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

[Smallc]

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!

On that we most certainly agree. I'm not saying that all ER waits are down (and neither is the news story, for that matter). What I was saying (and I should have made this clearer) is that the targeted program is working where it has been implemented, as best I can tell given the available statistics. That program is being expanded (maybe to an ER near you) and it should make things better as it apparently has in the places where it's already been implemented.

[Smallc]

All of that said, you can't argue that progress has been made with these types of province wide numbers:

http://www.thestar.com/article/842192--ontario-invests-100-million-to-drive-er-waits-down

A couple more years, and Ontario should meed both of it's targets. It has already basically met one.

[Wild Bill]

All of that said, you can't argue that progress has been made with these types of province wide numbers:

http://www.thestar.com/article/842192--ontario-invests-100-million-to-drive-er-waits-down

A couple more years, and Ontario should meed both of it's targets. It has already basically met one.

Actually, yes I can still argue! You are assuming that I must accept your cite as gospel. I don't!

It is all predicated on a press release! A health minister issues a press release through its Liberal Party media arm, the Toronto Star. It touts how the ER wait time at one specific hospital has been cut from 26 hours to 10 hours. There is no mention of who measured this decrease or what are the criteria involved. Far down the page it mentions how the average has dropped over the last 2 years from 10.3 to 4.3 hours. Again, there is no mention of any report that the public can examine. Besides, this is an average! How are we to know if there are some hospitals that have INCREASED wait times? An average is precisely that, an average, after all. Highs and lows become an average.

This is what Michael meant when he talked about the confusion between stats and just press releases. Your cite is nothing more than a press release. Apparently you expect me to treat it as gospel and stop arguing. If you believe that a press release is gospel then I am going to stop arguing but not because I concede the point. I just believe that there's no point in further arguing!

[Smallc]

Well of course and average is an average. An average that is going down in this case is a good thing, even if there may be a few hospitals where the time has gone up.

Edited July 30, 2010 by Smallc

[Michael Hardner]

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?

Ahem... using statistics out of context ?

For a newspaper to quote a single statistic as an example of something that is wrong is not out of context. We have a reasonable right that service levels improve across the board.

I would argue that for a sitting government to self report a single good statistic is out of context.

The standards are not the same - the newspaper is supposed to criticize, and if the government is self-reporting (they should not be) then they have to report ALL statistics...

[Michael Hardner]

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.

Bingo. Thank you, Sir B.

The only solution to such a malady is independent arms-length reporting, period.

[dre]

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!

Unless they have an elementary grasp of reason, logic, or information analysis. If they do, then theyll realize that its possible that their experience is an anomaly, and theyll want to see a more inclusive body of data before they make any sort of final judgement.

[Michael Hardner]

Well of course and average is an average. An average that is going down in this case is a good thing, even if there may be a few hospitals where the time has gone up.

I do recognize that we need to credit service improvements, but given the tenuous nature of improvements, and more to the point of public awareness - we all need to promote discussion, evaluation and criticism of Health Care performance statistics.

You have done your part here by pointing me to the latest graphs, so thanks for that.

I admonish everybody to bring this up with real-world, i.e. non-forum, people. We all need to talk about the fact that the system isn't adequately paid attention to and discussed, IMO.

[Wild Bill]

Unless they have an elementary grasp of reason, logic, or information analysis. If they do, then theyll realize that its possible that their experience is an anomaly, and theyll want to see a more inclusive body of data before they make any sort of final judgement.

Or, as a tech would say, you can't plot a curve with only one data point! However, most life experience is experiences repeated over a long time span. Yes, it should always be questioned but sometimes it's enough that it makes sense.

For instance, suppose you went to a card game that had been held for years at a neighbourhood home. They play poker and you have had innumerable reports that the games were strictly legit. You would think that you could accept all those reports as a large body of data and participate in the games without fear of any cheating.

However, as a game progresses you begin to notice that there is INDEED cheating going on! You don't make a scene but a week later you have to make a decision. Do you consider the incident to be an anomaly in the face of all those reports? Or do you decide not to play there any more?

Suppose you have had repeated dealings with a government bureaucracy and every time it has been a frustrating experience with rude employees hiding behind illogical rules. Some government department cites a press release touting how the measured index for pleasant government dealings with citizens is 98%! Are you going to automatically believe it?

