While administrators at Health Sciences North determine how the hospital can best serve patients in 20 years in a capital master plan, they are moving ahead with a short-term proposal to ease the bed crisis at Ramsey Lake Health Centre right now.
Last calendar year, there were only 18 days when the acute care site wasn’t operating at more than 100-per-cent occupancy. One record day, 539 patients were admitted to the hospital, which officially has 446 conventional beds.
The North East Local Health Integration Network looked at the capacity of hospitals in the Northeast last year. It was no surprise the highest pressure on and demand for acute care beds was in Sudbury. Health Sciences North serves the entire population of the Northeast.
Under pressure
HSN has been under bed pressure for years – essentially from the time the amalgamated hospital at the former Laurentian site opened after it was redeveloped to accommodate services from St. Joseph’s Health Centre and Sudbury Memorial Hospital.
With too few beds to serve the population of the region adequately, as well as the rapidly aging demographic of the Northeast, overcrowding has been an issue for a decade.
That has put doctors, hospital employees and administrators under stress, but patients have been paying the biggest price for high occupancy. Dozens of them are often admitted via the emergency department to beds in medical and surgical floor hallways or in linen closets and shower rooms, while waiting for beds in a proper hospital room.
The LHIN asked HSN administrators to develop ways to increase conventional bed capacity now and allocated $3.5 million to the hospital to put those plans into effect. HSN’s board of directors approved the expansion in January of this year.
Repurposing to create space
The short-term plan will create 20 new conventional bed spaces by “repurposing” square footage that already exists at the site, said HSN president and chief executive officer Dominic Giroux. Another 17 unconventional spaces will be renovated and equipped with washrooms and other amenities so patients can be cared for properly.
Renovations will be done and beds added in two phases. In the first, bed spaces will be created on the fifth, seventh and eight floors of the North Tower. If HSN receives the entire $3.5 million from the North East LHIN, space will then be renovated and beds added to the fourth, seventh and eighth floors of the North Tower, and finally to the fourth, fifth and sixth floors of the South Tower.
The renovations will bring spaces up to clinical standards with proper access to washrooms, with windows and walls providing privacy, and with call bells. Giroux said hospital planners have been creative to get the most out of the repurposed space.
When the beds will open depends on the timing of approvals and the procurement processes, said Giroux, but it should only take a few months before some of the new bed spaces are ready.
Patients and their families have spoken out in recent months — and for several years — after loved ones were admitted to beds in hallways, in linen rooms with only commodes and in shower rooms where dirty laundry was being stored. Earlier this year, the Komarechka family went public after Danny Komarechka, 51, spent his dying hours in the emergency department because there was nowhere else to place him in hospital.
It will only get worse
The bed pressure at HSN is only going to get worse as the population of Baby Boomers in the Northeast ages. The number of people aged 70 and older here is expected to increase 61 per cent in the next 20 years, meaning there will be 51,000 more people aged 70 in the region. That will create a need for more acute care, home and community care, long-term care and palliative care, said Giroux.
With spring approaching and flu season ending, bed pressure at the hospital has eased slightly in recent weeks. Even on a “good” day though, there were 17 patients admitted and waiting in the emergency department for a bed and 24 patients housed in unconventional bed spaces.
“Northerners know that HSN was built too small,” Giroux said in a recent interview, something he has repeated several times in recent months. Partly because the hospital is too small, HSN has opened more than a dozen out-patient and other clinics away the main campus, many at the Memorial site.
The high number of sites can make it difficult for patients to navigate the health system. For instance, mental health and addictions services are offered at no less than five different sites.
“That’s not patient-centred” care, said Giroux.
Beginning the implementation of its new capital master plan by 2024 is one of the top goals of HSN’s strategic plan.
It is too soon for Giroux to speak to how many new beds would be added in the capital master plan. Health planners will also be looking to provide more space for mental health and addictions care, to “cluster” programs for children and youths in a more convenient space, as well as reducing their need to travel outside the regional by “repatriating” some programs and services.
The capital master plan should go to HSN’s board of directors by June, said Giroux. Creating that plan has involved more than 230 people who participated in more than 90 meetings, at which they looked at all programs, services and departments within the hospital.
HSN received a $500,000 planning grant from the Ministry of Health and Long-Term Care last spring to complete its capital master plan.
“It’s about documenting what HSN and patients and families will require 20 years from now and what needs to be done by us to be ready for that demand that is coming in 2039,” said Giroux.
Giroux doesn’t care to look back at the history of why the amalgamated hospital was built too small. Still he said, around 2003, when the expansion of the one-site hospital was planned, government reduced the scope of the project by more than 80 beds because of budget restraints.
That is why current HSN administration, trying to be responsive to the communities HSN serves and mindful of provincial fiscal realities, is fulfilling the LHIN request of last year to do what it can “do fast, at an affordable cost, to help end hallway medicine.”
As HSN implements that short-term plan, it is looking at three options for the expansion of the hospital in 20 years’ time. The ministry requires hospitals to put forward three options and recommend one, said Giroux. Building additional floors on the three-storey centre tower is one of the options that will be explored.
Capital master planning is a thorough process directed by the ministry, said Giroux. “Hospitals can’t just come up with capital master plans with their wish lists.”
A third party, Chefurka Consulting International Ltd., will review population projections so they can be addressed in the capital master plan. Corpus Santhez International will focus on clinical flow and operating planning. The Health Care Management Group will provide assistance for clinical data modelling and for staffing projections.
Sudbury-based Yallowega Belanger Salach Architecture is the architectural firm involved in the project.
HSN wants its capital master plan “to be bullet-proof, recognizing that we’re only at stage one of a five-stage process,” said Giroux.
Carol Mulligan is an award-winning reporter and one of Greater Sudbury’s most experienced journalists.
