Reducing emergency room (ER) wait times and alternate level of care (ALC) days

The provincial context

When patients wait for too long to get emergency care or are stuck in a hospital bed because they can’t get the services they need, this indicates that the health system is not functioning the way it should.

While there are various and complex reasons for these delays, one of the main reasons emergency departments get backed up is that the hospital beds needed by ER patients are occupied by “alternate level of care” patients waiting to be transferred to a more appropriate care setting, such as in their own homes or long-term care. Of the total number of days Ontario patients spent in hospital in 2008/2009, about 16 per cent were ALC days.

The Toronto Central LHIN perspective

These ER and ALC challenges are reflected in Toronto Central LHIN hospitals where, in July 2009, patients who needed to be admitted spent 16.4 hours on average in the emergency department while those not requiring admission waited an average of 4.5 hours. The Toronto Central LHIN’s ALC days account for 10.6 per cent of total patient days in local hospitals (acute, rehabilitation and complex continuing care), which translates to more than 500 ALC patients waiting each day in hospital for the services they need to become available.

Focusing on reducing ER wait times and ALC days will improve the health system as a whole by ensuring patients and clients get the help they need, whether that’s in a hospital’s emergency department, a long-term care home, supportive housing or in their own homes.