Quebec health minister says emergency room overcrowding is improving, union says emergency rooms in ‘crisis’

MONTREAL – A new plan to reduce overcrowding in Quebec’s emergency rooms is paying off, the province’s health minister said Wednesday, but a major nurses union said while the measures were commendable, the situation remained critical.

Were it not for a number of recent changes to the health network, including new nurse-run clinics and the expansion of an urgent medical line, emergency rooms across the province would be in much worse shape, Christian Dubé told reporters.

“This combination of measures that we’ve implemented very quickly is making a difference,” the health minister said during a visit to a hospital on Montreal’s South Shore.

About 10,000 people visit emergency rooms in Quebec each day, he said, a similar number to this time last year. But if it weren’t for the additional measurements, Dubé said, that number would be higher.

“It’s hard to say, would we be at 12,000? 15,000? I don’t know, but we would be over 10,000.”

The average occupancy rate in Quebec emergency rooms was 130% on Wednesday afternoon, according to health data website IndexSanté. That figure, however, only considered the number of stretcher patients, not people in waiting rooms.

Roberto Bomba, treasurer of a major health union, said the situation in emergency rooms remained a “crisis” despite the latest government changes. The new nurse-run clinics and the expansion of the urgent care telephone line will help, but the number of people visiting emergency rooms will not decrease overnight, Bomba said, with the Fédération interprofessionnelle de la santé du Québec .

“Needs continue to increase, the population is increasing in number, chronic diseases are increasing and it is winter time, so you are at greater risk of viruses,” he said in an interview on Wednesday, adding that winter weather also leads to falls that can send people to the emergency room.

With emergency rooms overwhelmed and Quebec hospitals already short on nurses, Bomba said nurses are forced to work mandatory overtime and, in some hospitals, are under pressure to work overtime shifts, which are supposed to be voluntary.

“It’s becoming a practice, because of the shortage, because of the crisis, especially in[Emergency rooms]where there’s a tremendous amount of pressure being put on our healthcare workers by executives to work an extra shift,” he said.

Nurses, Bomba added, feel guilty about leaving their colleagues with extra work or being told patients will suffer if they don’t work overtime.

“Some hospitals are doing better than others, for different reasons; some are better able to attract healthcare workers, some are better able to retain healthcare workers,” she said, adding that some hospitals treat their staff better than other hospitals do. .

Hospitals in Quebec have been affected by three respiratory viruses: respiratory syncytial virus, influenza and COVID-19. More than 2,100 people were in Quebec hospitals with COVID-19 on Wednesday, including 746 people hospitalized due to the disease. On the same day last year, the Department of Health reported 415 COVID-19 patients in Quebec hospitals.

“The situation is still very critical with crowding,” said Dr. Judy Morris, president of an emergency room doctors’ association, on Wednesday.

At times, some emergency rooms have approached 200 percent capacity, said Morris, with the Association des médecins d’urgence du Québec. “This can create very suboptimal and potentially dangerous situations for patient care and it’s a huge strain on emergency room teams, so it’s still very difficult in the field.”

Morris, who practices at Sacré-Cœur Hospital in Montreal, said steps were being taken to increase access to outpatient care and primary care outside emergency departments, adding it would take some time before patients they fit.

At Montreal Children’s Hospital, the emergency room was less crowded this week than it has been recently, said Dr. Earl Rubin, director of the hospital’s pediatric division of infectious diseases.

“I would cautiously say that things are stabilizing and tending to improve, but things are changing day by day,” he said in an interview Wednesday. While the number of RSV cases has decreased over the past month, the hospital is now seeing more cases of the flu, she said.

Quebec’s decision to make the flu shot free for all came too late, after the start of flu season, Rubin said. The province initially made shooting free only to certain high-risk groups.

Rubin said measures to ease the pressure in emergency rooms will be tested during the holidays, as people gather and family doctors’ offices cut back on activity.

“I am very concerned. Because even if we are past the peak, all it takes is one infected person, who will then congregate in close proximity to other vulnerable, non-infected people,” he said.

This report from The Canadian Press was first published on December 21, 2022.

Jacob Serebrin, The Canadian Press

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