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Health Sciences North has put a six-month pilot into place in an effort to quell overcrowding issues.
As of May 24, the hospital is sitting at 109-per-cent capacity with 109 ALC (alternate level of care) patients, a number that fluctuates by the hour.
The battle to get ALC patients out of acute care beds and discharged into a transitional setting or back into their homes is one that the hospital has been fighting for a number of years, as an aging population continues to put stress on the system.
A new pilot program has been introduced with the Daffodil Terrace Lodge, which is located inside the Northeast Cancer Centre, opening up eight transitional beds to house ALC patients.
The pilot got underway on May 15 and is slated to continue for six months.
"When we looked at our ALC population, there's a group of patients that stay in the hospital but eventually get discharged home with (home care) services," said David McNeil, HSN vice president patient services.
"What we're testing is, can we shorten the length of stay at the hospital by moving them to a transitional setting, and the Daffodil Lodge is where we're piloting this work to see if there's this cohort of patients we can discharge and get out of the hospital sooner."
McNeil explained that this isn't merely about pushing patients out the door in an effort to make room, but getting these ALC patients into a care facility that is geared towards their needs.
"The idea is that if we can get these eight beds to work and identify the patient cohort for which this service would be effective in reducing their length of stay at the hospital, but at the same time still supporting them in a care environment, then we can start deploying these types of facilities throughout the community," said McNeil.
The Northeast Cancer Centre has been running at approximately 75-per-cent occupancy so space is not an issue. Where the HSN is facing challenges is that each patient presents a unique set of circumstances and getting them into their ideal location may not always be within reach.
"There are social or economic issues at hand," said McNeil. "Some patients live on their own and may have cognitive issues where living on their own in the short term isn't the right solution. Some patients may be better off living in a retirement home, but economically, at $3,000 a month it might not be affordable for them. Solving the ALC problem in the community is not a one step solution, as people finish their acute phase of illness, these are not all the same patients, they all require different types of care."
An 80-year-old patient, for example, may have been fully independent before going into the hospital, but after receiving their acute care they may need longer to recuperate and get back to the level of health they were at before their hospital stay.
"Functionally, a patient may have declined due to their condition and they just need more time to recuperate," said McNeil. "We're not providing them with any more medical intervention, they're cured, it's just about building their strength back up."
The overcrowding issues at the hospital is starting to become a race against the clock as Greater Sudbury goes through a demographic shift that is seeing the average age of the population steadily increase.
The number of people in the community over the age of 85 continues to increase, while the number of people over the age of 65 is increasing at an even more rapid rate.
Implementation of a system that will ease the pressure at the hospital is something that needs to happen sooner than later, according to McNeil.
"If we look at the model they've put in place in British Columbia, they have created these smaller transitional spaces located in various locations around the community where they've basically converted a house to make it suitable for these types of services for eight to 10 patients," he said.
"It gets them out of the hospital, gets them on the healing journey, makes them more independant and it doesn't make them feel like we're shoving them out the door. We're trying to do our job in terms of making their transition smoother."
At present, McNeil says HSN is falling short on their ALC prevention work. The Toronto-Central LHIN has developed a set of best practices for ALC prevention and HSN took that framework and applied it to their organization.
The results showed that HSN is 48 per cent compliant with the recommendations set out by the Toronto-Central LHIN.
"We evaluated ourselves pretty harshly, if we couldn't say that 90 to 100 per cent of the time we're executing this in an effective way then we're not meeting the standard," said McNeil.
"We have a working group working with patient advisors at HSN, applying that framework and making improvements in our ALC prevention. It does require a bit of a culture change by our doctors and clinical staff, but also just some reinforcement of some existing policies and processes."
McNeil has targetted 75 as the number of ALC patients at HSN. Each ALC bed at HSN costs $140,000 per year and the hospital could stand to save as much as $3.5 million if they're able to hit that target.
A lot of the work involved with ALC prevention starts and ends with open lines of communication, between both doctors and hospital staff, as well as doctors and patients.
"It's about getting those conversations right up front," said McNeil.
"It's making sure we're clear with patients, with families, with our teams around the pathway of how we're getting the patient home. We're starting that work and it will be ramped up over the next few months and those conversations will impact our patients and their families."
