Avoidable deaths in emergency rooms: Quebec chief physicians are sounding the alarm

During a press meeting at the end of last April, the Assistant Deputy Minister of Health, Lucie Opatrny, said that she was hopeful that health establishments would be able to grant summer vacation to hospital staff.

Obviously, we also have to balance that with the desire we have to enhance activities to catch up in all the different sectors where there is some catching up to do., she said. One thinks, for example, of waiting lists for surgery.

But, while the summer holidays are just beginning, the medical chiefs responsible for emergency services in Quebec hospitals are expressing their concerns about not being able to provide safe services for the summer period.

We cannot remain silent in the face of the fulminant deterioration of the services provided in our emergencies and the pressure our teams are facing.writes the representative of the Regroupement des chefs d’urgence du Québec (RCUQ), doctor Marie-Maud Couture.


In a letter obtained by Radio-Canada and sent in recent days to CEO health establishments in Quebec, all of Quebec’s emergency medical chiefs draw up a series of findings and suggestions.

According to them, it has become a daily occurrence that more than 50% of emergency room stretchers are occupied by hospitalized patients waiting for a bed upstairs [et que] these patients stay more than 24 to 48 hours in the emergency room, due to hospital congestion.

According to available data compiled by Radio-Canada, the percentage of patients on stretchers who stay more than 24 hours in the emergency room has gone from around 17% when the Coalition avenir Québec (CAQ) came to power in 2018 to nearly 22% last year.

Since the beginning of the holidays in the health sector, a week ago, this rate has fluctuated between 24% and 32%.

More than a million patients end up on a stretcher in the emergency room each year. Many will require hospitalization.

In the opinion of emergency managers, increased admission delays between emergency departments and care units are associated with a greater risk of mortality and complications for patients.

Several potentially preventable deaths have been reported by emergency managers in recent months due to lack of access to a stretcher and the care required by the condition. »

A quote from Marie-Maud Couture, representative of the Regroupement des chefs d’urgence du Québec

A doctor from the Montreal region who wants his identity to be concealed agrees. The fact that elderly patients remain in the emergency room for lack of beds elsewhere is clearly accelerating mortality and morbidityhe says.

According to the representative of RCUQdoctor Marie-Maud Couture, our emergencies are being forced to abandon their mission to become hospital overflow units. Patients on stretchers push back into the spaces provided for outpatients. The lack of capacity created by this congestion even goes so far as to delay the management and evaluation of new patients..

Insufficient support

In their missive, the chief medical officers believe that the management of non-emergency cases by their family physician colleagues is insufficient.

The burden of redirecting non-emergency clients to the front line weighs heavily on our teams; […] the first line is not able to respond to this requestthey advise.

These consider unacceptable that the management authorizes the closure of short-term beds for the summer period and that they do not [se] do not feel responsible for the population’s inequity in access to emergency services.

It is imperative that the general management are also accountable for this quality and safety of care now compromised.they add.

Called to react, the president of the Union of Nurses, Respiratory Therapists and Auxiliary Nurses of Laval (SIIIAL-CSQ), Déreck Cyr, recalls that its members have been living for months situations of exhaustion in the emergency room of the Cité de la Santé, frequent OSI (compulsory overtime) and work stoppages.

According to him, one of the solutions is to remove from the responsibility of emergency personnel the 15 overflow beds which have been added to the 49 stretchers on the emergency room permit.

5 measures required by the heads of emergencies

We demand that any establishment whose emergency presents recurrent congestion of its stretchers by patients waiting for a bed or by patients for more than 24 hours be forced to take the following measures, measures which will also be submitted to the Minister of Health :

1. Deployment of floor overcapacity protocols directly proportional to ED occupancy rates and based on the number of licensed beds.

2. An occupancy rate of 150% should necessarily be associated with an occupancy rate of 150% on the care units.

3. Notification to the ministerial team as soon as 24 hours have been reached for a patient in the emergency room, with an explanation of the delays associated with the patient’s stay in the emergency room, as well as the direction attributable to the delays.

4. The use of day surgery units, recovery rooms and outpatient clinics to accommodate any patient in a situation of overflow and waiting for a bed upstairs when there is congestion in the emergency room.

5. The use of overcapacity in residential units and rehabilitation settings for NSA (alternate level of care) type clients. The awareness of the hospital users’ committee to the reality of emergencies and the involvement of these members in the hospital fluidity committees.

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Avoidable deaths in emergency rooms: Quebec chief physicians are sounding the alarm

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