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00:00Emergency care is in crisis.
00:11It's been 8 hours.
00:1212 hours.
00:13We're tracking wait times across the country.
00:16Who's the longest right now?
00:18About 36 hours.
00:20Patients desperate for help.
00:22It makes me feel like our system is broken.
00:24How often then are you seeing a patient
00:27and thinking I should have seen you hours ago?
00:30Oh, every shift.
00:31For some, the consequences of a stressed system are deadly.
00:35We trusted the system to take care of our son.
00:38And that is a trust that is forever gone.
00:41This is your Marketplace.
00:46We're at two of this country's busiest emergency departments.
00:49Spending a day shift inside one
00:52and a night shift outside another.
00:55Following doctors.
00:58Talking to patients and tracking their wait times.
01:02Getting an up-close look at an emergency care system in crisis.
01:07It's early morning at Sunnybrook Hospital's ER.
01:11And the chief, Dr. Justin Hall, is starting his shift.
01:15Morning, Mike.
01:17Many of the patients he's about to see have been waiting overnight.
01:24I'm just going to turn the light on, sir, if that's alright.
01:28John's been here since 2am.
01:31Can you tell me what's brought you in today?
01:34Well, I have difficulty finishing a breath.
01:41Okay.
01:42Waiting for seven hours.
01:44And as Dr. Hall orders more tests.
01:47Can I, can we do a walk test for him?
01:51Yep.
01:52He'll likely be here for much longer.
01:55This Toronto hospital is the largest trauma centre in the country.
02:00Roughly 200 people come through daily.
02:04Last year, the median length of stay for patients was 8 hours and 13 minutes.
02:10Meaning half waited even longer.
02:13It is the longest in Ontario.
02:16Data shows wait times across the country are getting higher.
02:20We've been tracking and the numbers are stark.
02:24PEI's hospital with the longest wait is 5 hours and 19 minutes.
02:29And it just goes up from there all the way to 13 hours and 3 minutes.
02:34That's Quebec's longest wait.
02:37Behind the data, there's damage.
02:408 hours and 22 minutes.
02:43What does that length of time mean to you?
02:45It's a number I hate now.
02:50And it's 8 hours of 22 minutes that Finley had to suffer.
03:03In February last year, 16-year-old Finley Vanderwerken had severe abdominal pain.
03:09His parents, Hazel and GJ, rushed him to the nearest emergency room in Oakville, Ontario.
03:15I was so scared. I was just full of fear and wanted Finley to get seen immediately.
03:21Finley was triaged at level 2 on the Canadian Triage and Acuity Scale, meaning his case was emergent.
03:28Guidelines say he should have been seen by a physician within 15 minutes.
03:34Instead, he waited for hours.
03:38I had to go up several times to the nurse's desk and ask for them to come and see Finley.
03:47He was having problems breathing and he was in so much pain, he was crying out.
03:52Hospital records show every time Finley's vitals were taken, his oxygen saturation kept dropping.
04:00Eight hours and 22 minutes after he arrived, Finley finally saw a doctor.
04:07Then everything changed.
04:09There were lots of people involved.
04:12The doctor knew at that point that something was wrong and action had to be taken.
04:18By then, Finley had sepsis, his body's reaction to pneumonia.
04:22He went into cardiac arrest.
04:25His organs began to fail.
04:27You want your kid to be the miracle kid.
04:31I'm asking, is there a chance of a miracle?
04:36There wasn't.
04:39There's small comfort in us knowing that we tell our kids we love them every day.
04:54We know that Finley knew.
05:03But what can you say in those last moments?
05:08You've both had to injure something that no parent should have to deal with.
05:14Do you think that his death was preventable?
05:18Yes.
05:19Yes.
05:24Dr. Fraser Mackay is with the Canadian Association of Emergency Physicians.
05:29They've been sounding the alarm about long wait times for years.
05:34We know we work in a system that is falling apart.
05:37So how often then are you seeing a patient and thinking to yourself, boy, I should have seen you hours ago?
05:44Oh, every shift.
05:46Every shift.
05:47Undoubtedly.
05:48His own ER in New Brunswick is no exception.
05:52And so he avoids going into the waiting room altogether.
05:55When I have 40 pairs of eyes on me and they just want eye contact because they want to be seen.
06:02They want me to know that they're waiting to see me and they're suffering.
06:06I know that.
06:07Of course I know that.
06:08And that's a really hard thing to do.
06:10I don't know which of them is going to have a devastating diagnosis.
06:13I don't know which of them is going to get called in in five minutes.
