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CHEO leads Ontario ER delays as toddlers wait hours for care

CHEO leads Ontario ER delays as toddlers wait hours for care

Ryan St-Jean’s long wait for his 18-month-old to see a doctor highlights why CHEO ranked first for longest emergency room wait times in Ontario.

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When Ryan St-Jean’s 18-month-old son Marcus had a respiratory infection in October 2024, the “longest expected wait time” posted at CHEO was 16.5 hours.

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St. John was at least prepared, packing a change of clothes, food, snacks, and toys. Based on previous experiences — and they had several visits to CHEO together over the past year — the fastest time Marcus ever got for a first assessment was eight hours, when he was nine months old, to another respiratory infection.

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But a typical wait is about 14 hours, St-Jean said, except for that one time when they were rushed to intensive care.

“It’s stressful to keep your child in the hospital waiting for treatment,” St-Jean said. “They just need to recruit more doctors to meet the demand.”

But the father’s long night spent trying to entertain a sick child in a waiting room is not unique.

Of 127 hospitals analyzed in Ontario, Ottawa Children’s Hospital ranked first for longest emergency room wait times.

According to Health Quality Ontario, the average wait time at CHEO for an initial assessment by a doctor in the emergency room is 4.3 hours. For comparison, the Ottawa Hospital has its patients wait 3.5 hours and the Queensway-Carleton Hospital, on average, 3.9 hours.

Patients admitted for less urgent health issues spent an average of 6.1 hours in CHEO emergency rooms.

Ryan St-Jean at home. Photo by Tony Caldwell /POSTMEDIA

Tammy DeGiovanni, senior vice-president of clinical services and general manager of nursing at CHEO, said the emergency department was only built for 150 patients, but now sees an average of 200 children per day. CHEO began using more clinics outside the hospital to divert less urgent patients to meet demand, but that did not decrease the high volume of patients in the emergency room.

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“It’s all about moving around the department, and so trying to make sure that at every level we’re as efficient as possible,” DeGiovanni said.

But wait times have only exacerbated during this year’s virus season, with an increase in respiratory illnesses, such as the flu, RSV and COVID-19.

“We always see an increase in our emergency volumes this time of year,” she said. “This can really impact the very young and those with other complex illnesses.”

This season has been particularly challenging for hospitals due to a “staggering” number of pneumonia cases among children, adolescents and young adults, according to Perth emergency doctor Dr Alan Drummond.

Meanwhile, as more children show up at CHEO’s doors, DeGiovanni said the CHEO hospital has hired more nurse practitioners and physician assistants to follow several medical guidelines established at the department emergencies. She said the hospital has its “core shifts” covered, but with additional funding it would like to add more shifts and staff to provide more care.

“Our team of doctors are really stepping up to the plate and doing extra work, above and beyond,” DeGiovanni said. “We know, however, that we need to develop this team, and that is one of the things we are discussing with the ministry.”

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In July 2023, the Ford government announced it would invest $330 million per year to expand pediatric services.

While this funding has made emergency care visits easier, the need is greater within local communities, says Kimberly McMillan, associate professor at the University of Ottawa.

“We’re seeing a symptom of a much larger problem in health care,” McMillan said. “We don’t have the community services that these children and families need. There’s no funding there, there’s no incentive to work in primary care for doctors.

“Sometimes (emergency rooms) become like an entry point into the health care system.”

McMillan says CHEO is responsible for children across a large geographic area, which will increase demand for health services and “promote widespread burnout” among employees.

“We have so many children waiting to be seen, but we don’t have the physical capacity to see them in a timely manner,” McMillan added.

Ryan St-Jean and his son, meanwhile, were at least rewarded for their patience in October. As the night dragged on and the crowd in the waiting room slowly dwindled, little Marcus was finally called to a doctor at 3 a.m.

The wait time turned out to be a new personal best for the duo: just seven hours.

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