So it seems Ontario ER waits are improving....

[Smallc]

Hmmm...It looks like things are getting better, despite what some here say:

http://www.cbc.ca/canada/ottawa/story/2010/07/29/ontario-er-wait546.html

[Topaz]

Yes, I heard on the 23 hospitals in Ontario will get money for ER and they should, but, lets also remember there's an election coming up and the Libs are in a bad spot!

[Moonlight Graham]

Excellent news.

[Wild Bill]

Well, let's wait and see! We've heard the song before.

I've posted before my experiences with ER waiting rooms here in Hamilton, Ontario. I don't disagree that the case in other parts of Canada may be different but to dismiss my actual direct experience as a "mere anecdote" is ridiculous! It happened and is still happening everyday! Anyone can go and see for themselves!

It all depends on how you measure things. Change the yardsticks and you can easily claim improvements that are imaginary. I wrote of how one hospital put in electronic "numbers" like at a supermarket deli that sped up the time to see a triage nurse only to then put you into yet another waiting room! Your time for an ER visit was not improved but if you measure your improvement by the time from entry to seeing the triage nurse you can make the claim that things are dramatically improved!

More smoke, less mirrors please!

I will agree that things have gotten better when I next pay an ER visit and I see for myself that the process is indeed faster. Being a "tech" personality, one visit will not do it. You can't plot a curve from one point of data. However, if I have 3 such visits and they all show improvement I will be perfectly willing to post the experiences here and admit to them!

[dre]

but to dismiss my actual direct experience as a "mere anecdote" is ridiculous

Actually thats the exact meaning of the word anecdote...

[Wild Bill]

Actually thats the exact meaning of the word anecdote...

So it never happened? NONE of the visits were as I remembered? My wife's experiences were also imaginary?

It seems to me that to brand direct experience as merely anecdotal and dismiss it is a cheap debating trick! It's the equivalent of calling your opponent crazy instead of dealing with his points. Something that I would expect of someone who calls logic a delusion but I had thought better of smallc. Perhaps I was wrong.

Anyhow, here's more fuel for the fire:

http://nationalcitizens.ca/cgi-bin/news.cgi?rm=display&articleID=1225721400

"Tom Closson, president and chief executive officer of the Ontario Hospital Association, which has been gathering the data from its members, found that on any given day in July of this year, 2,800 patients were in acute-care beds waiting to be placed elsewhere. And 694 patients on average were waiting in emergency wards for an acute-care bed.

"They can't get into the inpatient unit," Mr. Closson said. "...It's a clear indication why something needs to be done."

Edited July 29, 2010 by Wild Bill

[Wild Bill]

So it never happened? NONE of the visits were as I remembered? My wife's experiences were also imaginary?

It seems to me that to brand direct experience as merely anecdotal and dismiss it is a cheap debating trick! It's the equivalent of calling your opponent crazy instead of dealing with his points. Something that I would expect of someone who calls logic a delusion but I had thought better of smallc. Perhaps I was wrong.

Anyhow, here's some more fuel for the fire"

http://nationalcitizens.ca/cgi-bin/news.cgi?rm=display&articleID=1225721400

"Tom Closson, president and chief executive officer of the Ontario Hospital Association, which has been gathering the data from its members, found that on any given day in July of this year, 2,800 patients were in acute-care beds waiting to be placed elsewhere. And 694 patients on average were waiting in emergency wards for an acute-care bed.

"They can't get into the inpatient unit," Mr. Closson said. "...It's a clear indication why something needs to be done."

[Smallc]

Well, let's wait and see! We've heard the song before.

I've posted before my experiences with ER waiting rooms here in Hamilton, Ontario. I don't disagree that the case in other parts of Canada may be different but to dismiss my actual direct experience as a "mere anecdote" is ridiculous!

Oh, but not at all. In the face of real evidence, your anecdotes are useless. The measure here it total time in ER, from entry to treatment. The time is down. I don't care about your anecdotes.

Edited July 29, 2010 by Smallc

[Wild Bill]

Oh, but not at all. In the face of real evidence, your anecdotes are useless. The measure here it total time in ER, from entry to treatment. The time is down. I don't care about your anecdotes.

I see. So the 'system' does not actually have to be improved. It's enough to simply say it is and publish some statistics that can be cited in a discussion board as proof.

Now, the people who actually make an ER visit may experience times that are directly contrary to those that have been published! And it doesn't matter! Repeated similar experiences also don't matter!

Okay! I give up! " The State says there are 5 fingers, Winston!" "Yessir! That's what I see!"

[dre]

So it never happened? NONE of the visits were as I remembered? My wife's experiences were also imaginary?

