Two years ago, Kenneth Cotterill attended the emergency room at Regina Pasqua Hospital due to what felt like a broken ankle.
He said despite it being “swollen up like a balloon” the process from being admitted, to seeing a doctor and getting an X-ray was approximately five hours. “The pain was pretty bad and I thought I made it clear that it was but they didn’t seem too worried about it,” he said.
Reducing wait times has been a challenge --- and budgetary expense -- for the province for several years now. This year will be no exception, with $12 million earmarked for Regina and Saskatoon hospitals to reduce overcapacity and emergency wait times.
It's just one small part of a large pie. The total Ministry of Health budget is $5.2 billion for 2017-2018.
According to Health minister Jim Reiter, the ministry is still in the process of figuring out exactly how the wait time reduction money will be used.
“We still have discussions to do, minister officials will be working with the health regions as far as the breakdown. I can’t give you specifics, other than just the general numbers right now,” he said.
When asked if any money would be used to purchase diagnostic equipment such as MRI or CT scans, he replied “probably not.”
He said that instead, the province would continue to use the two-for-one MRI program that allows patients who are waiting for an MRI in the public system, to go to a private provider and pay for it.
“What it has done effectively is every time that happens it reduces two people from the wait list,” he said. “We used the two-for-one MRI program to great success so we’re going to be continuing to do that.”
Meanwhile people seeking immediate assistance can expect to wait an average of 13 hours in Regina's emergency rooms, according to the Regina Qu’Appelle Regional Health Authority’s second quarter report released in November 2016. The total time is measured from patient registration to the time of discharge.
Patients admitted to the ER are prioritized based on the urgency of their need. Patients with life-threatening conditions are considered most urgent and are thus given primary care.
The Ministry of Health’s annual report for 2015-16 shows the goal to decrease the number of emergency visits by 50 per cent was not met.
RQHR set a new goal to reduce emergency wait times by 60 per cent by March 31, 2019. Wait time measures include the length of stay for admitted and non-admitted patients, time waiting for an inpatient bed and the wait for a physician’s initial assessment.
The provincial auditor of Saskatchewan conducted a waiting room observation and testing of triage files in 2013. The audit disclosed that staff did not regularly reassess the medical conditions of emergency department patients. The results were based on the Canadian Triage and Acuity Scale, which is a tool used to prioritize the emergency of patients.
Two years later, the Saskatoon Regional Health Authority planned to implement a triage captain position for each emergency room in two of its three 24-hour service hospitals. The triage captain serves as the first point of contact with emergency patients. The captain is also responsible for documenting the reassessment of patients in the waiting room and notifying nurses and/or physicians of changes in patient status. By 2016, only one triage captain was implemented.
The audit also found that for 100 per cent of the emergency department triage files that were reviewed, a physician did not see emergency department patients within the CTAS time goals.
In addition to poor wait time trends, The RQHR faces overcapacity pressures, meaning there are more patients than there are beds to hold them. During overcapacity, a patient is placed in a temporary area until a bed is available for them. No matter the location, however, the patient will still receive care.
Minister Reiter said although some goals to reduce overcapacity pressures and wait times in the ER were not achieved last year, they will continue to set goals.
“We’ve never been scared as a government to set goals. If you don’t set goals, you tend to not have successes. We’re not scared to do that. We’re not always successful, many times we are, we’re going to continue to set goals and strive to achieve them,” he said.
Also with this budget, the province is moving from 12 health regions to a single Provincial Health Authority. The move is intended to allow more focus on front-line services, according to Reiter.
“That’s what the people of Saskatchewan are looking for, they want to know that there’s a doctor, and a nurse and a care aid for them when they need it. They’re not so much concerned about management of health cares, just making sure the services are provided when they’re most timely,” he said.
At the same time, coverage of some preventative care services, such as podiatry services, is being cut. Tracy Zambori, president of the Saskatchewan Union of Nurses, said these changes may contribute to increased wait times. “When we see programs being cut, and we don’t know how far that’s going to go, the most vulnerable people in our population are often affected, and then that means more visits to the emergency room,” she said.