N.B. hospital patients will jump the line for nursing homes
Extreme measure needed to relieve unsustainable pressure on regional hospitals, says Horizon CEO
Horizon's four regional hospitals are in such a critical state of overcapacity, trying to cope with a record number of patients who really belong elsewhere, the CEO is calling on the province to bump those patients ahead of other New Brunswickers waiting for placements in nursing homes and other community care.
Margaret Melanson says more than 650 people who have no medical reason to be in the hospital are nonetheless there, taking up acute care beds, and it's having a profound impact throughout the hospital system.
"It means fewer beds for patients who need surgery," she said.
"It causes emergency department wait times to grow longer. It forces care to be delivered in hallways, dining areas, lounges, and other makeshift spaces — conditions that are far from ideal for patients, families, and staff."
Pushing these patients, mainly seniors, to the top of the waitlist for nursing home beds, is a measure of last resort, Melanson said.
"But we are now at a point where no other option exists."
Nursing home admissions are normally done chronologically.
However the minister of social development can prioritize admissions when requested by a regional health authority.
Minister agrees to fast-track patients for 30 days
Social Development Minister Cindy Miles confirmed Thursday that in response to Horizon's request, her department will prioritize patients at the Dr. Everett Chalmers Regional Hospital, the Saint John Regional Hospital, the Upper River Valley Hospital and the Miramichi Regional Hospital.
She couldn't say how many transfers to expect over the next 30 days
"You're looking for some hard numbers. I don't have those for you right now."
Horizon says the measure was last taken in January 2024, allowing 23 patients to be transferred out of the Saint John Regional and 52 patients to be transferred out of the Chalmers.
The issue of so-called bed-blockers has been building for decades, although the term is no longer used because it suggests the patients are at fault.
Health-care workers now refer to them as ALC patients, or alternate level of care patients.It's not exactly clear why the four hospitals are seeing record numbers of ALC patients now, but Horizon says they occupy about 40 per cent of available hospital beds.
Rising pressure in ER
That creates pressure all the way down to the emergency room, says Dr. Yogi Sehgal, a physician in emergency medicine at the Chalmers Hospital in Fredericton.
He said patients have been waiting up to 15 hours to be seen, and this is unacceptable.
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"In the last few weeks it's been surprisingly bad," Sehgal said. "We were just jam-packed with admissions continuously.
"And as much as people are doing really hard work to try to get patients out of the emergency room and get patients out of the hospital as quickly as possible, it backs up so quickly."
Sehgal is optimistic that the trend toward collaborative care will relieve some pressure on the system as new team clinics come online and pick up momentum.
Meanwhile, he said, the province really needs more nursing home beds or some kind of facilities where ALC patients can be cared for, outside the hospital system.
Dr. Fraser MacKay, chair of the rural, remote and small urban section for the Canadian Association of Emergency Physicians, said that overall, Canada has seen a decreasing number of hospital beds in proportion to the growing population.
National crisis gets emotional
He said the number one problem in emergency medicine is blocked access to care. Many patients admitted to hospital cannot get out of the emergency department because they have no place to go.
"It's very emotional. It's very hard on all staff, on all patients and all families," MacKay said.
MacKay said the system really needs some permanent structural change, and all departments need to come together to figure out long-term solutions.
"Until that happens, we just keep rolling deeper into our crisis."
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