Hamilton hospitals shuffling staff, shuttering services in race to add beds during COVID-19

Hamilton hospitals are shifting workers around to staff more beds and counter the cases of COVID-19 filling their wards with patients.

In a staff memo on Wednesday, St. Joseph's Healthcare Hamilton said roughly 80 staff in nursing and other clinical support roles have been moved to care for acute and critical care patients. It expects that number will surpass 100 people "within the very near future."

Hamilton Health Sciences (HHS) didn't offer as many details on redeployment to staff during its Thursday town hall, but noted workers from units that treat patients before and after surgery, and workers from procedural care areas, have been shifted around to help staff more beds.

Though one of the big moves both networks are making includes moving staff who perform outpatient care and ambulatory care. It won't affect paramedics.

Bruce Squires, vice-president of women and children's health at Hamilton Health Sciences (HHS), said in a Thursday town hall that the hospital network has come up with a framework to prepare for the shifts.

In the worst case scenario, some out-patient services would be cut by 50 per cent. There would also be "significant cancellations" of clinic visits and an increased wait list, which would lead to more emergency visits and in-patient admissions.

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"We're doing it where it assists in meeting our human health resources needs, always with a balance to how can we support continuation of care through virtual care and what are the impacts on any care that cannot continue on the health and well-being of our patients and their families," he said.

But Squires emphasized scheduled ambulatory visits are still proceeding right now and families should only be concerned unless they're directly told otherwise.

The memo from St. Joe's stated COVID-19 cases in hospitals and the community are also causing more health-care workers to quarantine. And without staff, hospitals can't add more beds for patients.

As of Friday, there are 24 staff and doctors with the virus and 186 staff self-isolating. There are also 120 people with COVID-19 in Hamilton hospitals.

Ramping down surgeries and other services

Surgeries are also being reduced to help free up staff. St. Joe's will scale back and postpone elective surgeries and non-urgent procedures, including:

• Hip and knee operations.
• Weight-loss surgery.
• Non-cancerous bowel surgery.
• Gynecology.
• Some cataract and endoscopy procedures.

"While St. Joe's had increased its surgery capacity to as high as 109 per cent of usual operations to address the backlog created by the first wave, today we are operating at about 55 to 65 per cent capacity, dependent upon the day," the memo said.

"We recognize the impact this has on our patients, are monitoring this closely and will increase volumes again as soon as possible."

At HHS, adult surgical capacity at the Juravinski Hospital and Hamilton General Hospital will be reduced by 35 per cent. Surgery capacity for adults at McMaster University Medical Centre will fall by roughly 25 per cent.

Endoscopies, heart rhythm procedures and operations at the heart investigation unit are dropping by 50 per cent.

HHS also listed other measures it is taking to open up staff, including:

• Temporarily closing the West End Urgent Care Clinic as of Monday, April 19. The COVID-19 assessment centre remains open at this location.
• Temporarily closing the West Lincoln Memorial Hospital operating rooms, and redirecting the site obstetrical service to Niagara Health as of Friday, April 16 at 3 p.m.
• Reducing Regional Rehabilitation Centre capacity by 50 per cent over the next week.

Hospitals opening up more ICU beds

Data presented during the St. Joe's town hall showed as of Tuesday, there are 76 critical care beds within Hamilton, St. Catharines, Burlington and Brantford.

Sharon Pierson, HHS chief operating officer and executive vice-president of clinical operations, said in a Thursday town hall meeting that the hospital network has opened up 12 ICU beds with plans to open up 18 more next week.

Meanwhile, St. Joe's is looking to add 12 more critical care beds next week, according to its town hall on Friday. It is also increasing its COVID-19 unit from 45 beds to 65 beds.

The St. Joe's memo states its intensive care unit has been operating at between 90 and 100 per cent capacity most days, as well as its medical and surgical beds. It states the number of COVID-19 cases, especially variants of concern and ill patients, are creating "dire pressures."

"Locally, we are seeing increasing COVID cases. St. Joe's two testing centres have been experiencing climbing demands and positivity rates since the beginning of March," read the memo.

"We also operate as part of a provincial hospital system, and this region has been accepting patient transfers of COVID-19 patients since early January, totalling 91 to the region, 20 of those patients to St. Joe's."

Pierson, of HHS, said the hospital network has seen 24 of those 91 patients, and the majority have gone to Joseph Brant Hospital in Burlington.

Patients from other regions expected to keep coming

Dr. Dominik Mertz, HHS medical director of infection prevention control, said during the HHS town hall that hospital admissions will likely rise because of patients from other regions.

"Many of the regions around us are seeing a steeper increase in case numbers than we do currently ... the load balancing within the province, in particular ICU patients coming in from the GTA [will] continue."

"With that, we will probably continue to see an increase in admitted patients, but not necessarily Hamiltonians."

St. Joe's executive vice-president, Dr. Cheryl Williams, also shared data during the Friday town hall that showed in the past week there have been there have been 36 patients from out of the region transferred to HHS, St. Joe's, Joseph Brant Hospital in Burlington, Brantford General Hospital and the Niagara Health site in St. Catharines.

Of those transfers, 24 arrived in the last 48 hours.