06:17We're starting the clock on a 12-hour overnight shift outside St. Michael's Hospital in downtown Toronto,
06:24tracking how long patients who have come to this ER will wait.
06:28Hey man, how you doing?
06:29My name's Chris.
06:30I'm a reporter with Marketplace.
06:32Right away, we meet Anthony, who's just arrived by ambulance.
06:36What did you come for?
06:37So I've been sitting in pain for two days.
06:39My foot's small, double twice the size.
06:41So, you know, I hope I don't need pins.
06:45Well, I hope your wait isn't too long, but stay connected and we'll keep in touch.
06:48All right, thank you.
06:49All right.
06:50Time passes.
06:52As we wait for an update from Anthony, we meet Jen, whose husband is inside.
06:57How long have you been waiting here for your husband?
07:00We've been here for eight hours now.
07:02Why did you and your husband have to come here to the ER today?
07:05Um, so he just has some, like, lower back pain problems that just came out of nowhere.
07:11We were getting ready for my sister's wedding.
07:13This is not how you were expecting to spend your sister's wedding day.
07:16Definitely not.
07:17No, he's missed the entire thing.
07:19It's now just before midnight.
07:21And as Jen heads back inside, we find Jonas in a lot of pain.
07:26I have probably my back.
07:28Oh, your back.
07:29Yeah.
07:30I guess they didn't give you any idea how long you might have to wait?
07:33No, he don't say nothing.
07:35He say you need to wait.
07:37And so she does.
07:40What does it feel like when you think about all the patients that are out in that waiting room
07:45and you can't get to them quickly and treat them the way that you want to?
07:50This is such a huge overwhelming problem.
07:53It's when it's the individual patient.
07:56That's when it hits.
07:57It sticks with you.
07:58Yeah.
07:59Yeah.
08:00It sticks with you.
08:01And it's because it makes you, it makes you question, are you good enough?
08:07And are you in the right job?
08:09And that's hard.
08:11Is crisis the right word to use when we describe the system right now?
08:16Crisis is a great word other than the fact that it implies sudden.
08:22We've been very clear for many, many years.
08:26We know these problems.
08:27We know they're getting worse.
08:29The problem is complex.
08:31Burnout is leading to staff shortages.
08:33And a lack of family doctors is pushing more people to depend on Emerge.
08:38But experts say the biggest issue causing long wait times is what's called boarded patients or bed block.
08:46ER patients who have been admitted to another unit in the hospital, but that unit is full.
08:51So the patient is left waiting in the ER.
08:55A few hours into Dr. Hall's shift inside Sunnybrook, we watched that unfold.
09:01We have 31 patients who are admitted to the hospital but are remaining in the emergency department because there's no bed.
09:08That's roughly half of your overall patients.
09:11It is.
09:12Just here waiting.
09:13Right now that's about half.
09:14Correct.
09:15Okay.
09:16That sounds like a big problem.
09:17It is.
09:18It's a big problem.
09:19And right now, this is sort of earlier in the day.
09:22But as the day goes on, this problem becomes more challenging.
09:25We start to see that number creep up.
09:27Who's the longest right now?
09:29Who's still in the department?
09:33Looks like about 36 hours.
09:3636 hours?
09:37Yeah.
09:38Dr. Hall gets back to the patients who have yet to be seen.
09:42I'm just going to sit behind you.
09:49Hello.
09:50Hello.
09:53And I understand you guys have agreed to have the team here as well.
09:56My name's Justin.
09:57I'm one of the emergency physicians.
09:58It's nice to meet you.
09:59But shortly after, an interruption.
10:03Apologies.
10:04Just give me one second.
10:07An urgent update from our first patient, John, who's been in the ER for nine hours now.
10:13Okay.
10:14Thanks for your help.
10:15Bye for now.
10:17So John doesn't get to go home?
10:19No.
10:20So John's going to stay.
10:21He's got a few things going on.
10:23I'm concerned about his breathing.
10:25So now essentially he's a blocked patient.
10:27He will be.
10:28So as we were chatting about earlier, now I think we have 33 admitted patients from what I can see.
10:33I've now just added one more patient to that.
10:36So he will get seen by our specialist colleagues, likely admitted here shortly.
10:42And then he will wait for a bed.
10:44So John stays waiting.
10:48Back outside St. Michael's Hospital, an update.
10:52It's 1am now and I just got a text message from Anthony.
10:55He's one of the first patients that we met.
10:57He came in with a foot cast complaining of swelling and pain.
11:01And he's just texting me to say that he's waiting for surgery now, still in the ER,
11:06some seven and a half hours into his wait.
11:08And we'll keep checking in.
