Short-term ED crisis solutions on meeting's agenda

Given the ongoing crisis in Health Sciences North's emergency department, local health-care officials will come together May 7 to discuss the problem.

Officials from the North East Local Health Integration Network (LHIN), the North East Community Care Access Centre (CCAC), Health Sciences North and local doctors have been invited to the meeting.

While many long-term solutions have been implemented over the last few years to deal with overcrowding at the hospital, those at the meeting will be focusing on what can be done in the short term.

Dr. Peter Zalan, the president of Health Sciences North's medical staff, has a few solutions he wishes to put forward at the meeting.

As a regional health centre, Health Sciences North cares for patients from across northeastern Ontario, he said. When they get better, and are able to be transferred back to the hospital in their home community, sometimes it takes several days to find a free ambulance to take them back home.

Meanwhile, the hospital's emergency department is “in distress” because there's too many patients waiting for inpatient beds there, he said.

“There are no hospital beds for newly-admitted patients,” Zalan said in his April 30 letter to the editor (see full letter on page 10).

“Sometimes admitted patients end up in a nursing unit specializing in another area of care. Sometimes they end up in a TV room. Most often, they just stay in the emergency department, sometimes for days, with patients in stretchers in hallways.

“Then the new arrivals in ED face long wait times for assessment because there is just no space to properly examine them. This situation has caused a number of patients to come to harm. The nurses and physicians involved are devastated. They feel responsible for the welfare of their patients.”

The letter also said the average wait time in the hospital's emergency department is now more than 19 hours for the seriously ill, which is the second worst performance in the province for a large-volume emergency department.

“The patients, their families and staff feel that they have been abandoned,” he said.

Because of this situation, sending already-treated patients transferred in from other communities back home in a timely fashion should become “a high priority,” Zalan said. “We need to enhance how we do emergency transfer services.”

He also thinks more needs to be done so that people can receive palliative care in their own homes.

The city has a hospice, but it's in such high demand that not everyone can access it, Zalan said. Many people end up dying in the hospital, which isn't an ideal situation, he said.

“In the short term, maybe we can do something about having people die with dignity, surrounded by their family in the home,” Zalan said.

The short-term solution many people seem to be talking about is reopening the 30 beds for alternate level of care (ALC) patients recently closed at the former Memorial Hospital site, he said.

ALC patients are those who no longer need acute care, but remain in hospital because they cannot find placement in a community facility such as a long-term care home.

With 78 of these patients at the hospital's Ramsey Lake Health Centre and 30 at Memorial, which is officially known as the Sudbury Outpatient Centre, ALC patients are partly to blame for the problems in the emergency department.

Zalan, however, said he doesn't think reopening the Memorial beds is the best thing to do.

“We'll all get together and see what everybody thinks,” he said. “But me, personally, I think there's other things we could do that would be less costly and be more effective.”

North East LHIN CEO Louise Paquette was not available to speak to Northern Life about the subject. However, she did issue a brief email statement.

“The North East LHIN is concerned that people are waiting too long to receive care in Health Sciences North's emergency department,” her statement said. “We appreciate that Dr. Zalan is speaking up about the situation and, as he mentioned, we have now called a special meeting for May 7 with hospital administrators, physicians and the North East CCAC to once again look at solutions.”

Dr. Chris Bourdon, Health Sciences North's chief of staff and vice-president of medical and academic affairs, echoed Zalan's statements about the dire situation in the emergency department.

As of May 1, there were 21 admitted patients in the emergency department, taking up more than half of the department's beds. The situation is frustrating for both patients and staff, he said.

“These are staff where their professional career is to treat emergency patients,” Bourdon, who used to run the hospital's emergency department, said. “That's what they signed up for. There are times when there's just no space to get patients into places to get them seen and assessed.”

He doesn't have any specific examples of short-term solutions local health organizations could implement to alleviate the situation.

However, Bourdon did say that you can't close 30 Memorial beds without having space for these patients elsewhere in the health system.

“One needs to be cognisant and attach the location where these patients will be cared for once you close and decommission (the Memorial beds), or change their role.”

As to whether some of the Memorial beds could be reopened, Bourdon said the hospital has “grand plans” to open outpatient clinics on the floor where those patients used to be housed.

“It's not to suggest that long-term care patients don't deserve a spot, but it's just there may be better uses of that space,” he said.

Posted by Arron Pickard