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Critically ill patients sent to Sarnia due to ICU overload

Posted: May 12, 2016

(May 12, 2016)

Author: Brian Cross, Windsor Star

A surge in the number of critically ill patients that “far exceeded” the capacity of Windsor Regional Hospital’s intensive care units on Friday prompted three of them to be rushed by ambulance to Sarnia’s ICU.

The situation is being cited by the Windsor Essex and Essex County health coalitions as an example of how inadequate Ontario government hospital funding is hurting patients. The coalitions are holding a news conference Wednesday to tell the story of one patient taken to Sarnia.

“It’s dangerous, patients in critical condition being transferred down the (highway). It’s also a concern because this is taking place before the latest round of cuts to nursing staff,” Essex County Health Coalition spokeswoman Kim DeYong said Tuesday, referring to the 169 registered nursing positions being eliminated starting in June as the hospital copes with a $20-million shortfall.

While the patient has received exceptional care in Sarnia, “if you’re being transferred to Sarnia, how is your family supposed to come visit you, how are you supposed to be close to the people who care about you?” DeYong asked. “We see this as the result of funding cuts.”

But medical officials say what happened Friday is a rare occurrence (the second time in the last three years) which was properly handled to ensure everyone who needed intensive care received it.

“It’s the exact opposite,” of inadequate funding harming patients, said Dr. Eli Malus, an ICU specialist who serves as the critical care lead for the Erie St. Clair LHIN. “What it really is is a sign of a well-designed, well-functioning critical care system that can surge to accommodate volume, so in times of crisis, it doesn’t fall apart.”

On Friday there was an unexplained spike in the number of patients with life-threatening conditions (usually requiring a ventilator to help them breathe) at the 20-bed ICU at Windsor Regional’s Met campus, triggering a “moderate surge plan” that is enacted whenever capacity exceeds 115 per cent.

“One-hundred-and-fifteen per cent beyond our capacity really does put patients in a situation where we want to ensure they are getting the appropriate care elsewhere versus not getting the care they need if they stayed here,” said Janice Dawson, the hospital’s vice-president of critical care and cardiology.

So medical staff selected five patients who could best tolerate the move. Two went to the 16-bed ICU at Windsor Regional’s Ouellette campus and three went to Sarnia. Extra staff and ambulances were put into service. The ambulances rushed with lights and sirens, with each patient attended by an ICU nurse and a respiratory therapist.

By Tuesday, one patient had been discharged from Sarnia’s Bluewater Health, one had returned to Windsor Regional and one remained.

“Sometimes it has to be elsewhere, and it’s not ideal for family members and certainly we recognize that, which is why we try to repatriate them as quickly as we can,” said Dawson.

She said Friday was a “crazy, challenging day,” but things actually went very smoothly thanks to the moderate surge plan and a team of health professionals who worked together to execute it.

The moderate surge plan — which hospitals across the region regularly practise — allows hospitals to flex above 100 per cent, said Malus who is responsible for co-ordinating the ICUs throughout the Sarnia-Chatham-Windsor region.

“I can count on one hand how many times this has happened in 10 years, but it does happen on occasion and the important thing is you have to plan for it.”

The Windsor ICUs usually run at about 80 to 85 per cent capacity, which is ideal, he said. When it goes over 100 per cent (a minor surge), staff can make changes to accommodate that overflow, but once capacity reaches 115 (moderate surge), they have to start sending patients elsewhere. A major surge would involve a significant province wide disaster.

“It’s heartbreaking to have to transfer somebody out, it’s not something we look forward to doing, but we understand health care is a team sport,” Malus said.

“Is it a perfect system? No. But is it a good system? Is it a safe system? Absolutely.”

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