Sante Quebec reports slight improvement in ERs

The overall situation in Quebec's emergency departments is improving, but only modestly, according to Santé Québec.

Data released Friday showed that the occupancy rate in emergency departments had fallen from 113 per cent last year to 106 per cent this year for the period from Dec. 28 to Jan. 8, despite the number of emergency room visits remaining stable. However, it remains at 145 per cent in the Montreal region.

The second indicator closely monitored by Santé Québec, average length of stay, fell by 1.3 hours per patient compared with last year, but remains at 17.9 hours.

Uneven performance

The situation varies from one hospital to another. Of the 55 large hospitals with 100 beds or more, nearly two-thirds (63 per cent) of them (35) saw an improvement in both indicators, 13 (24 per cent) saw an improvement in one of the two indicators, while seven (13 per cent) saw a deterioration in both indicators.

Four of the latter are located in the Greater Montreal area: the Montreal General Hospital, the Maisonneuve-Rosemont Hospital, the Santa-Cabrini Hospital and the Cité de la santé de Laval. The other three are Hôpital du Centre de la Mauricie, Hôtel-Dieu de Lévis and Hôpital régional de Saint-Jérôme.

Frédéric Abergel, executive vice-president of operations and transformation at Santé Québec, attributes much of the improvements to the fact that, for the first time, preparations for the winter peak began in July.

According to him, the network and its emergency departments have moved from crisis mode to one of “continuous improvement.” Abergel also highlighted the autonomy of hospital centres as they are working to implement measures specific to them and adapted to their reality, on top of the solutions put forward by Santé Québec.

Still too many unnecessary visits

One of the problems remains unnecessary visits to emergency departments. Nearly half (44.5 per cent) of all emergency visits are made by patients whose needs are not urgent and could be treated through first line care. Yet first line care appointment offers increased by 23 per cent, thanks in particular to additional efforts by family doctors.

Santé Québec said it wants to remind people there are other options besides the emergency room: 811 Info-Santé or Info-Social, the Guichet d'accès à la première ligne (GAP), pharmacists and family doctors.

Véronique Wilson, Assistant Director General at Santé Québec, acknowledged, however, that despite this increase in supply, it is not always easy to see a family doctor.

Sceptical union reaction

Faced with this picture, the Fédération interprofessionnelle de la santé du Québec (FIQ) is still talking about a "critical situation" and says that these data illustrate "a constant overload in many regions."

In a news release published late on Friday afternoon, the FIQ said that "the current context of austerity does not allow us to put enough care professionals in place to meet the increased needs in emergency departments, which are nevertheless foreseeable during the winter." It also condemns "contingency plans, which include job cuts, limits on overtime and reductions in service hours."

The union points out that the reasons for the overcrowding have long been known: "The lack of staff on the floors, cuts in operating theatre hours, as well as the shortage of post-operative services and alternatives such as CHSLDs, create a bottleneck in the patient pathway, which can have the effect of keeping patients on stretchers in emergency departments."

This report by The Canadian Press was first published in French Jan. 10, 2025.