Complete guide to Canadian hospital emergency departments — CTAS triage levels, wait times, access block, provincial ED targets, ED efficiency strategies, virtual ED, and ED software.
CTAS is the national triage system with 5 levels. Access block affects 20-30% of admitted ED patients. CIHI reports national ED data. This guide covers Canadian ED management.
CTAS Triage Levels
| Level | Acuity | Target Time | Examples |
|---|---|---|---|
| 1 | Resuscitation | Immediate | Cardiac arrest, major trauma |
| 2 | Emergent | 15 min | Chest pain, severe SOB, stroke |
| 3 | Urgent | 30 min | Abdominal pain, fracture, fever |
| 4 | Less urgent | 60 min | Minor injury, sore throat |
| 5 | Non-urgent | 120 min | Minor rash, prescription refill |
ED Efficiency Strategies
- Fast track: Separate fast-track for CTAS 4-5 patients
- Physician at triage: Physician at triage for early assessment
- Advanced triage: Nurse-initiated tests at triage (labs, ECG, X-ray)
- Discharge by noon: Discharge inpatients by noon to free ED beds
- ALC management: ALC placement team for patients awaiting long-term care
- Virtual ED: Virtual ED for low-acuity patients (video triage)
- Predictive analytics: Predict ED demand and staff accordingly
- ED observation unit: Observation unit for short-stay patients
ED KPIs
| KPI | Target | Canadian Average |
|---|---|---|
| CTAS 1-3 within target | > 90% | 75-85% |
| CTAS 4 within target | > 80% | 60-70% |
| CTAS 5 within target | > 80% | 50-60% |
| LWBS rate | < 3% | 3-5% |
| Door-to-doctor time | < 30 min | 30-60 min |
| ED LOS (discharged) | < 4 hours | 4-6 hours |
| ED LOS (admitted) | < 8 hours | 10-20 hours |
| Access block (> 8h for bed) | < 10% | 20-30% |
Frequently Asked Questions
- What is CTAS?
- CTAS (Canadian Triage and Acuity Scale) is the national triage system used in all Canadian EDs. 5 levels: Level 1 (resuscitation — immediate, life-threatening), Level 2 (emergent — 15 min), Level 3 (urgent — 30 min), Level 4 (less urgent — 60 min), Level 5 (non-urgent — 120 min). CTAS is maintained by CAEP (Canadian Association of Emergency Physicians).
- What are Canadian ED wait times?
- Canadian ED wait times (median): CTAS 1 — immediate, CTAS 2 — 15-30 min, CTAS 3 — 30-90 min, CTAS 4 — 60-180 min, CTAS 5 — 120-240 min. Long waits are common for CTAS 4-5. Provincial targets vary: Ontario — 90% of CTAS 1-3 within target, BC — similar targets. CIHI reports national ED wait time data.
- What is access block in Canadian EDs?
- Access block is when ED patients wait for an inpatient bed. Access block affects 20-30% of admitted Canadian ED patients. Average wait for bed: 10-20 hours. Causes: 1) Hospital overcrowding, 2. ALC (Alternate Level of Care) patients waiting for long-term care, 3. Insufficient beds, 4. Discharge delays. Solutions: ALC placement teams, discharge by noon, virtual wards.