GREY-BRUCE – Even though there were no patients in South Bruce Grey Health Centre hospital sites as of Dec. 31, there continue to be concerns about capacity.
Hospital CEO Michael Barrett said in an interview that the situation has eased from two weeks earlier, but it’s still something that warrants close monitoring.
“All hospitals across Grey-Bruce are nearing or at capacity,” he said.
Locally, the problem isn’t that hospitals are being inundated with COVID-19 patients. In fact, Barrett said there are a very small number of COVID patients currently in hospital. As of this past weekend, that number was two. “Actually, our hospitals are in pretty good shape,” he said.
Nevertheless, he said that “all hospitals are caring for an increased number of patients for a number of reasons.”
Those reasons include policy changes due to COVID-19 that result in fewer long-term beds, an ongoing shortage of human resources, and a high number of patients awaiting transfer to nursing homes.
Barrett explained that one reason for increased concern about capacity in the days just before Christmas was “significant outbreaks at University Hospital in London.” That reduced the capacity for both University Hospital and Victoria Hospital to admit patients.
London Health Sciences Centre is one of this area’s major referral centres. University Hospital was taking only “life and limb” patients, and releasing or transferring any patients they could. University Hospital is where Grey-Bruce hospitals send patients requiring more advanced care than is available locally.
Not only were local hospitals unable to send patients to London, they were actually accepting patients from there.
Barrett said hospitals across the region have been “meeting to assist in the discharge of some of their patients.” He noted Grey-Bruce hospitals have accepted only a small number of LHSC patients, and have taken all necessary public health precautions.
Concerns have since lessened regarding the situation at University Hospital.
One situation that has not eased is the large number of Alternate Level of Care (ALC) patients presently waiting in hospital, said Barrett. ALC patients are people who have completed their hospital stay, no longer require acute care, and are waiting for their next destination whether it is home, long-term care, supportive housing, etc.
They don’t need to be in hospital, but due to the shortage of long-term care beds, there’s no place to send them.
A recent report presented to Bruce County council about Brucelea Haven stated the long-term care facility is operating at capacity, with a lengthy waiting list.
Barrett added that the ALC situation in general is exacerbated by a change in long-term care home policy due to the COVID-19 response. With the pandemic, ward rooms in long-term care homes are now restricted to two residents, compared to previously where a room may have had three or four residents.
Said Barrett, “Although this is good from an infection control standpoint, it has reduced the number of long-term care home beds across the province. In Grey Bruce, there are now 147 less long-term care home beds than what were in place before the pandemic.”
To create additional capacity, the South West Local Health Integration Network has opened 15 transitional beds in retirement homes in Grey Bruce.
This has helped with capacity issues, but is only a small increase in overall capacity. The hospital CEO said the LHIN is seeking to open an additional five transitional beds, but cannot find another retirement home in Grey Bruce which has the staffing available to open the additional beds.
“Shortages of health human resources are significant, and probably the largest, constraint in the system now,” said Barrett.
He explained that the provincial government has provided funding for additional hospital beds across the province, but some of these beds cannot be opened because of a shortage of staff. This shortage means that if hospitals have to increase capacity, the hospital has to slow or stop other services to free up staffing.
The impact of this would be felt throughout hospital operations. A slow-down or stopping of services could impact outpatient clinics, elective diagnostic imaging, and surgeries.
Barrett said that currently, hospitals are attempting to keep these other services operational, but if capacity increases, it will require changes to these services.
“This is happening at a time when the demand for home care nursing has never been higher – and with a shortage of nurses in the community, it is challenging for the LHIN and the contracted service provider organizations to meet this increased demand,” he said.
COVID-19 has meant many changes to the way social services operate, and that, too, leads to decreased capacity in hospitals. Barrett explained that programs like Day Away, that provide supports for people to live independently, provide respite for the caregiver, and ultimately keep people out of hospital, must limit the number of clients they help. And that means a much higher chance people not receiving the care they need in the community will end up being admitted to hospital.
Barrett concluded by saying that if hospital occupancy continues to increase, it will mean hospitals will have to slow or stop services, or worse, will have challenges meeting all the needs of all people seeking care in the hospital.
“This is why hospitals are requesting that everyone across Grey Bruce follow Public Health measures to prevent the spread of COVID in our communities, to help ensure that your hospitals are available should you require hospital care,” said Barrett.
Pauline Kerr, Local Journalism Initiative Reporter, The Walkerton Herald Times