Fixing the Emerg

Dr. Chris Bourdon, chief of staff at Health Sciences North, has a message for anyone in Sudbury requiring emergency care: go to the emergency department.

Speaking at a meeting of the hospital’s board of directors Tuesday evening, Bourdon expressed concern that recent media coverage of long wait times in the ED would lead some to try and seek help at a hospital in another community.

“There is a risk with the inaccurate reporting of these numbers,” Bourdon said. “The last thing we want to risk is to have someone delay their visit to the emergency department.”

While wait times are too long, Bourdon said that most of the time, the average wait time of someone who goes to the ED with a serious illness is 8.1 hours. That figure includes the time from arrival in hospital to being discharged. The provincial target is eight hours, although the provincial average is 5.8 hours.

Sometimes there are spikes when wait times are much longer, but most of the time, HSN is hitting that target.

“So, 72.4 per cent of the time, we’re hitting the provincial target,” he said. “I don’t say this to minimize the problem, but it’s important that we use these figures accurately. The last thing we want anyone to do is to hop in their car and drive to Espanola if they’re having chest pains. That could be lethal.”

Bourdon updated the board on what is being done to address the problems in the ED. On May 7, hospital representatives met with staff from the Northeast Local Health Integration Network and from the Community Care Access Centre in an attempt to find short- and long-term solutions.

The problem still centres on the high number of patients in hospital whose needs would be better met somewhere other than the hospital. As of May 7, there were 96 of these alternative level of care (ALC) patients in hospital. The average for April was 110. When ALC levels surpass 28 patients, the ED begins to have serious problems.

“The largest contributing factor is the ALC problem,” Bourdon said.
There is a major roadblock in transferring patients from the ED into a hospital bed; because of the ALC crisis, none are available. Thirty temporary beds that operated in the former Memorial Hospital and the opening of St. Gabriel Villa in Chelmsford only eased the problem temporarily.

However, Joe Pilon, HSN senior vice-president and chief operating officer, said reopening the temporary beds is not a solution. He said operating an acute care bed, where most ALC patients are now, costs between $800-$1,000 a day; an ALC bed, such as the ones at Memorial, costs $350; a long-term care bed costs $150; while assisted living or home care costs $100 a day.

The key to solving the problem, Pilon said, is creating a “reservoir” of home care for ALC patients.

Making better use of community care would mean the creation of the equivalent of 105 ALC beds for the same price as 30 acute beds.
“It also creates a better quality of care for seniors, because we know they do better when they are able to stay in their home.”

The province has also made it clear that it is willing to increase funding for programs that provide care to people living at home.

“We know it’s going to take system-wide solutions” to deal with the ED crisis, he said. “We know our ED (problem) is a symptom of a health-care system that isn’t working. When patients can’t get the care they need in the community, they come to the emergency department.”

At the May 7 meeting, there was agreement among staff from the hospital, the LHIN and the CCAC, Pilon said, that they must work together to find ways of creating that reservoir of care for the ALC patients.

To that end, each group agreed to come up with three priorities each to help solve the problem, and they were to bring those priorities to a May 9 meeting.

Posted by Arron Pickard