub-regions, no region has an average stay time of fewer than eight hours. 

The report also says the Central East and Mississauga Halton sub-regions experienced the greatest increase in ER stay times. 

Durham Region hospitals appear to be bucking the trend, at least according to the Lakeridge Health ED Wait Times Tracker, which show wait times at the Oshawa hospital at just two hours and eleven minutes, Ajax at 2:52, Port Perry at 2:57 and Bowmanville hospital at 3:07.

Lakeridge Health also reported, however, that “critical” staffing shortages and high patient volume is increasing the time it takes to offload ambulances at local hospitals.

According to the report, the average ambulance offload time in Ontario in September 2022 was 90 minutes–a 52.5 per cent increase over September 2021. Offload time is the amount of time that passes between the arrival of an ambulance patient at the ER and when they are transferred to a gurney, bed or other acceptable location as the ER then takes over responsibility for their care.

Since April 2010, ambulance offload times have increased by 76.5 per cent. The report says that over the course of 2022, Hamilton Niagara Haldimand Brant and the Central East sub-regions had the highest ambulance volume. 

The report comes at a time when healthcare professionals are warning people to brace themselves for increased pressure on hospitals, as RSV, flu and COVID cases are expected to increase. 

At a Nov. 9 press conference, Dr. Rose Zacharias, president of the Ontario Medical Association, said that so far this year, Ontario has 1,544 flu cases recorded, compared to only seven cases this time last year. For the last two winters, flu cases were low because people followed public health measures to prevent the spread of COVID-19, such as mandatory masking and physical distancing.

Ontario will likely face a “triple threat of respiratory illnesses” this season, Zacharias said.

There is also increased pressure on the pediatric healthcare system. 

New data shows Ontario’s pediatric intensive care units are operating over capacity, with the number of children receiving care exceeding the number of available beds across the province. Critical Care Services Ontario’s daily census shows there are currently 122 children in pediatric ICUs, up from 111 the day before.

Trillium Health Partners (THP), which operates both Mississauga Hospital and Credit Valley Hospital in Mississauga, is also seeing a high volume of patients.

“The patient volumes we are currently seeing is due to a number of factors including, but not limited to; more acute and/or complex medical cases presenting to our emergency department requiring admission, a rising increase in cold and flu, respiratory and COVID-19 activity, and the number of discharges not keeping pace with the number of admissions due to longer hospital stays,” a THP spokesperson said in an email to insauga.com. 

“These factors combined, amongst others, are putting a strain on hospitals across the province. We thank our community for their patience and continued support and encourage them to be aware of all the healthcare options available to them, including family doctors, Health Connect Ontario, and walk-in clinics.” 

Shamji said the newest report shows the healthcare system is deteriorating further despite lower-than-normal patient volumes overall. 

“Ontarians should not have to learn about the state of our healthcare system through leaked reports,” he said in a statement. 

“We are calling on Doug Ford and Sylvia Jones to come clean about the state of our healthcare system and explain why our emergency rooms continue to get worse under their watch.”

While hospitals are seeing more patients, the province’s healthcare system is also suffering from significant staffing challenges. 

In August, Jones, under fire for staying silent despite multiple ER closures across the province, provided information on the province’s upcoming strategies for addressing the persistent staffing crisis. 

The crux of these closures stems mainly from a lack of nursing staff. A StatsCan report from June found that 86 per cent of nurses felt increased stress at work, 76 per cent feeling overburdened with work duties and 55 per cent doing work they normally would not.

Over the last two years of the pandemic, vacant roles in Ontario hospitals have grown more than 90 per cent. This is expected to greatly worsen over the next three years, with nearly a quarter of nurses planning to leave their jobs in that time.

Other roles in the system are also set to see increased strain, though not as badly as nursing, with 16 per cent of personal support workers (PSWs) and 11 per cent of doctors looking to quit as well.

Jones told The Canadian Press (CP) the government is examining ways to expedite certification for foreign nurses to come work in Ontario as quickly as possible to fill staffing gaps.

Jones told CP Ontario will continue to do what it has done for four years by continuing to add nurses, adding that the government has hired 10,000 nurses in the last two years. She also said they will introduce “additional measures” to combat the shortage and mentioned a backlog of workers waiting for certification.

However, an additional hurdle for nurses has been Ford’s controversial Bill 124. Passed just before the pandemic in November 2019, Bill 124 capped healthcare worker wage raises at one per cent per year until 2023.

Opposition parties and the Ontario Nurses Association have long called for the bill’s repeal as an effort to compensate nurses more, encouraging them to remain in the field. However, Jones said the repeal remains “a conversation for another day.”

Despite ongoing issues with emergency department stay times, medical professionals at yesterday’s Ontario Medical Association press conference said that anyone in need of medical care should not hesitate to visit the hospital.

“Despite everything you read in the news, our emergency departments are open,” said Dr. Howard Ovens, staff emergency physician at Sinai Health “We have triage processes in place.”

He has seen patients who needed to come to the emergency department, but put it off because of concerns over wait and stay times or not wanting to be a burden on the system.

“Some people with real emergencies who need to see us are delaying and making themselves sicker and making the care that we need to give them more complex,” said Ovens. 

“My most important message is if you have what you believe is a serious or even potentially life-threatening emergency…don’t delay, once you feel that you are having an emergency, please come to see us.”

With files from Liam McConnell, Karen Longwell, Glenn Hendry and The Canadian Press