Health

Emergency Rooms in Vancouver – How do they Measure Up?

Posted on February 23, 2017

CityMash.com - Nobody wants to visit the emergency room. At best you’ll sit in a crowded waiting area for hours, at worst you’ll be rushed there by ambulance and not know what is going on.

How will you fare if you end up in an emergency room in Vancouver? What is the quality of care like? How long are the wait times? If you have a choice, which ER should you choose? We took a close look at Vancouver’s four emergency rooms (we excluded BC Children’s), and this is what we discovered.

St. Pauls

Located at 1081 Burrard Street, St Pauls is one of the provinces busiest ERs. Open 24 hours a day; they provide care to patients in the downtown core of Vancouver, including some of the most vulnerable residents of the city.

The department is staffed by a team of 20 specialist emergency doctors, as well as specialist domestic abuse, elder abuse, and geriatric care staff. St Pauls also provides paediatric emergency services – although they do not have a paediatric ward, so any admissions go to BC Children’s.

The report card for St Pauls found at BC Emergency Care and written by ER doctors, says that St Pauls needs more two more ER physicians to meet the needs of the 76,000 patients they see every year and the overcrowding is rated as fair because patients are rarely left waiting for a bed.

Patient reviews often complain of the number of homeless using the waiting room for shelter or sleeping on the seats. This is, however, anecdotal and the patients admit they have no real way of knowing who was waiting for medical assistance and who was using the waiting room for shelter.

VGH

The busiest trauma centre in BC, Vancouver General Hospital has a failing grade from its emergency physicians due to inadequate staffing levels and a lack of available beds. At times nearly all of the acute care beds in the ER are filled with admitted patients waiting for a bed on a ward.

This prevents staff from seeing new patients and those brought to the hospital by ambulance often have to wait on stretchers in hallways until space is available to assess them.

The hospital runs at over 100% capacity, which means that all beds are always full. For a hospital that admits patients to its ER from all over the province there should be at least 10% of beds free at any one time.

For an excellent insight into the workings of the department you can watch – Emergency Room – Life and Death at VGH on Knowledge networks website.

Mount St. Josephs

Located on Prince Edward Street in East Vancouver, Mount St Josephs provides emergency care between 8:00 a.m. and 8:00 p.m. Although it is a fully staffed and equipped emergency room, some patients needing more aggressive treatment are transferred to St. Pauls or VGH. As a consequence, even if you choose to go to Mount St. Josephs there is no guarantee you will, if necessary, be admitted there.

Mount St Josephs is an excellent option if waiting times are unusually long at VGH or St Pauls and you have an injury that may need stiches or a problem of a similar severity.

UBC Urgent Care

The UBC Urgent Care Centre is open between 8:00 a.m. and 10:00 p.m. seven days a week. Like Mount St Josephs, acute patients are transferred to St.Pauls or VGH as UBC does not have the subspecialty staff available to treat these sicker people.

However, if you have a ‘minor emergency’ such as a sprain or possible broken bone, a minor burn, sports injuries, IV therapy, or a smaller wound that might need stitches, UBC is an excellent option.

 Wait times

It is a common misconception that wait times in the ER are so long because of people with minor ailments clogging up the system. ER’s in Vancouver use the Canadian Triage and Acuity Scale (CTAS). This scale allows the triage nurse to grade your emergency on a scale of one to five. Level ones are seen by a doctor immediately because there is a grave risk to life, twos are potentially fatal and should be seen within 15 minutes. The scale goes down to level 5’s who should be seen within 2 hours, but the wait may be much longer if the ER is busy.

Patients with minor issues also take a lot less time to see, so they tend to be in and out quickly. The main issue with wait times is the ER becoming filled with patients who need to be admitted and there is no hospital bed available. These patients cannot be moved from the ER until a bed on a ward is ready for them. Consequently, beds in the ER are filled, and fewer patients can be seen.

Current wait times for all four Vancouver ER’s can be viewed in real time at EDWaitTimes.com but the basic wait time is not the only thing you should take into consideration if you need to visit the ER. The time taken to travel there and back, which hospital you would want to be admitted to if admission is necessary, and any history you have with a particular hospital should all factor into your decision.

Patient Reviews

All four of the emergency rooms in Vancouver have similar reviews regarding staff. Admitting staff are often seen a brusk and uncaring, working on the assumption that everyone is a time waster.

This is understandable if you sit and watch them for a few hours. Patients are often rude and abusive; front line staff are the only point of complaint about wait times and they are often faced with mentally ill, drug addicted, drunk, or dementia patients. It is not surprising under the circumstances that they can be less than smiley and friendly.

On the other hand, most patients are average people, who are often scared so the effort to make them feel relaxed with a smile or a kind word would probably go a long way for both the patients and the staff.

There is also a consensus that the medical staff do a fantastic job with limited resources. The occasional review picked out an incident with an impolite staff member or a disagreement about appropriate treatment, but on the whole – staff in Vancouver’s emergency rooms provide world class care in less than optimal conditions. We are lucky to have them.

What has your experience been like in Vancouver’s ERs? Do you have a story to share with us?

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