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home / 世界杯决赛2022 / how nlhs triages in emergency departments and calculates wait times

how nlhs triages in emergency departments and calculates wait times

nlhs has been posting boards in the emergency departments with how long people will be waiting to be seen, but how do they know that?

by cameron kilfoy, st. john's telegram
published may 14, 2025
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how nlhs triages in emergency departments and calculates wait times
nl health services has been posting this board in there emergency departments in the health sciences centre, st. clares and the janeway to help people make a more informed decision about where they receive healthcare and when they might be seen. supplied
recently, a photo of a board posted in the emergency department at the health sciences centre in st. john’s started making the rounds online.
it caught people’s attention because the board highlighted the wait time to be seen for urgent and less urgent complaints. the board, which was posted on instagram on may 6, showed an eight to 10 hour wait for an urgent complaint and 20 to 22 hours for a less urgent complaint.
the wait times caused plenty of concern on social media, but robert coffin, director of emergency services, critical care, and ambulatory care for nl health services (nlhs) eastern urban zone, said posting the wait in their emergency department isn’t about scaring or deterring people. rather, it’s about allowing them to make an informed decision.
“that’s why we provide a range in times. some people might decide that they’re going to go somewhere else to seek care, or they don’t want to wait that long, and they’ll try another time,” said coffin.
however, coffin said that if people are truly sick and need to be in the emergency department, nlhs wants them to stay.

is the board posted anywhere else?

posting the wait times, coffin said, is something nlhs has been doing since january.

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these boards are also posted at st. clare’s and the janeway in st. john’s. coffin could not comment on whether they are posted in other zones, as he is only in charge of the eastern urban zone.

how is the wait time calculated?

coffin said the time frame for waiting is based on the people who are already waiting. he added that the wait times are updated every four to six hours.
“so, you know the person that’s to go in tentatively next, and you know what’s their current wait time,” said coffin.
coffin said that determining the average wait isn’t an exact science, however, with the potential for new emergencies coming in at any time. it’s meant to give patients an idea of when they might be seen.

what is urgent versus less urgent?

when it comes to what’s deemed urgent and what is less urgent, there’s a scale that’s used, called
the canadian triage and acuity scale (ctas). it’s a national triage tool used across all ers in canada.
coffin said that based on a patient’s symptoms, presenting complaint, and vital signs, they are given a ctas score, which determines urgency. ctas scores go from one to five, with one being the most urgent and five being non-urgent.
what does that mean? coffin provided examples of various complaints and what ctas score they fall under:
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  1. ctas 1 – resuscitation: cardiac or respiratory arrest.
  2. ctas 2 – emergent: chest pain, stroke symptoms, shortness of breath.
  3. ctas 3 – urgent: abdominal pain or headache with moderate pain.
  4. ctas 4 – less urgent: sprains, minor lacerations.
  5. ctas 5 – non-urgent: prescription refill, dressing change.
ctas scores of four and five would be treated in a fast-track area. patients with scores of one through three would be seen in a monitored space with beds and a lower patient-to-nurse ratio.
“your care would be expedited a bit quicker,” said coffin about the monitored space.
coffin added that sometimes someone may arrive as a four and go to a two or even a one. if that happens, staff will reevaluate your condition and change your score to put you in the correct waiting bracket.
however, you cannot go from a one to a five — it can only happen in the reverse, said coffin.

what factors are affecting the wait time?

when it comes to what’s exacerbating the wait times, coffin said that there are several factors, but the main one is the availability of emergency department beds for emergency patients.
a number of these beds are occupied by admitted inpatients who are waiting to move into the inpatient units at hsc, creating a bottleneck.
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“it’s patients in the hospital that could be at an alternate level of care that can’t get out to long-term care or to rehab,” said coffin.
“it could just be the acuity patients that are in the beds, and there’s just not enough discharges, the demand and the capacity don’t match up.”
this article was originally published in the st. john’s telegram on may 14, 2025.

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