The times that patients wait for emergency-room care needs to be capped and limited, says a new report by the Wait Time Alliance.

The WTA, a coalition of medical specialists working under the umbrella of the Canadian Medical Association, says patients should not have to wait more than 30 minutes for a medium emergency, such as a moderate asthma attack.

They should also not have to wait more than two hours for a low-level emergency such as treatment for a sprained ankle. And, of course, patients should get immediate attention for a high-level emergency, such as a heart attack.

The Alliance notes that these wait-time benchmarks should be viewed as "maximum acceptable" wait times -- not "ideal" wait times.

"For many Canadians, emergency departments continue to be a major point of access to the health-care system, with approximately 10 million visits annually,'' says the study.

"Emergency departments are frequently viewed as highly visible indicators of the state of Canada's health system.''

The other new areas for which the coalition has set new benchmarks are:

  • psychiatric care
  • gastroenterology
  • plastic surgery (for non-cosmetic reasons, such as burns and trauma)
  • anesthesiology

"These five new areas represent medical specialities in which thousands of Canadians require treatment every day," said WTA co-chair and President of the Canadian Association of Nuclear Medicine, Dr. Jean-Luc Urbain.

"Those patients now have more information about how long they are waiting, and most importantly, whether the system is forcing them to wait longer than the medical consensus says they should."

In December 2005, the WTA released its first set of wait-time benchmarks for five priority areas (diagnostic imaging, hip and knee replacement, radiation oncology, cataract surgery and cardiac care).

Then, in an April 2007 report, the Alliance noted that some progress had been made in reducing wait times. And, even in areas where reductions had not yet occurred, such as MRI scans and other diagnostic imaging tests, it said steps were being taken toward improvement.

It was because of that success that the Alliance decided to propose that the benchmarks be expanded to new areas.

Yet, it said much more work still needed to be done and progress on reducing wait times should not be limited to the priority areas they had earmarked.

The alliance says part of the problem in addressing wait times is there is an "alarming lack of standardized data" for monitoring progress. It says wait-time data are captured and reported differently across the country.

"The lack of comparable data makes monitoring and cross-jurisdiction comparisons extremely difficult and leaves patients and governments largely in the dark as to what progress is being made," the report says.

Call for multi-year targets

Of critical concern to the alliance now is whether governments will meet their self-imposed deadline of Dec. 31, 2007 to announce multi-year targets for meeting wait-time benchmarks in the initial five clinical priority areas.

Under a federal-provincial deal signed in 2004, governments agreed to aim at "significant'' wait-time reductions over a 10-year period.

"The WTA continues to do its part on behalf of patients, we expect our political leaders to do nothing less than the same," said WTA co-chair Dr. Lorne Bellan, the president of the Canadian Ophthalmological Society.

In order to meet those wait-time reduction targets, there needs to be more staffing, the Alliance concludes. They say there remain significant health workforce shortages that undercut efforts to treat patients quickly.

Dr. Mary-Lynn Watson, president of the Canadian Association of Emergency Physicans, adds that the shortages of hospital beds is the reason behind ER backups.

The Alliance says its next goal is a review of the 10-year plan that began in 2004. The federal legislation that was passed calling for funding commitments for the plan stated that there would be parliamentary reviews in 2008 and 2011 to assess progress.

"The WTA will be an active participant in the spring 2008 review and will release another report card on progress toward improving access to timely care for Canadians," the report says.