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Sault Area Hospital reports hike in alternate level of care patient numbers

Posted: October 28, 2022

(October 27, 2022)

By: Jeffrey Ougler, The Sault Star

Sault Area Hospital has posted an increase in alternate level of care patient numbers in the past so many months, the facility’s board of directors heard this week.

Officials were told Monday there are currently 62 alternate level of care patients in hospital, occupying 23 per cent of in-patient beds.

SAH’s Quality Committee chair’s report indicates 18 are waiting for long-term care.

“Our geriatric services provide enhanced care to help individuals maintain their care at home, and to transition back to their home rather than to assisted living or going to long-term care,” Johanne Messier-Mann said in her report to the board during the open portion of its regular meeting. “The goal is to ensure the patients receive the right care at the right place.”

Messier-Mann said the Quality Committee’s Sept. 21 meeting discussed Bill 7, the controversial legislation, which, in late September, brought new community case management responsibility and authority for decision-making with patients and families regarding long-term bed selection and placement. The legislation allows for a community case manager to identify and enable a hospital patient designated ALC, and waiting for long-term care, to be placed in accommodation available up to 150 kilometres in Northern Ontario – 70 kilometres in southern Ontario – from their preferred address, or hospital, while waiting for their first-choice bed selection. Hospitals will be directed to discharge the patient when admission to long-term care is authorized.

SAH receives an average of 57 alternate level of care patients a day, and generally has up to 15 patients waiting for long-term care placement, accounting for approximately 25 per cent of its ALC patient population.

lla Watson, SAH president and CEO, said the hospital is working with Ontario Health to implement “initiatives that further our work” with the ALC patient population and the internal and community-based groups that support their care.

“A hospital is not intended to be anyone’s home,”  Watson told September’s board meeting. “We recognize difficult decisions must be made, however we’re committed to ensuring this legislation is implemented in a compassionate and respectful way that’s aligned with our hospital values.”

Bill 7 has drawn fire from many fronts, especially from public health advocacy groups.

The province’s stand that the legislation will free up badly needed acute-care beds in hospitals rings hollow and unfairly hurts seniors and their families, says Marie DellaVedova, Ontario Health Coalition’s Sault Ste. Marie representative.

“Is the onus on elderly, frail people to do that? Why are we looking at voiceless people to solve a problem?” DellaVedova told the Sault Star.

“Why are we causing them more hardship and doing that to family members? That doesn’t seem to me as though we’ve looked very hard or very far to find a solution.”

The province says there are about 6,000 patients in hospital who require an “alternate level of care” and should be discharged from hospital. Among those patients, 2,000 are on a waiting list for long-term care homes, the province said.

DellaVedova doesn’t buy the province’s reasoning.

“We wouldn’t treat any other group, I don’t think, in society this way,” she said. “But these are vulnerable people. Most don’t have a voice. So, it seems to me we’re taking advantage of their vulnerability to do this.”

Meanwhile, the average length of stay for chronic obstructive pulmonary disease patients is above target, but admission volumes are lower than the previous year.

“Small patient numbers have a significant impact on results,” Messier-Mann said, adding there were no COPD readmissions during the report period.

The average length of say for patients with congestive heart failure is “above target,” said Messier-Mann, but added that, again, admission volumes are lower than the previous year, and small numbers “really” impact results. Of the three readmissions, two were unrelated to their congestive heart failure.

“So, a patient with a diagnosis of (congestive heart failure) is still counted as a readmission for congestive heart failure for any reason they come in,” Messier-Mann said.

“Barriers to timely consults are being reviewed to ensure consults occur in a timely fashion.”

The frequency of visits to the emergency department for mental health and addiction and readmission rates are both within the target range.

The most common reasons for these visits to the emergency department include substance use and anxiety disorders, Messier-Mann said.

“The outpatient mental health team has implemented a pilot of remote care monitoring to assist these patients in self-monitoring and accurate navigation of the system,” she added.

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