montreal er patients in worse health today than five years ago: report
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as hospital emergency rooms across montreal struggle with a shortage of nurses, the remaining er medical staff are treating patients with much more complex medical problems than in the past five years, according to a new report.
anecdotally, emergency specialists have already noted that the patients they treat nowadays are not only older by and large, but they’re showing up to ers generally weaker and with more severe medical conditions like congestive heart failure and chronic obstructive pulmonary disease (copd).
and now for the first time, a report by the department of emergency medicine at mcgill university confirms those anecdotes with hard data concerning 25 ers in the greater montreal area, along with two hospitals in the outaouais region.
five years ago, for example, 56 per cent of all er patients at st. mary’s hospital in côte-des-neiges were considered “heavy cases.” today, that figure has jumped to 72 per cent, challenging the er staff as never before. at the same time, the 22-bed er is short-staffed three nurses every weekday and evening shift, and lacks as many as eight nurses on weekends.
source: comité d’information sur la santé — le département de la médecine d’urgence université mcgill.
and amid all the overcrowding that sometimes soars above 200 per cent of the er’s capacity, st. mary’s staff now say a prayer before the start of each shift.
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at maisonneuve-rosemont hospital five years ago, 70 per cent of er patients were considered heavy medical cases. today, that figure has increased to 74 per cent.
“even before the pandemic, we did notice that the cases were getting heavier and heavier,” said dr. françois marquis, chief of intensive care at east-end maisonneuve-rosemont.
“today, the patients are sicker and sicker. in the last three weeks, our icu was very busy, much busier than for this time of the year.”
marquis added that physicians at maisonneuve-rosemont have to more closely supervise medical residents (doctors in training) because of the increasing complexity of cases.
“the medical residents find it tougher,” marquis added.
the mcgill report did not delve into whether the covid-19 pandemic is to blame for the fact that a growing number of er patients are sicker. but marquis suggested that many patients put off going to the er during the pandemic and disregarded their health only to seek urgent medical attention much later when their medical problems grew worse.
another theory advanced by doctors is that quebecers in their 70s and 80s who contracted covid are generally weaker and in poorer health than before the pandemic, and so when they visit the er, the staff have a harder time stabilizing them.
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the mcgill report also noted that the ers at the jewish general and royal victoria hospitals treat the highest percentage of patients requiring the most urgent attention under the canadian triage acuity scale. the most urgent patients, classified as p1, require immediate attention, followed by those classified as p2, who must be examined by a doctor within 15 minutes. p3 patients must be seen within 30 minutes.
source: comité d’information sur la santé — le département de la médecine d’urgence université mcgill.
at the jewish general, 83.1 per cent of the er patients range from p1 to p3 on the triage acuity scale. at the royal vic, it’s 77.6 per cent, underscoring the enormous pressures the er staff find themselves in every day.
yet the report also noted that most montreal ers fall far short of the canadian triage response guidelines, with the royal vic faring the worst. what’s more, the report found that a rising number of montrealers seeking medical attention nonetheless leave overcrowded ers without ever being seen by a doctor because of lengthy waits. again, the royal vic’s er fared among the worst in that category.
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