Photo courtesy, ASMUQ
Dr. Gilbert Boucher, Physician
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These delays illustrate the waiting time before obtaining a bed on a hospital floor or, more rarely, discharge. Already waiting in the emergency room is painful for anyone who is sick, such a long delay has repercussions for seniors.
“For the elderly, it’s a disaster,” reacts Dr. Marcel Émond, emergency physician at the Enfant-Jésus hospital in Quebec.
Generally, patients who stay in emergency rooms for long periods do not have a clear diagnosis, which requires investigation time (confusion, weakness, mental health, etc.) According to Dr. Émond, seniors represent at least 50% patients who remain on a stretcher for more than 48 hours.
Lack of beds
The lack of beds on the hospitalization floors explains in large part why patients stay so long in the emergency room.
“The pre-pandemic trend just continued. […] And it is not good”, notes Dr. Boucher, who believes that the directives now rely more on “hospital fluidity”.
Since beds must remain available to patients after surgery, other patients must remain in the emergency room. In the context of COVID-19, Quebec has fallen far behind in its surgical schedule, and the pressure is strong to revive this sector.
Management also mention the shortage of staff to explain the long delays. Over the past year, 22% of patients in Quebec have spent more than 24 hours on a stretcher. Again, the department’s target is zero.
► Since the pandemic, the MSSS has raised its target for the average length of stay on a stretcher, going from 12 p.m. to 3 p.m.
Confused seniors after two days
The long hours spent on a stretcher in the emergency room have serious consequences for seniors, who often become confused and have a longer stay in hospital.
“Complications start in the first hour,” says Dr. Marcel Émond, an emergency physician at the Enfant-Jésus hospital in Quebec City, and a researcher specializing in geriatric care. In 24 hours, they can lose up to 10% of their ability to do their usual tasks. »
“It has a great impact on them, adds Dr. Jacques Morin, president of the Association of Geriatric Physicians of Quebec. They are fragile people. »
According to Dr. Émond, it is imperative to tackle the problem of emergency room stays for seniors, in particular because deconditioning (loss of capacity) prolongs hospital stays by an average of four to seven days.
Irreversible loss
Sometimes the agitation even requires physical or chemical (medication) restraint.
“Often, they end up forgetting their name or the date after two days,” notes Dr. Gilbert Boucher, president of the Association of Emergency Medicine Specialists of Quebec.
In some cases, the lack of physical activity can lead to an irreversible loss of physical autonomy. Moreover, these patients often need help to eat or go to the toilet.
However, “there are not too many attendants” in the emergency room, reveals Dr. Boucher.
A push
According to Dr. Émond, the prehospital system must be completely overhauled to better serve this clientele outside the hospital.
“The system is not made to send people home,” he laments. Is the Park to the urgency in the hope that solutions will be found. »
Among the avenues for the future, we must improve care in the community and home services.
“It’s a win-win solution for everyone. But that requires a big boost in the system, thinks Dr. Émond. We must tackle this phenomenon. »
The worst hospitals
◆ Du Suroît (Salaberry-de-Valleyfield) 22 % (8 %)
◆ Albert-Prévost Mental Health Hospital 22 % (4 %)
◆ St. Jerome 20 % (8 %)
◆ Lakeshore (Pointe-Claire) 18 % (5 %)
◆ Royal Victoria (CUSM) 18 % (8 %)
◆ Comeau Bay 17 % (6 %)
► Provincial average 6 % (2 %)
*Data from the MSSS for the period from April 2021 to February 2022. The rate represents the percentage of patients who spent more than 48 hours on a stretcher, in the emergency room, before having access to a bed or having leave.
Editor’s note: The figure in parentheses represents the same data four years earlier, in 2017-2018
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