By Don Peat
Toronto Sun
Copyright 2008 Toronto Sun
TORONTO — Hospital backlogs that leave patients in waiting rooms or on stretchers in a so-called “hall of shame” are to blame for three people dying within 24 hours at Etobicoke General Hospital, a city paramedic union leader alleges.
Glenn Fontaine, unit ambulance chairman for Toronto Paramedic Local 416, claims three people died between Monday and Tuesday at the hospital, with one of them going into cardiac arrest after sitting in the waiting room with chest pains for three hours and another patient dying after waiting with paramedics on an “offload delay” before getting a bed.
Offload delays refer to paramedics at the hospital with a patient waiting for a bed.
Paramedics call the hospital’s back hallway where they routinely wait with patients for an emergency room bed the “hall of shame,” Fontaine said.
Dr. Naveed Mohammad, the hospital’s corporate chief of emergency services, flatly denied that patients died in a waiting room or on a stretcher and said emergency room deaths are not uncommon.
“We did experience an unusually high number of admitted patients in the Etobicoke General Hospital’s emergency department ... on Monday and Tuesday of this week,” the hospital said in a statement.
Mohammad confirmed there was at least one death in the emergency department.
“I can’t disclose any sort of information about any specific patient,” he said.
“We did have an extraordinarily busy day,” he said, adding there were no patient complaints that day.
The hospital’s statement said no patients “lost vital signs” while in a waiting room or on an ambulance stretcher.
The hospital, part of the William Osler Health Centre that includes Brampton Civic Hospital, said if their clinical care team has any concerns about patient treatment, a review would be conducted.
But paramedics say not enough is being done to address backlogs and the issue of offload delays is at all hospitals and far too many patients are waiting far too long.
Too many hospitals have “halls of shame,” Fontaine said.
Although they only bring in 15% of emergency department patients, Toronto EMS offload delays are a sign of the backlog in city hospitals.
Those delays are the largest contributor to the $6.7-million overtime for city paramedics last year — $3.6 million over budget.
Offloads are at their worst in the city’s northwest section, said Mark Ferguson, vice-president of the Toronto Civic Employees Union Local 416.
“You saw this coming when they started to close hospitals,” he said, noting the northwest area lost three hospitals.
“Because there’s no beds for these patients, they need to go somewhere and it’s a backlog situation,” Ferguson said. “No one wants to take the bull by the horns and solve this issue.”
Norm Lambert, EMS deputy chief, said the service has seen the worst offload delays ever this week.
Despite attention drawn to the issue, the delays haven’t improved in the last few years, he said.
35 minutes ideal
Ideally, paramedics should be back on the road 35 minutes after arriving at hospital, Lambert said.
The average offload delay across the city is 65 minutes, but paramedics can wait up to 10 hours for the hospital to take a patient.
Yesterday, offloads were at their worst at 6:30 a.m., with 19 delays of the 45 ambulances on the road.
Since November, the service has had 120 to 160 offload delays three hours or longer each week, Toronto EMS spokesman Lyla Miller said.
According to city budget briefing notes, offload delays also hamper EMS response time.
Paramedics respond to a call in under nine minutes only 69.1% of the time — down from 84% in 1996.
“The good news is that action is being taken now,” Lambert said, adding the province, paramedics and hospitals are working together to address the issue.
“I think we are seeing some action at the expert panel level ... very soon some resolve could be coming out of this.”
Health ministry spokesman Laurel Ostfield said reducing emergency wait times is a top priority for the provincial government.
Two days after Premier Dalton McGuinty’s re-election, he named Dr. Alan Hudson to expand the government’s strategy to reduce emergency department wait times.
“People will start seeing the tracking of (emergency) wait times,” Ostfield said. “If you can’t track it, you can’t lower it.”