11:14Coming up, patients fed up with waiting, walking out of emergency departments without care.
11:20From what I know now, I did put myself in jeopardy.
11:23That's after the break.
11:34We're outside Toronto's St. Michael's Hospital, tracking how long ER patients are waiting.
11:40It's 2 o'clock in the morning and we meet Joyce, who had a sewing needle lodged in her foot.
11:46We have been waiting out here for hours.
11:48We've heard from at least two people who mentioned the girl who was screaming with the needle.
11:52Inside of them.
11:54And so I just can't even imagine how much pain you must have been in.
11:58I was in so much pain.
11:59Yeah.
12:00I was in so much pain.
12:01I'm so sorry.
12:02Yeah.
12:03What do you think of this seven hour wait that you have?
12:04It's insane.
12:05Jen and her husband, who came in with lower back pain, are finally cleared to go home.
12:10Jen, my goodness.
12:11Yes.
12:12At the end of the day, how many hours was it?
12:14It's been 10 hours in total.
12:15Hours.
12:16How do you feel about this?
12:18Exhausted.
12:19Yeah.
12:20But Jonas, who's also been here for hours with back pain, is leaving without seeing a doctor.
12:29What are you doing right now?
12:30I go home.
12:31Too many people wait inside.
12:35St. Michael's Hospital tells us they've experienced higher than normal demands for urgent care in recent months.
12:43They say they see the sickest people first, but see all patients as quickly as possible.
12:49I can tell you're in a lot of pain, so I want to let you go.
12:53Okay.
12:54But thank you.
12:55You're welcome.
12:56I hope you're feeling better.
12:58Okay.
12:59She represents a growing number of Canadians leaving emergency rooms without being seen by a doctor.
13:05Last year, in Ontario and BC, about 5% of patients walked out.
13:09In Nova Scotia and Newfoundland and Labrador, 10%.
13:12It's about 12% in Quebec, Nunavut and New Brunswick.
13:17And two provinces, Manitoba and PEI, have an even higher rate.
13:22It's rare that a shift will go by where one of the patients I'll see isn't someone that was there yesterday or the day before and couldn't handle the weight and left.
13:32And now they come back and now they're that much sicker.
13:35In New Brunswick, where Dr. Makai works, that breaks down to nearly 60,000 patients who walked out of Emerge just last year.
13:43We're on the road to meet one of them.
13:46It was chaotic.
13:47It was loud.
13:48There was a lot of people that are just really upset about waiting.
13:53Susan Gordon arrived at the Moncton ER by ambulance this past June.
13:58She'd been vomiting repeatedly and had sharp stomach pain.
14:02You know how they always ask you your pain out of a scale of 10?
14:06I was at a 15 about that night.
14:08Oh my God.
14:09But after more than three hours in a crowded waiting room, she gives up and walks out.
14:15And when you made that decision to leave, do you think you put your health in jeopardy?
14:19From what I know now, I did put myself in jeopardy.
14:22After leaving the ER, her pain intensifies until she collapses and ends up back in Emerge.
14:29She said, it's your appendix. I needed to have surgery and they were doing it immediately.
14:33So you went in with what you now know is appendicitis.
14:36Yes.
14:37And you didn't end up getting care.
14:39How does that make you feel?
14:40It makes me feel like your system is broken.
14:42Horizon, the health authority that runs the Moncton Hospital ER, tell us they don't want any patients to leave without being seen.
14:51And say the long waits are a result of blocked patients waiting for beds in overcapacity hospitals.
14:58They add they're trying to find solutions under these challenging circumstances.
15:03New Brunswick's Ministry of Health tells us they're taking steps to improve patient flow and increasing access to primary care to reduce pressure on ERs.
15:15Inside Sunnybrook Hospital, Dr. Hall is trying to prevent patients from leaving before they're seen by increasing overnight coverage using private donor dollars.
15:27Ensuring Sunnybrook will always have at least two doctors working the night shift, something that's not possible in many hospitals across the country.
15:36Typically in the later evening and overnight were some of our longest wait times.
15:40He says the time patients spend waiting before a doctor sees them has gone down by about 30 minutes.
15:47Why is that so important, that metric of initial assessment by a physician?
15:52So when someone's been triaged but they haven't been seen potentially by the physician yet, that is a bit of a grey zone or a black box.
16:01We don't know what's there and some patients might be getting sicker during that time.
16:06So the earlier we can see patients, the better that it is.
16:09Patients like Finley Vanderwerken, who waited more than eight hours at the Oakville Hospital.
16:16Do you think if a doctor set eyes on Finley sooner, the outcome would be different?