When I follow my life experience it is not for having only one data point! I'll forgive anybody for making a mistake! It's how they handle it that truly reveals their character. What's more, I am certainly NOT going to blindly accept a cite to a press release of hospitals measuring THEMSELVES and providing positive stats contrary to repeated personal experience!

[charter.rights]

Or, as a tech would say, you can't plot a curve with only one data point! However, most life experience is experiences repeated over a long time span. Yes, it should always be questioned but sometimes it's enough that it makes sense.

For instance, suppose you went to a card game that had been held for years at a neighbourhood home. They play poker and you have had innumerable reports that the games were strictly legit. You would think that you could accept all those reports as a large body of data and participate in the games without fear of any cheating.

However, as a game progresses you begin to notice that there is INDEED cheating going on! You don't make a scene but a week later you have to make a decision. Do you consider the incident to be an anomaly in the face of all those reports? Or do you decide not to play there any more?

Suppose you have had repeated dealings with a government bureaucracy and every time it has been a frustrating experience with rude employees hiding behind illogical rules. Some government department cites a press release touting how the measured index for pleasant government dealings with citizens is 98%! Are you going to automatically believe it?

When I follow my life experience it is not for having only one data point! I'll forgive anybody for making a mistake! It's how they handle it that truly reveals their character. What's more, I am certainly NOT going to blindly accept a cite to a press release of hospitals measuring THEMSELVES and providing positive stats contrary to repeated personal experience!

Bill...ffs....

Your personal experience is not the experience of others collectively. And while you might have had one or two bad experiences it may likely be influenced by your apparent poor attitude towards the medical profession.

In terms of deciding if there has been sufficient improvement in the emergency department government will look at your experience (if you are polled) and weigh it out against tens of thousands more to see if all results are the same. Obviously your experience is not the general trend, and therefore in isolation it has no relevance to this subject matter.

If you don't get that, then you might want to go to a hospital and check in....

[capricorn]

What's more, I am certainly NOT going to blindly accept a cite to a press release of hospitals measuring THEMSELVES and providing positive stats contrary to repeated personal experience!

Speaking of statistics and wait times, here's an article that may interest you Wild Bill.

Ottawa Hospital's sickest waiting longer

Delays continue despite funding to fix ER problem; officials blame rise in visits

http://www.ottawacitizen.com/health/Ottawa+Hospital+sickest+waiting+longer/3339311/story.html

[Wild Bill]

Speaking of statistics and wait times, here's an article that may interest you Wild Bill.

http://www.ottawacitizen.com/health/Ottawa+Hospital+sickest+waiting+longer/3339311/story.html

Ah so! I particularly got a kick out of "officials blame rise in visits"! They're saying the problem with their ER wait times is that people visit the ER!

Logic worthy of CR!

Anyhow, we've drifted far from the real question. Is it a problem of money or of management? The report you cited for the Ottawa hospital says that they've done poorly despite being given an increase in money.

My experience with my local hospital is that their management is loopy! When you have minimum times of 8 hours for an ER visit it does not make sense to put in parking meters that have a maximum of 1 hour's time! Or when people complain to address the problem by putting bill changing machines on the wall!

In my work career I found that old companies like GE or Westinghouse operated in a similar fashion to these public sector institutions. Being a salesman for high tech electronic parts gave me the opportunity to visit literally hundreds of businesses and get to see how they operated. Over the years I noticed many old names go under or drastically reduce in size, for not being able to change with the times. Public sector accounts still persist in their "horse and buggy" attitudes because they have nothing to force them to change! They are funded on perpetual tax money. I've come to believe that if your institution is not subject to market forces it may be impossible for you to stay modernized and even half-way efficient.

Interestingly, some of the private companies that were very badly run were run by engineers! Some brilliant engineer would come up with a great new product and form a company. Invariably, the only department that worked well would be engineering. Accounting, shipping, purchasing or whatever was always badly screwed up. Why? Because managing a company is a completely different skill set than being an good engineer. Yet that brilliant engineer always seemed to have a blind spot about that and believed that he could manage things just fine himself. I learned very quickly with such accounts to keep a close eye on their account balance and their credit rating.

