What a new report reveals about the true cause of Canada’s massive emergency wait times

A hospital emergency room entrance is shown. (Pixabay / Pexels.com)

CALGARY – A new report suggests the causes of Canada’s long emergency department wait times often lie far beyond the emergency room itself, with shortages in hospital beds, long-term care and community supports creating a bottleneck that is leaving some patients waiting days for care.

“This is a national problem. Every province is struggling with this,” said Dr. Paul Parks, president-elect of the Alberta Medical Association and an emergency physician.

The report, released Thursday by the Canadian Institute for Health Information, found that one in 10 emergency department patients — about 1.5 million people — spent more than 14 hours in the emergency room in 2024-25.

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Patients requiring admission to hospital faced the longest waits. One in 10 admitted patients, which equates to around 180,000 people, spent more than 48 hours in the emergency department waiting for an inpatient bed.

“It has been a struggle for a long time, but it’s gradually getting worse and worse, and this absolutely reflects what we’re seeing,” Parks said.

“We’ve been calling a state of emergency and state of crisis, and saying our emergency departments are no longer functioning the way they should.”

‘Why did we wait so long?’

For Brenda Trottier, the long waits became personal.

On May 22, her 33-year-old daughter, Odessa, went to the Rockyview General Hospital emergency department in Calgary with abdominal pain after first calling Health Link. Trottier said a nurse advised them to seek emergency care if the pain didn’t improve.

They arrived at about 2 p.m. and did not leave until after midnight. Odessa was eventually prescribed antibiotics for an infection.

“It was frustrating. They were very laissez-faire about it,” Trottier said. “Why wasn’t the urine test done? Why wasn’t her pain addressed? Why did we wait so long?”

Trottier said lengthy waits have become normalized.

“People are basically camped out because they know they’re going to be there for X number of hours,” she said.

“When you’re in a situation where you are in pain, or you’re bleeding, or you’re having breathing problems or even a heart attack, you have no other recourse or no other place to go that’s accessible.”

Despite her frustration, Trottier said she does not blame front-line staff.

“There’s some amazing doctors and nurses out there. But a lot of them throw up their hands. ‘What are we supposed to do? We have to work within these constraints,’” she said.

‘Very sick’ patients cause overcrowding: doctor

The report says limited acute care capacity, combined with challenges accessing home care and long-term care, is slowing patient flow through hospitals and contributing to overcrowded emergency departments.

As admitted patients remain in emergency rooms awaiting beds, they continue to require care and occupy space, putting additional strain on staffing and limiting the ability of emergency departments to assess and treat newly arriving patients.

Parks said overcrowding is not being driven by patients with minor ailments seeking care in emergency rooms instead of from a family doctor.

“This emergency department overcrowding has nothing to do with inappropriate use of the emergency department, or patients with minor conditions that could be seen by their family physicians,” he said.

According to Parks, the overcrowding is due to “very sick, dying patients, patients with surgical conditions, strokes, cancers that can’t get admitted into the hospital and can’t move into the hospital.”

The report found emergency departments are also caring for increasingly complex patients.

In 2024-25, about 66 per cent of emergency department visits were classified as high acuity, meaning patients required immediate or urgent medical attention. That represents an increase of seven percentage points since 2018-19, or about 1.7 million additional visits.

Meanwhile, nearly one-third of visits involved patients with multiple medical conditions, requiring more complex assessments, testing and care co-ordination.

As for length of stay, the data shows that while most patients admitted to acute care through emergency departments were discharged within a median of four days, about 114,000 patients remained in hospital much longer because they required additional support and were designated as alternate-level-of-care patients.

Among those waiting for placement in long-term care, half waited up to 44 days in hospital.

Parks said those delays create a domino effect throughout the health-care system.

“Many of our rooms in our hospitals, where they were designed for two people, they have four people,” he said. “We have rooms where people are placed where they don’t even actually have access to a bathroom.

“We’ve used every space we can and there’s still no space,” he added. “And that’s why it’s all backing up.”

Government neglect part of problem: doctor

Parks added that the pressures facing emergency departments did not develop overnight.

“Our government has been neglecting some of the capacity and workforce building, but then they’re adding privatized models to our care,” he said.

“The privatized model just makes everything in the emergent hospital system infinitely worse, because they’re just taking off our health-care resources into private community clinics."

Emergency physicians warn that overcrowding can have serious consequences for patients.

The Canadian Association of Emergency Physicians highlighted that every additional four hours a patient spends boarded in an emergency department while waiting for an inpatient bed, is associated with an 8.4 per cent increase in the risk of death within 30 days.

The association also said older adults who remain overnight in emergency departments while awaiting admission face a 39 per cent increase in in-hospital mortality.

The consequences of overcrowded emergency departments have at times been tragic in Alberta.

In December, 44-year-old Prashant Sreekumar went to the Grey Nuns Community Hospital in Edmonton with severe chest pain. The father of three died from a suspected cardiac arrest after waiting nearly eight hours to see a doctor.

More recently, 33-year-old Travis Smith died while waiting for medical care in the emergency department waiting area at Edmonton’s Royal Alexandra Hospital on May 8.

The Alberta government said emergency department pressures are being felt across the country and that the province is experiencing similar challenges.

“Significant population growth, rising demand and increasing patient complexity are all contributing to longer stays system-wide, with average acuity rising alongside volumes, meaning patients are sicker on average and require more time to treat,” said Maddison McKee, spokesperson for Alberta’s Hospital and Surgical Health Services.

She said the province is making investments across the continuum of care, including urgent-care centres, new inpatient beds, virtual-care options and continuing care spaces, while Acute Care Alberta works to improve patient flow and ensure patients receive the right care in the right setting.

McKee added that Alberta’s physician workforce is at a record high of 13,848 doctors, including more than 6,700 family physicians, and that approximately 90 per cent of Albertans have access to a primary care provider.

Parks said solving emergency department overcrowding will require more than changes inside emergency rooms.

“I think the feds have to get involved now and actually start to say, ‘Hey, we need to look at this as a national solution,’ and really be creative around what we do with our workforce and what we do with investing in long-term care and continuing care,” he said.

Trottier said she hopes governments across the country find ways to improve the system.

“I’ve seen the destruction of it in my lifetime,” she said. “I would like to see it get better.”