When Health Minister Christine Elliott needs to see Ontario’s hallway medicine problem in action, she doesn’t need to travel very far, as one of the province’s most overcrowded hospitals is in her riding.
Southlake Regional Health Centre in Newmarket is one of Ontario’s largest, with 502 beds. It’s also among the hospitals most frequently filled beyond capacity, according to an investigation by CBC News into the hallway healthcare situation province-wide.
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Data obtained from the Ministry of Health show that Southlake was over capacity for all but seven days in the first half of 2019. In that time period, the hospital’s average daily occupancy ran at 110 per cent.
That did not improve in the second half of the year, according to figures provided by the hospital, averaging 113 per cent.
A visit to Southlake this month reveals patients housed in a range of what are officially called “unconventional spaces,” including a former exercise gym.
Here the beds are separated by portable surgical screens, the makeshift nursing station is a collection of desks and tables mostly covered with medical supplies, and there’s no bathroom, so patients have to walk down the hall.
Patients who spoke to CBC News in the exercise room said it was better than staying in Southlake’s crowded emergency room, but less than ideal.
“The elderly people, it’s got to be real tough on them,” said patient Ron Dane, who spent two days in the ER before getting an overflow spot in the gym.
“Obviously, there’s a long way to go to get up to the standard of care that we should really expect.”
The nursing manager who covers the overflow areas at Southlake doesn’t disagree with him.
“This is not the optimal place to be providing care,” said Tammy Rogers, who also manages the rehab and neurological units’ discharge planning group. “We don’t have the same access to the equipment as you would on a set-up acute medical floor.”
Rogers praises her nursing team for their dedication.
“I am forever thankful to them for the work that they do every day,” she said during an interview in a kitchenette that’s become the latest spot to put patients, a space that staff call the pantry.
“I know it’s not easy for them to come here to work when we’re opening up a pantry or putting patients in the hallway, that’s not why they became a nurse,” she said.
“They give it 150 per cent. They still provide excellent care to our patients and I’m sure at the end of the day they’re not always happy with what’s happening.”
Rogers said there have been patients in the hallway on her floor daily for the previous two weeks.
No one on Southlake’s staff is content with the overcrowding, from the nurses to the hospital’s chief executive.
“It’s a very difficult situation for patients,” said Arden Krystal, the hospital’s president and CEO.
“When I see patients in areas such as our gym, I think about how would I feel if that was my Dad in that bed,” Krystal said in an interview with CBC News.
“I wouldn’t feel that good about it. I would be disappointed.”
The perpetual overcrowding at Southlake means hospital staff are daily putting anywhere from 20 to 50 patients into spaces that were not intended for patient care.
But that’s not the only way the hospital tries to cope with the demand for beds.
Like many hospitals in Ontario, Southlake has large numbers of older patients occupying beds who don’t actually need acute care, but can’t leave the hospital because they need more care than they can receive at home. They’re known as “alternate level of care” patients (ALC).
Last March saw the launch of a program called Southlake@home, designed to provide enough support to ALC patients outside the hospital walls so that they could be discharged more promptly.
The hospital partnered directly with home-care providers, a community support service agency, and family doctors to ensure the necessary services were made available.
The program has helped more than 200 patients make the transition out of the hospital, and has reduced their re-admission rates.
“We’ve had great success with that,” said Krystal. “But no sooner do we get some people home than there’s a whole pile more waiting to come in.”
The key challenge for Ontario hospitals, said Krystal, has been figuring out how to cope without additional bed capacity.
“No matter how great a job we do in moving people into the community and keeping them healthier, the sheer growth that we’ve had in Ontario means that we need more hospital beds,” she said.
The number of acute-care beds in the province has essentially remained the same for 20 years, while the province’s population has grown by three million.
Elliott — who is the Progressive Conservative MPP for Newmarket-Aurora as well as Premier Doug Ford’s health minister — says the government would like to see the Southlake@home program replicated in other hospitals around the province.
“We recognize the difficulties that hospitals are experiencing,” Elliott said in an interview.
“I’m sorry that anybody has to receive health care in a hallway. They should be in a hospital bed in a hospital room.”