Wait-times in the emergency departments of Simcoe County hospitals are all roughly within two hours — with slightly shorter intervals to see a doctor in Midland and Collingwood, and longer waits in Barrie and Alliston.
The shortest wait-time in the province is at Newmarket’s Southlake Regional Health Centre, where the data assembled by Health Quality Ontario for February shows a 36-minute wait. Windsor Regional Hospital's Metropolitan Campus posted the longest wait-time, at three hours and 36 minutes.
The provincial average was one hour and 48 minutes.
And while the local hospitals all deem the two-hour or less range to be an acceptable amount of time to wait for a first assessment by a doctor, there are challenges.
“It’s not unusual to be a large, regional centre and have a wait-time of around two, two-and-a-half hours,” said Sharon Ramagnano, operations director of emergency, critical care, trauma at Barrie’s Royal Victoria Regional Health Centre (RVH).
“We are the regional centre. We have the stroke program, the STEMI program for heart attacks," she added of a protocol in which paramedics bring heart-attack patients directly into the RVH cardiac care unit. "We have the pediatric intensive care unit. We have the mental health level Schedule 1 beds.
“So a lot of our area sends patients to us specifically for the level of care that they require. Based on that, and our volumes being higher than other organizations in our area, our wait-times should, actually, be a little bit higher," Ramagnano said.
RVH, like all of the area’s hospitals, says it continually focuses efforts on reducing emergency department wait-times. The initiatives differ for each hospital, their location and the unique demands they face.
Barrie
RVH, with an average wait-time of two hours, is a busy spot, with plans for expansion and the creation of a new campus in Innisfil also in the works. Its emergency department sees about 85,000 to 90,000 patients every year, which works out to about 220 to 250 per day.
Ramagnano said patients now tend to be sicker than they were prior to the pandemic, and that translates to more people being admitted to the hospital. Currently, there are 30 to 32 admissions on average every day, up from the 25 to 28 pre-pandemic range.
For many years, RVH has been running at or above capacity, with the exception of the pandemic era. Currently, capacity is back up to 100 to 102 per cent.
“What that correlates to is that snowball effect of if patients are sicker when they’re arriving, they’re taking more time from the clinicians to see them. But we have the same number of clinicians to see these patients,” said Ramagnano. “There ends up being a backlog in the emergency department.”
That is complicated by the estimated 70,000 people in the area estimated to have no family physician who have limited access to health care.
RVH has been able to mitigate the issue in the emergency department by creating flex space in emergency for when the Georgian Drive hospital is full. The commitment to patient flow resulted from a pediatric surge the hospital experienced last September.
There is a focus on patient flow during the emergency department’s busiest times during the late afternoon and early evening.
A plan to include physician assistants in emergency is designed to help deal with increased demands. It is to be implemented during the summer, ahead of the fall flu season.
RVH has been working to expedite flow for those seeking attention for mental health and addictions services to outpatient services.
The big picture is the expansion project, which includes the doubling of the current facility with the addition of 240 beds over the next 10 years, in addition to building a south campus in Innisfil.
Orillia
Growth is the source of a great deal of pressure at Orillia Soldiers' Memorial Hospital (OSMH), as it is at many hospitals in Simcoe County. The wait-time to see a doctor in the emergency department in Orillia is one hour and 42 minutes.
“Along with the rest of the hospital, our emergency department continues to feel the pressure of rapid community growth in Orillia,” Carmine Stumpo, OSMH president and CEO, said in an email.
“One initiative that has helped alleviate some of that pressure is a service offered through the Couchiching OHT (Ontario Health Team) Care Clinic at OSMH, that is focused on providing care to patients without a primary care provider, such as a family physician or nurse practitioner," he added. "We are always looking for ways to improve access and service to the community.”
Collingwood
Collingwood General and Marine Hospital’s interim vice-president Tracey Fletcher also referred to a number of initiatives introduced in the past year allowing its wait-time to be one-and-a-half hours, which is below the provincial average.
Among them is the 2022 launch of the wait-time clock allowing the community to view estimated wait-times, along with the number of patients being treated or waiting to be treated.
“This allows patients and families to make informed decisions and helps set expectations, prior to arrival,” Fletcher said in an email. “Additionally, in the hospital’s See and Treat area, an additional registered practical nurse (RPN) was added to the day shift between 11 a.m. and 7 p.m. for a total of two RPNs on shift.”
A physician 'up-staffing' in emergency was also implemented during peak afternoon times to help meet the volumes.
Midland
Georgian Bay General Hospital (GBGH) serves cottagers and visitors and therefore sees a surge in patient visits to the emergency department over the summer months. It has an average wait-time of one-and-a-half hours.
Given limited walk-in clinic and urgent care services in the area, and family doctors who are already stretched, the GBGH emergency department is often in high demand for lower acuity conditions, president and CEO Matthew Lawson said in an email.
“We have been proactively educating the public on what types of illness or injury necessitate a visit to the ED (emergency department), as well as ensure they are aware of alternatives to the ED,” said Lawson. “Last summer, GBGH launched a partnership with Rocket Doctor, a virtual emergency medicine service, giving patients an alternative option to the ED, while still providing access to appropriate health services for our community.”
The Rocket Doctor aimed at patients with mild conditions and minor injuries diverted up to 10 patients per day from emergency last summer, he said.
The Midland hospital also launched a wait-times clock on its website. That allows patients whose condition is not urgent to see when the ED is expected to be busiest over the next six hours.
Lawson also points to collaboration through the North Simcoe Ontario Health Team which looks at how an integrated approach to managing patients can reduce the need for emergency visits.
Alliston
Stevenson Memorial Hospital’s two-hour wait-time is largely associated to space challenges, forcing emergency staff to work with five times the volume the emergency department was intended for.
“As a community hospital with a growing population and increased demand for services, we manage very well considering the challenges we are faced with,” Kim Charman, director of emergency, medicine and critical care, said in an email.
“Space and volume continues to be a challenge across the hospital, and it does have a trickle effect that impacts our department, including waits for testing/imaging or bed capacity in our medical inpatient unit," Charman added.
A province-wide health human resources crisis has increased the pressure. Charman said the emergency department picks up the slack left by limited options in the community during evenings and on weekends as well as patients needing support services at home returning for help.
Recent improvements to address the issues include introducing a surge plan for when the hospital is close to reaching capacity, limiting impact to patients.
“We have recently partnered with Riverwood Senior Living in launching a transitional care program, providing patients no longer in need of acute health-care services — alternative level of care or ALC patients — an opportunity to transition out of hospital and into a local retirement residence, where they can receive additional rehabilitative services as they await their permanent bed, either at home or in a long-term care facility,” she added.
