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Hospital beds too few, too ‘stopgap’

Posted: October 25, 2017

(October 24, 2017)

By: Jim Moodie, The Sudbury Star

A promise from Queen’s Park to boost the number of beds in hospitals — including 16 more at Health Sciences North — is welcome news, but a move that doesn’t go nearly far enough.

That’s the position of Natalie Mehra, who has been pushing for years to protect the province’s health-care system as part of a public-interest network.

“It’s a good, tiny, temporary Band-Aid for this situation,” says Mehra, executive director of the Ontario Health Coalition. “But this is not the solution.”

Mehra says the hospital system hasn’t been so stretched since the early years of the Mike Harris government.

“I’ve done this for 17 years, and I haven’t heard stories like this since the mid-1990s,” she says.

Health Sciences North has been pushed beyond capacity for the better part of the past year, beginning with an occupancy rate of 116 per cent in January.

That number didn’t come down much over ensuing months. In mid-March, the hospital’s VP of patient services, David McNeil, said HSN was “at 110 per cent occupancy most days.”

That meant patients were overflowing into hallways and lobbies and front-line staff were being stretched to the limit.

The new beds are too few in number, and too stopgap in nature, to truly tackle this overcrowding problem, according to Mehra.

“The minister has been absolutely clear, these are temporary and transitional beds,” she says. “There’s no plan to build hospital capacity to meet the needs of the growing and aging population.”

The beds that have been announced so far “aren’t even enough to meet the current backlog, let alone what’s going to happen when the flu season hits,” she says. “And by every account, it’s a very bad flu season that’s coming.”

In all, the Northeast Region is set to receive 40 additional beds, with eight each going to the Sault, Timmins and North Bay, and twice as many to Health Sciences North.

“That is an immediate benefit to the hospital and local capacity for the system,” says Kate Fyfe, executive director of the North East Local Health Integration Network. “Any capacity we can add into the system helps the hospital to support patient flow, so it certainly helps.”

Four transitional spaces have also been established as part of the announcement. These are located at the Independent Centre and Network in Sudbury, “which offers a variety of services that include supports for post-stroke transitioning, supportive housing and outreach,” says Fyfe.

The option means patients who don’t require acute care but aren’t quite ready to go home can still receive some interim support, while freeing up room in the hospital, she says.

As well, the province has committed resources for an additional 31 beds in the northeast that haven’t yet been assigned to any particular hospital, but can be created as needed.

“We will be able to allocate them as pressures emerge across our system,” says Fyfe. “So what we will do is work with our hospital providers and determine the best approach to be able to allocate those beds. Depending on where the pressure is, we would be redirecting the capacity to meet those needs.”

One of the main factors in hospital overcrowding is the number of so-called ALC — or alternative level of care — patients, who may be better served in a long-term care facility but don’t yet have a placement.

Health Sciences North is already working “on a number of strategies to help reduce their ALC situation, and we’ve been working in partnership with them to bring those numbers down and better support patients at the right location,” says Fyfe.

The LHIN has also hired an individual to focus on this area. “Elaine Burr is working with each of our larger hospitals to improve patient flow, and was instrumental in developing an ALC avoidance framework that has a structured approach and specific actions that providers — both hospital and community — can take to help support a patient’s transition through the system,” says Fyfe.

Mehr argues, however, that ALC patients have become easy scapegoats, when the real problem is a lack of investment in hospitals.

“All of the government’s messaging is about blaming it on bed blockers or what they call alternative level of care patients,” she says. “But about half of those ALC patients are actually waiting for a hospital bed.”

She says the designation includes those waiting for a space in a nursing home but also patients who are “in one type of hospital bed but ought to be in another, so it refers to surgical patients, or patients waiting for a rehab bed or a mental-health bed.”

Meanwhile, if a long-term care facility is not able to take in an ALC patient, “it’s because there’s no bed available in the community that can meet their care needs, because those needs are too heavy for any of the homes in the area,” says Mehr.

For that reason, the health coalition president argues the term ALC has become something of “a misnomer,” and the real focus should be on bolstering the system.

“All of this is used to cover for the fact that Ontario’s hospitals have fallen far behind any other comparable jurisdiction,” she says. “We’re an extreme outlier. No-one else in the country, no-one else in the developed world, has cut as much as we have.”

Still, Fyfe argues the additional capacity being provided now — even if it’s not guaranteed to continue indefinitely — is both welcome and timely.

“Absolutely it’s a great investment and I think what’s very positive about it, too, is it’s in advance of flu season,” she says. “So we are proactively approaching pressures that the hospitals are experiencing and may experience as they move into the coming flu season.”

The extra beds, however, should not cause people to be complacent about protecting themselves from illness.

“We encourage all people to go out and get their flu vaccine,” says Fyfe. “We want people to stay healthy.”

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