16:22Yes.
16:23Yes.
16:24When we see the hospital record, I want to read you a note from the doctor who finally assessed Finley that morning.
16:33Unfortunately, there have been long wait times overnight.
16:36Current wait times are over 10 hours.
16:39He had waited eight hours to be assessed.
16:42What do you think when you hear that note back from the doctor?
16:45Anger.
16:46Anger, frustration.
16:48If this is known, why is it still like that?
16:51There's an acceptance.
16:53There's an acceptance that this is just how it is.
16:58But they refuse to accept it, filing a lawsuit against the hospital and some of its staff.
17:05Halton Healthcare has filed a statement of defense denying negligence.
17:10They tell us they've improved scheduling so there's more doctor coverage during periods of high patient volume and add that in the past eight months, the time it takes for that physician initial assessment at the Oakville location where Finley went has decreased by more than 32%.
17:29But Hazel and GJ are advocating for greater change, including maximum wait times for children in the ER, calling Finley's law and calling on lawmakers to listen, starting with local city councillors urging them to put pressure on the provincial government and council agrees.
17:48This region, this region, this province and country let Finley down, let us all down.
17:55By not paying attention to the data, everything that pointed and screamed that our healthcare was failing.
18:02So I say to you all, the time for action is now.
18:09Do not dismiss me or ignore me.
18:13Ontario's Minister of Health is Sylvia Jones.
18:16And after months of asking, Hazel and GJ get a private meeting with her.
18:22We catch up right after.
18:25Are you satisfied?
18:28I don't think we are satisfied just yet.
18:31I was glad to hear the Minister acknowledge that she's the one responsible for restoring the faith that we lost.
18:42So it's a good step, but more conversations will be needed.
18:54Coming up, we go searching for answers from Ontario's Minister of Health.
18:59Minister Jones, I'm Chris Glover with CBC Marketplace.
19:02That's after the break.
19:04Got a story you think Marketplace should investigate?
19:10Reach out to us at marketplace at cbc.ca.
19:14We're finding wait times in Canadian ERs are climbing, and the consequences are too.
19:29I lost a son, and it didn't need to happen.
19:33For weeks, we ask multiple times for an on-camera interview with Ontario's Health Minister, Sylvia Jones.
19:41We call, email, and text, but her office declines.
19:46Then we learn she's attending a Remembrance Day dinner in her riding, so we approach her outside ahead of the event.
19:53Minister Jones, I'm Chris Glover with CBC Marketplace.
19:56Finley, we've been trying to talk to you, and Finley Vanderwerken's parents tell us that you took responsibility for restoring their faith in the emergency department system in Ontario.
20:09We're just going in.
20:10How are you planning on doing that?
20:11Guys, I'm going into a Remembrance Day service.
20:14We know this is an important day, but we've been trying to talk to you and get to you through your office for weeks.
20:20So contact my staff.
20:21We already did, and what we can tell you is we spent time in emergency departments as well as talking to patients.
20:27I'm going to remember.
20:29We take her lead and follow up with her staff, asking again for an interview, but they never grant one.
20:36Her office sends a statement saying they've made record investments in healthcare in the past three years, including $44 million to tackle emergency department wait times, and they recognize there's more work to be done.
20:51But they still haven't responded directly to our findings, so we're here at the Ontario Legislature to try one more time.
20:58But she doesn't show up to question period.
21:03So we are left without answers.
21:08At the end of our shifts inside Sunnybrook and outside St. Michael's, an update on the patients we met at the start.
21:16After 12 hours in Sunnybrook's ER, John still hasn't moved up into the hospital.
21:22So he wouldn't be getting a bed on the ward probably anytime soon, just based on what I'm seeing.
21:27And after some monitoring, he's offered the choice to stay and wait or go home.
21:33He decides to leave.
21:34Sometimes patients will make the decision and say, actually, I'm going to go home now.
21:38But outside St. Michael's, Anthony doesn't get that choice.
21:42Anthony is still waiting.
21:45He just texted me now.
21:48I am still waiting for surgery.
21:51He's still in the emergency department.
21:5312 hours and counting.
21:55Some continue to wait for care and change.
22:00He was just an amazing kid.
22:02And the world is not a better place for him not being in it.
22:10And it's our job now to use his voice to turn things around.
22:20Both lives and children are part of my own home to town,
22:22they are the most important.
22:24All talent is different.
22:26And all what they feel will get our community,
22:27they are they are the most important.
22:29collective compassion and love which we're very proud for them are 100 people.
22:30To provide your education now to the community,
22:30they're all
22:42to be wished on.
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