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Steph Markou
Andie Silva
English 1020
March 30, 2008
Attention City Council Members of Windsor, Ontario,
People are seeking health care in our city more than ever due to Windsor’s aging
population, and an increase in health problems. Hospital visits and admissions are on the rise,
and it has become almost impossible for our facilities to keep up with demands. The public has
been patient in the past but is now becoming irritable with long wait times; in turn they feel their
needs are not being met by city hospitals and services. Emergency Department wait times have
increased significantly over the past five years and it is time for a solution to be made.
Ambulance services are caught in the middle waiting for patients to be admitted by local
hospitals. Due to a shortage of hospital beds paramedics are placed on, what is called “Code-7,”
where they are to remain with their patients in hospital emergency rooms until a bed is cleared
and their patient can be admitted to the hospital. This prevents paramedics from being able to
responds to other emergency calls. Due to this growing problem it is time for action to be taken;
opening an additional hospital, expanding the emergency department, and increasing the number
of long term care facilities in the city would help alleviate the problem. An addition idea is
seeking health care teams that can go into the homes of elderly people to review safety measures
in hopes of preventing unnecessary trips to the emergency room.
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Roughly eight years ago there were a total of four hospitals in the city of Windsor that all
had open emergency departments; at this time weight times were significantly shorter and
patients concerns were addressed more efficiently. Today Windsor has been cut down to two
hospitals that operate with emergency departments; Hotel Dieu and Metropolitan Hospital, as for
the other two hospitals one was closed, and the second was converted into a long term care
facility that does not have an open emergency department. According to Statistics Canada,
Windsor and surrounding areas combined make up about three hundred and twenty thousand
people; of that fourteen percent are over the age of sixty five. Windsor hospitals are seeing an
overwhelming amount of elderly people in emergency waiting rooms that are in need of medical
attention, most of which need to be admitted due to aging factors. With these elderly patients
taking up the majority of chronic care beds in the hospital, there are fewer beds available to
accommodate other patient’s needs. Many of these elderly patients need to be admitted to long
term care facilities, rather than spending months at a time in hospital beds.
A “Code-7” is defined as an ambulance stalled at the hospitals waiting to discharge
patients. When paramedics are held on “Code-7” they are required to stay with their patients in
the hospital hallways until a bed is free for their patient to be admitted, this in turn leads to one
less ambulance on the air able to receive calls and able to attend to new people in need of their
services. With a back log of paramedics waiting for their patients to be admitted, this leads to
more and more paramedics standing in line to admit their patient. On average the city of Windsor
has about twenty ambulances in service to attend to emergency calls, but when the patients are
not admitted right away this causes the ambulances to be tied up and not in service. Windsor
Regional Hospital CEO David Musyj says “Code 7’s” are really a symptom of hospitals here
being overwhelmed with the domino effects of an aging population. It's a multi-faceted
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problem." (Ambulance gridlock tackled, windsorstar.com) Expanding the emergency department
will help alleviate the growing problem of elderly patients that occupy acute care beds that
cannot be moved to a long-term facility. On average the emergency department sees about one
hundred and sixty people a day, which is up fifteen percent from the last two years. Musyi
estimates that twenty percent of the three hundred beds available as acute care beds are taken up
by patients that should be in a long term care facility. “We have very sick people coming to our
emergency; the community is getting older and sicker." With these recurring problem, Windsor
Regional hospital is offering a solution to the problem; by changing a classroom into an extra
emergency department, they are going to open an extra sixteen beds which will help keep the
wait times down and get patients admitted by paramedics to receive a bed sooner. This solution
brought forth by Musyi, seems to be a band aid solution, and dodges the real problem the city
needs to face. Opening an addition sixteen beds will not completely relieve the backlog of
patients. This solution will somewhat help wait times, but it is enviable that an extra hospital is
required to better service the community and residents.
With Windsor having only two hospitals in our city that accommodates three hundred
and twenty thousand people; local hospitals are stressed. Hotel-Dieu and Metropolitan hospital
are operating at or above one hundred percent. An editorial to the Windsor Star describes a
woman’s experience with long wait times and a tragic outcome. Her husband had been
diagnosed with a respiratory disease and for fear that his oxygen tank would run out, he went to
the emergency room and waited eight hours before being admitted. After being admitted, treated
for pneumonia, then sent home, her husband had taken a turn for the worst. Waiting till morning
in hopes his condition improved, and avoiding another long hospital wait, upon checking on his
well being come morning she found her husband dead. Now this grieving widow is forced to
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carry on her life knowing that her husband’s death may have been avoided if not for extended
wait times. Dalton McGuinty, The Premier of Ontario, says hospital care and waiting times have
greatly improved in Ontario, especially in Windsor. If that is the case then why are some waiting
eight hours in an emergency room before any treatment is sought. It is unfortunate that long
hospital wait times are causing people to think twice before they go to the emergency room, even
in serious life threatening emergencies. (System failed husband, mourning wife complains, The
windsorstar.com)
Wait times are affected by the shortage of beds; hospitals can not admit patients if there
are no beds available. Patients are waiting too long to be seen in emergency rooms because of
overcrowding and backlogs in the system. George Smitherman, Ontario’s health minister, says
“much of the waiting can be attributed to a high number of elderly patients, who often have
complex symptoms and cannot be treated easily or quickly.” (Study sheds light on ER wait times
in Ontario, CBC.ca) Opening an additional hospital will alleviate the stress in the over crowed
emergency rooms and opening a new long term care facility will free up the used acute care beds.
