Hospitals warn province they are ‘on the brink’
Hospitals need ‘significant investment’ to maintain the status quo
St. Joseph’s Healthcare was so overcrowded in the summer that its occupancy rate for non-surgical beds soared to 139 per cent on Aug. 10.
The staggering number means all of the beds funded by the province were full for acutely ill patients not requiring surgery at the hospital on Charlton Avenue East.
But a hospital can’t put out a “no vacancy” sign, so it became overfull to the point that it had 39 per cent more patients than funded beds.
To put it in perspective, an occupancy rate of around 85 per cent is the international standard for safe hospital capacity.
St. Joseph’s spent most of August at one-and-a-half times or more that rate, revealed the Ontario NDP, which released overcrowding numbers Wednesday obtained through the province’s Freedom of Information and Protection of Privacy Act.
“Ontario’s hospitals are on the brink,” said Anthony Dale, president and CEO of the Ontario Hospital Association (OHA). “We’ve got, all across the province, many hospitals in a real capacity crunch.”
The OHA is calling on the Liberal government to increase hospital funding by 4.55 per cent for the fiscal year that starts April 1 in its submission for the 2018 Ontario budget.
“We really do recommend a very significant investment in hospital services to maintain existing access to care,” said Dale. “Without that kind of investment it’s very difficult to see how existing levels can be maintained.”
The report flags growing wait times and overwhelmed emergency departments. It details equipment and infrastructure that is run down, at the end of its life or outdated.
“Emergency departments are a critical barometer for how the health-care system is functioning — and the warning alarm is sounding loudly,” states the prebudget submission. “While hospitals typically see an increase in patient volume in January and February, this past summer was particularly troubling.”
It is easy to see the pressure building in hospitals by looking at the number of patients waiting in the St. Joseph’s emergency department for an in-patient bed in the hospital from June 1 to October 1, which is typically not the busiest time of year.
On any given day, between five and 31 admitted patients were stuck in the emergency department until a bed became available on the overcrowded wards.
Considering the entire hospital had about 287 medical and surgical beds, it meant there were times in the summer when roughly 10 per cent of the hospital’s admitted patients were being cared for in the emergency department.
One of the worst days was August 8, when 27 admitted patients in the ED faced the gridlock that has become the norm at Hamilton’s hospitals.
They could not leave the ED right away because the medical beds at St. Joseph’s were at 130 per cent capacity or more from August 3 to August 11, peaking at 139 per cent on Aug. 10. In fact, the occupancy rate for medical beds dipped below 125 per cent only once in the entire month — it was Aug. 30 and the rate was still a whopping 121 per cent.
“It’s a system that is in absolute crisis,” said NDP Leader and Hamilton Centre MPP Andrea Horwath. “We’ve been raising the alarm bells for a long time.”
The overcrowding data released by Horwath shows St. Joseph’s operated at least nine unfunded beds — meaning they are not paid for by the Ministry of Health — every single day of the summer.
Most days it was much higher, with the peak being 34 unfunded beds operating on Aug. 10. Of those, 15 were in unconventional spaces such as sunrooms and hallways.
“You name it, any place where they can squeeze in a bed,” said Horwath. “But those places don’t have a call button to push if they need a nurse and they don’t have proper access to patient washrooms. It’s very undignified and it’s certainly not in any way private in terms of their health care.”
The province provided some relief in October with $100 million to make more than 1,200 additional hospital beds available across Ontario.
“That’s almost 10 per cent of new beds into the province,” said Health Minister Dr. Eric Hoskins during question period at Queen’s Park on Wednesday.
“I applaud the hard work and the advocacy of all of our hospital officials, front line workers and leaders, including the OHA,” he said. “Their input and our close relationship is critically important to getting this right and get it right we will.”
However, the funding for the new beds runs out March 31 and the number of beds isn’t enough to solve the problem. While St. Joseph’s got funding for 36 more beds from the province, it is still so overcrowded that it is operating an additional 21 unfunded beds.
“The funded beds have been a big help to us,” said Winnie Doyle, executive vice-president, clinical services. “But the volume of patients isn’t any lower than it was … It has an effect across the entire hospital.”
The Spectator reported in October unusual levels of overcrowding in Hamilton’s hospitals heading into the busy flu season. The OHA reported wait times for patients admitted through the emergency department were the longest during the month of September over the last seven years.
“Without action, patients will wait far too long in the emergency department and may even be redirected elsewhere because there simply isn’t any room,” warns the prebudget submission.