Record-high rates of patients leaving without being seen in Lower Mainland hospitals

A historically-high percentage of patients are leaving Metro Vancouver emergency departments without being seen by a doctor, another sign of the crisis gripping British Columbia’s hospital system.

CTV News has obtained statistics from Vancouver Coastal and Fraser Health authorities showing that the rate of patients leaving before treatment is double or triple the typical rate of two to 3.5 per cent, with up to one in 10 patients giving up after excessive wait times in the region’s biggest hospitals.

Officials say that typically, most people who leave after being registered but before being seen by a doctor are usually there for minor issues or feel better, but they are concerned that some who need urgent care are walking away without getting it.

“It's really critical,” said Dr. Eric Grafstein, chief medical information officer for VCH and Regional Emergency Department Head. “I think of myself as an in-patient person and the idea of making people wait is terrible.”

Of acute care facilities under his purview, Lions Gate Hospital saw four per cent of patients leave unseen in May (compared to three per cent in January), with seven per cent at St. Paul’s Hospital (six per cent in January) and 10 per cent at Vancouver General Hospital (nine per cent in January).

In Fraser Health, 11 per cent of Abbotsford Regional Hospital patients left unseen in May (versus nine per cent in January), nine per cent at Langley Memorial (seven per cent in January), six per cent at Royal Columbian (three per cent in January) and seven per cent at Surrey Memorial Hospital (nearly five per cent at the start of the year).

DIFFERENT SOLUTIONS FOR SIMILAR PROBLEMS

Fraser Health’s regional director of emergency medicine pointed out all hospitals across the country are facing soaring wait times amid a staffing crisis magnified by high patient demand.

“It's a national phenomenon where emergency departments are really strained with the demands they're facing right now,” said Dr. Craig Murray. “We're struggling to see patients as quickly as we would like.”

Grafstein confirmed the rates both health authorities are seeing are “historically high” and unprecedented. In VCH, they’ve found more funding to hire more emergency physicians and end a provincial policy limiting the number that can be hired, while Fraser Health is working on recruiting more staff while streamlining the process to get the most urgent patients seen as quickly as possible.

Murray said the “left without being seen” rate is typically known as LWBS, and considered a key indicator of the performance of the emergency department. The urgency of patients and staffing levels impact the wait times and LWBS rate.

“We have staffing variabilities which we smooth out as best we can, but people can choose where they work,” he said.

“I think this is something we can wrestle and bring back to historical levels,” added Grafstein. “Emergency departments are the safety net in healthcare, it’s where people go when they don’t feel like they can go anywhere else.”

CONFIRMATION OF THE HEALTHCARE CRISIS

B.C. has recently seen a spate of letters openly published or leaked by healthcare workers indicating major gaps in staffing and planning that have seen patients facing life-threatening waits for treatment, while waiting in hallways and other makeshift treatment spaces.

Fraser Health recently joined a government website that’s been posting emergency department wait times for Vancouver Coastal Health for years. Officials hope patients first try walk-in clinics or urgent care centres for non-emergency issues, then refer to the wait times site to spread out demand and help cut down on frustration while improving access to medical treatment.

“Our system, while stressed, is still capable of seeing the sickest patients—people who are critically ill, urgently ill are seen in a timely fashion,” said Grafstien. “Anybody who needs care should still come to the emergency department.”