I suspect there may be a parallel with how hospitals are run. Sir Bandalot may be able to tell us from his experience if hospitals are run by the best doctors or the best managers. Like with engineers, they are rarely the same person.

Throwing more money at hospitals may be a waste of funds to solve problems like ER waiting times. I would suggest perhaps a management structure revue might work better but still, hospitals are in the public sector so that may be a also just a waste of time. Maybe there just isn't any solution with a government-run medicare system! Maybe it will just continue to swallow ever increasing amounts of money until we all go broke!

Edited July 30, 2010 by Wild Bill

[Smallc]

Hospitals are not in the public sector. They are private, not for profit institutions.

[Argus]

Well of course and average is an average. An average that is going down in this case is a good thing, even if there may be a few hospitals where the time has gone up.

I went to the hospital a while back after hurting my back. It was at about 3am, and when the nurse told me it'd be at least six hours before anyone saw me - sitting up, which I couldn't do - I went home.

Presto! ER time down!

[Argus]

Unless they have an elementary grasp of reason, logic, or information analysis. If they do, then theyll realize that its possible that their experience is an anomaly, and theyll want to see a more inclusive body of data before they make any sort of final judgement.

None of us live in a vacuum. We all have friends and family, and all of them relate when they have to go to an ER and I've never heard anyone say they went to ER and didn't experience an interminable long wait.

[Guest TrueMetis]

None of us live in a vacuum. We all have friends and family, and all of them relate when they have to go to an ER and I've never heard anyone say they went to ER and didn't experience an interminable long wait.

Really it seems like everyone I know who has been to the ER only waited a short time. The longest I've ever waited was all of 30 minutes and I wasn't even that hurt.

[Argus]

Really it seems like everyone I know who has been to the ER only waited a short time. The longest I've ever waited was all of 30 minutes and I wasn't even that hurt.

You live on a different planet from the rest of us.

[Smallc]

Yes, you see TrueMetis, your anecdotes don't count. Only ones that paint the system in a bad light and disagree with the official figures provided are acceptable.

[capricorn]

The longest I've ever waited was all of 30 minutes and I wasn't even that hurt.

You weren't that hurt? If you knew you "weren't that hurt" and you still made your way to the emergency ward, you sir, are part of the problem. Did you check for a walk in clinic in your community that could have looked after your self proclaimed minor health problem? Next time, I suggest you do so and help rid our emergency wards of cases that are not emergencies.

[Guest TrueMetis]

You weren't that hurt? If you knew you "weren't that hurt" and you still made your way to the emergency ward, you sir, are part of the problem. Did you check for a walk in clinic in your community that could have looked after your self proclaimed minor health problem? Next time, I suggest you do so and help rid our emergency wards of cases that are not emergencies.

I was 12 and my mom made my. What do you want? Broken toe is one of the weirdest things ever.

[capricorn]

Hey, man. That's ancient history. Why would you even bring that up? I just hope you and your friends use common sense where the proper use of public services is concerned.

[Guest TrueMetis]

Hey, man. That's ancient history. Why would you even bring that up? I just hope you and your friends use common sense where the proper use of public services is concerned.

That's the most recent time I've ever been to the ER. If I had a more recent story I'd bring it up. My point was just to counter their anecdotes with one of my own.

[charter.rights]

None of us live in a vacuum. We all have friends and family, and all of them relate when they have to go to an ER and I've never heard anyone say they went to ER and didn't experience an interminable long wait.

I have been to the ER of a couple of major hospitals and had to wait very little. Of course I wasn't in there for a hang-nail, and if I was it is likely they would make me wait 8 hours or more.....

But for serious ailments I was through triage within about 10 minutes in a bed by 20 minutes, and saw the doctor within 30 minutes. I believe that is pretty normal for people who go in for serious issues.

[Smallc]

I've never had to wait more than an hour at an ER, and never more than 2 hours at a walk in clinic.

[Argus]

Yes, you see TrueMetis, your anecdotes don't count. Only ones that paint the system in a bad light and disagree with the official figures provided are acceptable.

I knew his anecdote was nonsense. And he's just confirmed it was ages ago. Even the government's own figures, which are undoubtedly massaged to give them the best possible message, say that at best, average wait times are in the 4-6hr range - AT BEST. And yet he says 30 minutes is the most he's ever waited.