Having a variety of emergency bases in Windsor and surrounding towns helps
paramedics get to an emergency quick and efficient, but if paramedics are backed logged and are
waiting for their patients to be admitted to hospitals, then no time is being saved. Paramedics
respond to emergency calls in about five to ten minutes, and can wait for up to four to five hours
for their patient to be admitted to the hospital. If paramedics can respond quickly to someone’s
needs, then a hospital that is better equipped to handle emergencies should be able to as well.
Neil McEnvoy CEO of Hotel-Dieu Hospital recently had two hundred and seventeen patients
come into the emergency room in one day. McEnvoy knows that change is necessary, and needs
to be implemented. In the next five moths Metropolitan hospital will be undergoing construction
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to the emergency department which will add an addition sixteen beds; this will help treat
emergency patients quicker and free up more beds for paramedics that bring in patients, but the
finished product cannot come fast enough. Once construction is completed the emergency room
will be able to hold fifty beds, but there is not enough funding to add an addition to Hotel-Dieu.
McEnvoy says “expansion is impossible right now, we do not have a single square foot to put
new beds.” Both McEnvoy and Musyi who are the CEO’s of Hotel-Dieu and Metropolitan know
what is causing this extra stress on the system; the crowded emergency rooms and hospitals are
reaching capacity due to the aging population. Hotel-Dieu Grace has three hundred and two
acute care beds, and twenty per cent of the people occupying them, should be in a long-term care
facility. Alleviating this problem can put patients in rooms quicker, instead of occupying a bed in
the emergency department.
Windsor has been told a new long term care facility will be opening which will occupy
three hundred and twenty acute care beds, but 2010 is still two years away for this desperate
change to happen. Eleanor Groh, director of emergency services states “Hotel-Dieu Grace has a
forty two bed emergency room and sees the area's most serious trauma cases; that includes head
injuries, cardiac problems, renal failure, and severe mental illness.” (Hospitals work on ER
logjam, windsorstar.com) Not having enough beds and long term care facilities is really having a
toll on our city and on our health care system. These patients rely on the hospital to help them get
well, but without the adequate space needed to service them, their health could dwindle.
We know expanding the emergency department takes times, as well as adding addition
beds require the space to do so. Helping to treat the cause from outside the hospital like
providing programs to educate the elderly in their homes of safety measures can help prevent
unnecessary trips to the emergency room. Starting a program designed to teach the elderly about
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proper care, and how to prevent accidents by making their home a safer place would alleviate
future problems. Windsor is expected to expand and open a new long-term care facility, this
would help open up some beds being occupied by the elderly in the hospital but because of the
large numbers of people waiting to be accepted to local nursing homes, this addition would
quickly fill up, and we would find ourselves back to square one. The city needs to come to terms
with the fact that an additional hospital and emergency department is needed before any relief
will be noticed. Also building a greater number of long term care facilities will help free up beds
being occupied by long term care candidates in local hospitals. Although this option will cause a
financial strain on the city, the city and its residents will benefit in the long run with a better
health care system, and more reliable care. The health care system in this city should be top
priority and action needs to be taken.
Work Cited
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1. "Experts Hope Report Helps Cut Hospital Mortality." CTV.Ca. 29 Nov. 2007. 23 Mar.
2008
<http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20071129/hsmr_071129/20071
129?hub=Specials>.
2. Rennie, Gary. "Ambulance Gridlock Tackled." The Windsor Star. 25 Feb. 2008. 22 Mar.
2007 <http://www.canada.com/windsorstar/news/story.html?id=37641b14-13a5-44ac8b8d-9719ff676cef>.
3. Rennie, Gary. "ER Wait Times Challenge Windsor Hospitals CEOs." The Windsor Star.
04 Mar. 2008. 22 Mar. 2008
<http://www.canada.com/windsorstar/news/local/story.html?id=00a479a9-2a0e-463a88bb-7a0fffe0c58b&k=9208>.
4. Rennie, Gary. "Hospitals Work on ER Logjam." The Windsor Star. 05 Mar. 2008. 21
Mar. 2007 <http://www.canada.com/windsorstar/news/story.html?id=2c77e591-ad204834-9f15-b3952f987959>.
5. "Study Sheds Light on ER Wait Times in Ontario." CBC.Ca. 25 Jan. 2007. 20 Mar. 2008
<http://www.cbc.ca/canada/story/2007/01/25/er-waits.html?ref=rss>.
6. "System Failed Husband, Mourin Wife Complains." The Windsor Star. 10 Mar. 2008. 22
Mar. 2008 <http://www.canada.com/windsorstar/news/letters/story.html?id=93b50624fa74-485a-95e1-f19103c4d07d>.