July 19, 2024 from National Post
Canada’s emergency rooms are at a breaking point, with overcrowding, staff burnout, and systemic inefficiencies potentially leading to thousands of preventable deaths each year. According to a recent report published in the Canadian Journal of Emergency Medicine, between 8,000 and 15,000 Canadians may be dying unnecessarily each year due to hospital crowding.
The Growing Crisis in Emergency Care
Emergency room doctors across Canada are sounding the alarm about the dire conditions they face. A survey conducted by Dr. Kerstin de Wit, a professor in emergency medicine at Queen’s University, found that emotional exhaustion and depersonalization among emergency doctors have surged since the onset of the COVID-19 pandemic. The survey revealed a near-universal sentiment of despair among these frontline workers, with 98% of comments describing negative experiences.
“The environment is drowning me slowly, and it’s increasingly difficult to come up for air,” one doctor reported. Another said, “After 23 years in the ED, I don’t think I’ll last another year. I’m done.”
These statements reflect the overwhelming stress that emergency doctors are under, as they struggle to manage overcrowded departments with limited resources. In Ontario, the average wait time in emergency rooms in May 2023 was 18.8 hours, with fewer than one-third of patients being moved to a bed within the government’s eight-hour target. This situation is exacerbated by a practice known as “boarding,” where patients are held in hallways or makeshift spaces because there are no available beds in the wards.
The Impact on Patient Outcomes
The consequences of this crisis are severe. A task force from the Canadian Association of Emergency Physicians warned that patients with time-sensitive conditions, such as heart attacks or strokes, may go unnoticed amidst the chaos, leading to delayed treatment and potentially fatal outcomes. The report cited that in Nova Scotia alone, emergency department deaths reached a six-year high in 2023, with 666 deaths recorded, up from 558 the previous year.
The situation in Canada mirrors recent findings from the United Kingdom, where studies have linked emergency room overcrowding to excess deaths. If similar patterns hold true in Canada, the result could be between 8,000 and 15,000 preventable deaths each year due to overcrowding and delayed care.
Systemic Issues and Burnout
Emergency room doctors are not only dealing with overwhelming patient loads but also facing moral injury from being unable to provide the level of care their patients need. The survey by Dr. de Wit found that 59% of emergency doctors reported high levels of emotional exhaustion in 2022, up from 41% in 2020. Similarly, 64% reported high levels of depersonalization, a condition where doctors become emotionally detached from their patients—a significant increase from 53% two years earlier.
“Physician burnout is a huge patient safety risk,” Dr. de Wit emphasized. Burnout increases the likelihood of medical errors, misdiagnoses, and rushed decisions, all of which can have serious consequences for patient care. The strain on healthcare workers is further compounded by the exodus of skilled professionals from the field, with many doctors leaving emergency medicine due to the unbearable conditions.
A Broken System in Need of Repair
The emergency room crisis is symptomatic of broader issues within Canada’s healthcare system. A shortage of family doctors, delays in specialist care, and insufficient long-term care and home care options all contribute to the pressure on emergency departments. With more patients than available beds, hospitals are forced to rely on short-term solutions, such as adding hallway spaces or implementing “over-capacity protocols,” rather than addressing the root causes of the crisis.
“If the emergency system collapses or becomes non-functional, it’s a threat to the entire health of Canadians,” Dr. de Wit warned. The emergency department is the main entry point to the hospital, and if it fails to diagnose, treat, and triage patients effectively, the entire healthcare system—and patients—will suffer enormously.
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