How does Ontario's 3-hour ER wait time stack up to the rest of the country?

Ontario has made great strides in reducing emergency department wait times, making the country’s most populous province the best performer when it comes to ER visits.

Over the past seven years, the wait time for nine out of 10 Ontario patients to see an ER doctor dropped from 3.6 hours to three in 2014-2015.

Nine out of 10 patients who had to be admitted to hospital waited 7.8 hours, down from 8.7 seven years ago, says a report from Health Quality Ontario, a provincial body that monitors health care quality.

That’s despite the fact that the volume of patients at ERs has increased, along with how sick they are when they come through the doors, says Dr. Joshua Tepper, president of Health Quality Ontario.

“I think a lot of people would say even just being able to have held the same wait times in the face of steadily increasing volumes would have been a success but, in fact, the times have gone down,” Tepper told Yahoo Canada News.

That said, the wait times remain high for patients to be admitted to a hospital bed, he says.

The decrease makes Ontario among the best performing provinces across the country.

A report by the Canadian Institute for Health Information for 2014-2015 found Ontario’s patients waited 3.1 hours to be seen by a doctor and discharged. Alberta and B.C. had the same wait times.

Of the provinces that provided data, only Prince Edward Island had a shorter time, at 2.6 hours. In Nova Scotia the wait was 3.5 hours, in Saskatchewan 3.9, and in Manitoba 5 hours.

The institute will release updated figures at the end of the month.

“I think we’re doing quite well,” Tepper said.

His advice to other provinces seeking to cut ER wait times is that it takes a number of changes throughout the health-care system.

“You need to look outside of the hospital,” he said, likening emergency departments to the canaries in a coal mine.

“Emergency departments are a focal point of the health care system. When the numbers around the emergency department don’t look good, you have to look outside of the emergency department to see what’s happening in community care or home care, what’s happening in primary care, what’s happening in long-term care, what’s happening in the rest of the hospital.”

These drive traffic in the ER, Tepper says.

A report last year by the Fraser Institute said waiting in hospitals cost the Canadian economy $1.1 billion in lost workplace productivity in 2013. Many provinces have pledged to address the problem.

In Ontario, there was a comprehensive effort to tackle wait times, including a major investment from the provincial government.

The province increased the number of health care providers, especially physicians. It began to routinely “and vigorously” track and report health-care data.

Emergency departments re-organized their approach to lab and imaging tests, how they triaged patients and how they organized the flow.

There has also been a substantial investment from the province, including in infrastructure, training and diagnostic capacity, Tepper says.

And primary care was strengthened so that patients were able to see their family doctors or nurse practitioners in a timely way, meaning ERs were seeing fewer less sick patients.

“A lot more Ontarians have family doctors than they used to have, and a lot of family doctors are increasingly turning to models where they’re offering after-hours and weekend care,” Tepper said.

“There’s still lots of room for improvement but I think there have been a combination of efforts that have been helpful.”