Hospi­tal off­load de­lays jump 57% in Water­looWelling­ton

Bot­tle­necks con­tinue to put strain on para­medic ser­vices in re­gion; de­lays come amidst ris­ing de­mand

The Woolwich Observer - - NEWS - FAISAL ALI

HOS­PI­TALS CON­TIN­UED TO BE a ma­jor bot­tle­neck for am­bu­lances in the Water­loo Re­gion, ac­cord­ing to a new re­port by re­gion’s pub­lic health and emer­gency ser­vices depart­ment. Be­tween Jan­uary and Au­gust of this year, off­load de­lays – the amount of time spent by paramedics wait­ing to turnover their pa­tients at the hospi­tal – rose an­other 57 per cent in the Water­loo-Welling­ton area.

The de­lays put a ma­jor strain on the re­gion’s al­ready tightly stretched emer­gency ser­vices, which have only just kept up with ris­ing de­mand in the re­gion.

“That’s a con­tin­u­ing is­sue. Ac­tu­ally, last year we had a 102 per cent in­crease [in off­load de­lays]. So this is just a con­tin­u­ous rise in off­load delay within the sys­tem,” said Stephen Van Valken­burg, chief of para­medic ser­vices for the re­gion.

On av­er­age, the re­gion’s am­bu­lances lost a com­bined 22 days per month wait­ing at the hospi­tal to off­load their pa­tients. That was up from 14 days in 2017 over the same pe­riod. Put an­other way, al­most a month-worth of am­bu­lance ser­vices was spent de­layed at the hospi­tal.

“We’re re­ally sort of at the mercy at the hos­pi­tals - if they can’t ac­cept a pa­tient, we can’t just dump the pa­tient and walk away. We have to stay with them in the hall­way un­til they can ac­tu­ally take over the pa­tient,” Van Valken­burg ex­plains.

The hos­pi­tals in turn are at the mercy of the pre­vail­ing health de­mands of On­tario res­i­dents, as well as the man­age­ment prac­tices of the province.

“The in­crease in off­load de­lays is due to an in­crease in surge rates at our lo­cal hos­pi­tals. This surge in EMS (emer­gency med­i­cal ser­vice) has been seen across On­tario and is putting pres­sure on many Para­medic Ser­vices,” said a spokesper­son for the Water­loo-Welling­ton Lo­cal Health In­te­grated Net­work (LHIN). The Water­looWelling­ton LHIN op­er­ates hos­pi­tals in the area un­der the di­rec­tion of the pro­vin­cial gov­ern­ment.

“There are nu­mer­ous fac­tors caus­ing this, in­clud­ing an ag­ing pop­u­la­tion, in­creas­ing com­plex­ity of health is­sues in the com­mu­nity, and in­di­vid­ual’s choice to call 911 and re­quest Para­medic trans­port to hospi­tal.”

The re­gion did see a slight im­prove­ment this year in paramedics re­sponse time, which in­creased on av­er­age ten sec­onds for the re­gion. How­ever, the im­prove­ment is not nearly com­men­su­rate with the num­ber of am­bu­lances that have been added to the re­gion’s fleet in re­cent years. In Fe­bru­ary of this year, two new 12hour am­bu­lances were put into ser­vice. An­other three am­bu­lances were added to the re­gion’s fleet in July of last year and two more the year be­fore that.

“It’s a bit of a vi­cious cir­cle for us, that we add re­sources on when [re­gional] coun­cil ap­proves re­sources, and we cer­tainly don’t want them caught up in the vor­tex of off­load delay. We have mod­i­fied our de­ploy­ment plan, and we’ve re­ally done as much as we can to try and cre­ate ef­fi­ciency within the sys­tem,” said Van Valken­burg.

While am­bu­lances and hos­pi­tals have sim­i­lar roles in health­care, the two are man­aged un­der by dif­fer­ent lev­els of gov­ern­ment. The re­gion han­dles the re­spon­si­bil­ity for emer­gency ser­vices and am­bu­lances while the province op­er­ates the hos­pi­tals through the Lo­cal Health In­te­gra­tion Net­work (LHIN).

“We do have the off­load nurse pro­gram which is in ef­fect, but that’s a band-aid solution for a much big­ger sys­tem is­sue,” he says. “So we look to the gov­ern­ment and the hos­pi­tals to fig­ure out what they’re go­ing to do on this... We’ve be­come caught up in the off­load delay sit­u­a­tion be­cause of the sys­temic is­sues in the hospi­tal.”

The province has pledged to end “hall­way medicine” and curb de­lays in of­fload­ing pa­tients at hos­pi­tals, which Van Valken­burg says have been af­fect­ing mu­nic­i­pal­i­ties through­out the province.

“There has been some ad­vo­cacy on be­half of re­gional coun­cil to­wards the min­istry, to in­crease the off­load fund­ing to our hos­pi­tals, and I’m sure there’s go­ing to be some more ad­vo­cacy with the re­sult of the re­port,” said Van Valken­burg.

“But this is not just a re­gional is­sue here –it’s across the province, it’s across Canada. It’s a big is­sue, and as bad as our sit­u­a­tion seems, there’s other mu­nic­i­pal­i­ties that are five-times what we are. So it’s a huge health­care is­sue.”

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