Long ER wait times, staffing challenges wreak havoc on small southwestern Ontario hospitals

Hospitals across Ontario are dealing with extremely long wait times in their emergency rooms (ER), citing factors including capacity challenges and staff shortages. ERs in smaller, rural hospitals in the province's southwest are no exception. 

Long delays were a problem even prior to COVID-19-related caseloads and backlogs, but physicians say the pandemic has worsened the conditions. 

Dr. Rod Lim, medical director and section chief at the London Health Sciences Centre's (LHSC) paediatric emergency department told CBC's The Current that the staffing situation at his hospital is very poor due to many people leaving the medical profession.  

"We're trying to plug every hole we can and we're often running short of nurses, and at night time we have staffing that is frankly unsafe at times. It's just not possible to function," he said. 

LHSC said high volumes in its ER are due to worsened illnesses as a result of  patients delaying care during the pandemic, more respiratory illnesses in addition to COVID, along with limiting surgical and ambulatory capacity during high-periods of hospitalization throughout the pandemic. 

The hospital put out a release offering tips to parents on how to keep their children out of the ERs over the summer. 

While Lim's is the largest hospital in London, hospitals in its surrounding areas say that the impact of long wait times is trickling down into their daily operations. 

Here's how they're grappling with this issue: 

St. Thomas Elgin General Hospital

In a news release, St. Thomas Elgin General Hospital (STEGH) informed residents of Elgin County of the pressures it's facing.

Heading into the summer after a very challenging two years has made it difficult to staff all programs and services, with a growing number of health care providers not willing to take on extra shifts to make the system function, the release said. 

"We, like most other hospitals, anticipate a very busy Emergency Department (ED) throughout the summer months and into the foreseeable future," said STEGH's president and CEO, Karen Davies.

"Staffing challenges, inpatient overcapacity and a very busy ED is resulting in higher than average wait times for patients visiting the ED. It poses challenges for those who require immediate, emergent care."

Davies says in March of this year, STEGH was seeing around 900 patients a week. They're now seeing over 1,200. 

Similar to LHSC, STEGH also has staff and physicians who have retired from the health care profession. The number of unfilled positions in the last year increased by 91 per cent, compared to 2020, they said. 

"The wellness of the workforce is the lowest that I've ever seen it, the humane care that is really being provided is on the backs of people that are absolutely exhausted," said Lim. 

Although the hospital has increased nursing and physician hours in response to the increasing visit volumes, they find that pandemic related staffing challenges are impacting ER operations. At the start of the pandemic, STEGH added 22 new beds, all of which are being used. 

Demand for extra capacity poses a significant risk to the sustainability of the system at a time when health care workers are burned out and exhausted," Davies said.

"The pressures on the system are exacerbated by the increasing shortage of health human resources, and limited support for patients after hours."

Clinton Public Hospital 

The ER at Clinton Public Hospital was temporarily closed throughout Canada Day long weekend due to the nursing and physician shortages, the hospital said in a release. 

The department will reopen to patients on Tuesday. Officials suggested patients in need of emergent care to go its nearby facilities.  

Woodstock Hospital

Human resource issues have also made their way to Woodstock Hospital, about 30 kilometres east of London, where the ER is facing higher volumes than usual. 

"Although our exact wait times fluctuate, for those requiring emergency medical care, Woodstock Hospital urges visitors to the ED to prepare for an increased wait," the hospital's spokesperson told CBC News in an email. 

"Though wait times may be increased, high quality, patient-centred care remains our top priority at Woodstock Hospital."

According to Lim, the post-pandemic disease burden is very unusual, with winter-time viruses creating a huge surge in patients. 

"The types of viruses that we're seeing, we never see in May and June," he said. "All parts of the health system are stressed and have the same challenges we do."

St. Mary's General Hospital and Grand River Hospital

In a statement, the presidents of both St. Mary's General Hospital and Grand River Hospital said they operated over capacity almost every day even prior to the pandemic. 

"This, along with a number of staff who are off due to COVID-19 or other absences, causes significant capacity pressures at our hospitals and for patients which can mean longer wait times," they added. 

The hospitals continue to urge patients to first consult with their family physicians and look into other services available within the community before making their way to the ER. 

Bluewater Health

A wide range of variables are affecting the length of time patients may experience while being assessed and ultimately treated at Bluewater Health in Sarnia, the hospital's spokesperson Keith Marnoc said in a statement. 

"One of the factors that we are acutely aware of are pressures related to adequate staffing in all service areas. We are also seeing an increase in absences of existing staff," he said.

Like many hospitals across the region, Bluewater Health is actively engaged in efforts to recruit and retain more health care professionals to allow us to continue to manage and deliver the care our patients deserve."

Alexandra Hospital Ingersoll/ Tillsonburg District Memorial

Similar to the ER, many other departments at the partnered hospital are also experiencing recruitment challenges. Their inpatient units are typically over capacity every day, officials say.

"Regardless of how an individual comes to one of our emergency departments for care, their wait time will vary depending on their clinical presentation," they said. 

Tillsonburg District Memorial Hospital added four extra beds during the pandemic, which continue to be used up on a daily basis. 

Strathroy Middlesex General Hospital (SMGH)

More non-urgent patients are visiting the ER at SMGH and Four Counties Health Services, in the recent months, leading to longer wait times, the Middlesex Hospital Alliance (MHA) told CBC News. 

"We are anticipating and planning for a challenging summer," they said. This combined with it becoming increasingly difficult to staff all shifts and all departments."

MHA said they're facing a specialty physician shortage and has had to adjust services accordingly. The obstetrics department at SMGH is dealing with a shortage of nurses.

"These problems have been extremely long withstanding, staff shortages require a sustained, persistent effort to solve it. Not a Band-Aid solution," said Lim.