Spotlight 3/5

More than one-third of complainants had concerns with the overall quality of care they received, 20% expressed concerns about long wait times and 15% described a lack of sensitivity, caring, courtesy and respect in their interactions with health care providers.

Almost all complaints included concerns about communication, and patients frequently reported that they did not feel that their care providers listened to them. Of the 11% of complainants who reported having mental health or addiction challenges, many reported that their physical symptoms were not given due consideration in emergency departments because of their mental health history.

Emergency department overcrowding has been a problem globally since the 1980s, and has been a significant factor limiting the timeliness, quality and efficiency of hospital care.² A 2023 report by Canada’s Drug Agency (formerly Canadian Agency for Drugs and Technology in Health) noted that emergency department overcrowding creates an unsafe environment where patients experience delays, missed or inappropriate care, reduced patient satisfaction, loss of dignity and physical, emotional and psychological harm.³ The agency suggests that the problem is growing in jurisdictions across Canada, including Ontario, in addition to the challenge of temporary emergency department closures and service reductions.⁴

Many studies have highlighted the importance of compassionate communication in patients’ satisfaction with their care in emergency departments. They further suggest that providing information, including information about likely wait times and updates while waiting, has a positive impact on patient experiences.^5,6,7 One study noted that, “Although wait time is a major driver of patient experience, provider and staff communication are critically important and excellent communication and perceived empathy may mitigate long waits, overcrowded environments, and other challenges.”⁸

Overcrowding also has a negative impact on health care providers who work in emergency departments. Workplace violence, staffing shortages, emotional and moral distress and missed learning opportunities can lead to issues with staff retention, burnout and compassion fatigue.⁹ A 2025 study describes compassion fatigue as a reduction in a “professionals’ capacity and interest to act empathetically when faced with situations of distress in others,” which can affect professional performance and patient safety.¹⁰ The Canada’s Drugs Agency suggests leaders should promote the well-being and retention of emergency department staff by providing incentives for senior staff to remain in their positions, promoting interprofessional collaboration and enhancing learning opportunities.¹¹ Additional research highlights that focused customer service training can improve patient satisfaction without making interactions between patients and care providers more time-consuming.¹² It is also important to note that many hospitals are making significant investments to improve safety and reduce violence in emergency departments by installing metal detectors and other technology solutions.^13,14

Both the academic literature and the complaints Patient Ombudsman’s received suggest that patient experiences in emergency departments could be improved with a focus on compassionate communication. This includes addressing the communication skills and support needs of the health care professionals that provide care in emergency departments.