It seems to me that to brand direct experience as merely anecdotal and dismiss it is a cheap debating trick! It's the equivalent of calling your opponent crazy instead of dealing with his points. Something that I would expect of someone who calls logic a delusion but I had thought better of smallc. Perhaps I was wrong.

Anyhow, here's more fuel for the fire:

http://nationalcitizens.ca/cgi-bin/news.cgi?rm=display&articleID=1225721400

"Tom Closson, president and chief executive officer of the Ontario Hospital Association, which has been gathering the data from its members, found that on any given day in July of this year, 2,800 patients were in acute-care beds waiting to be placed elsewhere. And 694 patients on average were waiting in emergency wards for an acute-care bed.

"They can't get into the inpatient unit," Mr. Closson said. "...It's a clear indication why something needs to be done."

So it never happened? NONE of the visits were as I remembered? My wife's experiences were also imaginary?

It seems to me that to brand direct experience as merely anecdotal and dismiss it is a cheap debating trick! It's the equivalent of calling your opponent crazy instead of dealing with his points. Something that I would expect of someone who calls logic a delusion but I had thought better of smallc. Perhaps I was wrong.

Nobody is saying it never happened.

Your evidence is anecdotal and not valuable for judging the system as a whole because you are a 1 person sample of a system that serves 30 million people.

I would expect of someone who calls logic a delusion but I had thought better of smallc. Perhaps I was wrong.

The reason/logic for being wary of anecdotal evidence are actually extremely solid.

[Topaz]

The problem with ER is, people are forced to go there if their doctor's office are closed after hours and on weekend and holidays, so why not have certain doctors open there offices, like they used to?

[Smallc]

I see. So the 'system' does not actually have to be improved. It's enough to simply say it is and publish some statistics that can be cited in a discussion board as proof.

Excuse me but, what exactly are you talking about? The statistics show that the times are shorter. Statistics come from experience....from the experience of many, not just you.

Now, the people who actually make an ER visit may experience times that are directly contrary to those that have been published! And it doesn't matter! Repeated similar experiences also don't matter!

Again, I don't really care about your experiences.

Okay! I give up! " The State says there are 5 fingers, Winston!" "Yessir! That's what I see!"

OK then.

[Wild Bill]

Excuse me but, what exactly are you talking about? The statistics show that the times are shorter. Statistics come from experience....from the experience of many, not just you.

Some stats may indeed come from the experience of many. Perhaps even most! Still, with any political premise I don't think it wise to accept any and all stats as gospel! You have to look carefully at the source of such stats. You have to examine for any bias or hidden agenda.

There is an old axiom in business that also applies to politics. "A consultant is someone you pay to tell you what you want to know!" In politics that would read "A poll is something you commission to back up whatever you were doing anyway!"

That's why I credit personal direct experience! It's too easy to get into "stat wars", hurling stats at each other when the real world experience is plain.

[Michael Hardner]

Sorry - what statistics are we quoting here ?

I have long been posting on this topic and - correct me if I'm wrong - but isn't this the source of the claim that waits are improving:

The hospitals operating under the plan "have been able to demonstrate a reduction in wait times by almost 25 per cent," said Matthews. "So we know it works."

Read more: http://www.cbc.ca/canada/ottawa/story/2010/07/29/ontario-er-wait546.html#ixzz0v7ASZWKT

That is - the Minister at her own PR event saying the system works ? Sorry, but that's worse than Wild Bill's claim. She has a vested interest in quoting some small improvement somewhere, and as I have already well documented the data on Ontario Wait Times and costs is tightly controlled, and even when released hasn't been that good.

McGuinty gets a big FAIL on this topic, and anybody who defends this government on this topic is an unknowing enemy of public health care, in my books, because you would rather defend a poorly managed socialized system against attacks than criticize it to make it better. The real data was the emergency cancer care wait time that was reported earlier this year (sporadically) and shown to be inadequate.

Where were the headlines ?

If you want Socialized medicine, as I do, then criticize it when it doesn't work rather than saying "it's better than the American system". Because if that's your defense, you're guaranteeing that it will only get worse until the American system is better.

[Smallc]

Well, Michael, you have a problem here. We have a statistics from the hospitals showing improvement, and then we have you, and BIll. I'll go with the hospital stats.

[Smallc]

That's why I credit personal direct experience! It's too easy to get into "stat wars", hurling stats at each other when the real world experience is plain.

And that's why you have no place lecturing anyone else about facts. You personally don't ever use them, and you dismiss them out of hand.

[Michael Hardner]

Well, Michael, you have a problem here. We have a statistics from the hospitals showing improvement, and then we have you, and BIll. I'll go with the hospital stats.

As I pointed out - this is management by press release.

Actual performance statistics aren't currently provided in a way that is properly:

1) Accurate, i.e. independent

2) Timely

3) Easy to access

4) Simple

Instead, we have had management of information - which has led to mismanagement of delivery. The citizens of Ontario have happily played along and the McGuinty government has made their political careers in doing this.

Only a few weeks ago we had this:

Globe and Mail

Cancer treatment is supposed to be a major area of improvement in Ontario, but the council reports that “only 53 per cent of urgent cancer cases are completed within the two-week target.”

There was no uproar, and little coverage. A sitting government should be embarrassed to use such tactics as press releases to make claims about service levels and yet this government does it time and time again. I am thoroughly disgusted with them.

Edited July 29, 2010 by Michael Hardner

[Smallc]

ER wait times are reported online. It isn't just the press release. You can watch them go down over time.

[Michael Hardner]

ER wait times are reported online. It isn't just the press release. You can watch them go down over time.

Yes and no.

The ER wait time page has been updated, and improved too.

link

They show an improvement over 2008 as well. All of these things are good.

What is bad is that it's not independently audited. ( Note the suspicious footnote. ) Also there is no trend or data plotted over time.

Nonetheless, this is better than what we had before.

[Shwa]

There was no uproar, and little coverage. A sitting government should be embarrassed to use such tactics as press releases to make claims about service levels and yet this government does it time and time again. I am thoroughly disgusted with them.

Perhaps the government had a closer look at how the Globe (among others) used statistics out of context in order to sell the story and, in turn, sell more news. Is this possible? The Globe could never be accused of "management of information" could they?

Why no uproar about that?

[Sir Bandelot]

So it never happened? NONE of the visits were as I remembered? My wife's experiences were also imaginary?

If it can't be found on Google, it can't be true.

[Sir Bandelot]

Here is my anecdotal experience as a health care worker on the inside, for over twenty years. When there is a problem in the provincial report, as there recently was in cancer care showing that our hospital was among the worst in the province, management has emergency meetings to discuss how to deal with the problem. Dealing with the problem means, in the first case to provide better statistics. In the case of cancer care, it means re-interpreting the meaning of the statistics by, for example, identifying a population of patients who do not qualify for the statistics and thus they can be dropped off of it, not included and so this improves the "report card". Things look better now, with no actual changes to the way health care was delivered.

Edited July 30, 2010 by Sir Bandelot

[Wild Bill]

Here is my anecdotal experience as a health care worker on the inside, for over twenty years. When there is a problem in the provincial report, as there recently was in cancer care showing that our hospital was among the worst in the province, management has emergency meetings to discuss how to deal with the problem. Dealing with the problem means, in the first case to provide better statistics. In the case of cancer care, it means re-interpreting the meaning of the statistics by, for example, identifying a population of patients who do not qualify for the statistics and thus they can be dropped off of it, not included and so this improves the "report card". Things look better now, with no actual changes to the way health care was delivered.

Sorry, Sir Knight! Despite the fact that you work intimately in the field of the debate, have 20 years of direct personal experience and have been told first hand by the management involved as to how they actually deal with the problem, you have no credibility!

Your experience is merely anecdotal. You gave us no cite for each and every one of your personal experiences. A quick google failed to turn up anything to confirm what you've told us.

As Bullwinkle J. Moose would say "It's just a figamentation of your imagination!"

[Smallc]

But that's just it. What he said is meaningless. It doesn't apply here, first of all, and second off all, we have no method of verification, and so I take it with as much truth as you telling me you're an 18 year old belly dancer.

[Wild Bill]

But that's just it. What he said is meaningless. It doesn't apply here, first of all, and second off all, we have no method of verification, and so I take it with as much truth as you telling me you're an 18 year old belly dancer.

To be fair, that's true enough. You need adequate reason or evidence to change your opinion and I guess I can understand that.

However, the reverse is also true. When you make a claim that contradicts someone's direct personal experience there is no way you are going to get them to change their mind! All the cites in the world will not get someone to throw away direct experience. As Galileo once said "Nevertheless, it moves!"

When I speak of my own personal history and experiences or Sir Bandelot mentions hospital management techniques that he directly witnessed it is usually impossible to provide cites or sources. Certainly no manager of any hospital would want Sir B's experience aired publicly!

Neither of us then can ever agree. Sir B and I have the evidence of our own eyes and ears. You have your cites. You do seem to take them all as gospel, unquestioningly. If they comfort you, you are welcome to them.