Horizon and Vitalité scramble to fix ER overcrowding

Hospitals in New Brunswick are running over capacity, with long waits in emergency rooms, because too many seniors are in hospital beds who don't need to be, says the chief of staff of Horizon Health Network.  

Dr. John Dornan says about 24 per cent of beds are occupied by people who need an alternative level of care. These patients require places in the community such as nursing homes or other specialized assistance.

They aren't acutely sick but are not well enough to return home, he said.

Overcrowding is a sign of the times, and it's up to the provincial and federal governments to fix that "paradigm that comes with an aging population," Dornan said.

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"Because our population is getting older, there are more people that need nursing home care," he said in an interview with Information Morning Fredericton.

"We just don't have the number of nursing homes in our community to deal with such folks. So they stay in hospital because they get safe care in hospital, but what happens is they consume a large number of our acute-care beds."  

Kept in hallways 

At the Dr. Everett Chalmers Regional Hospital in Fredericton, wait times in the ER are as long as 7½ hours, while doctors and nurses work with the resources they have.

Some patients are spending up to three days in a hallway, where there's no privacy, because no rooms are available.

Meanwhile, other hospitals care for patients in rehab rooms, and some clinics end up re-purposing areas over the winter months.

This time of year, Dornan said, a lot of people are in hospitals because of flu-like illnesses that require admission but there aren't beds for them.   

"They clearly require hospital care and are in our emergency departments," he said. We then have fewer beds to work with within the emergency department."

And sometimes it's not the infrastructure that's the problem but the lack of staff.

"Sometimes we identify space where we put patients but it's of little value if we don't have the appropriate nurses for that area," Dornan said.

"We would like every patient to go straight to a bed on the floor," he said.

Other hospitals affected 

Some hospitals in the Vitalité Health Network are dealing with similar problems and are sometimes forced to postpone non-urgent surgeries for patients.

Crowding in smaller places such as Sainte-Anne-de-Kent, Tracadie and Campbellton fluctuates, depending on the day.

"You can be in over capacity now and then in two hours, not be," said Allison White, director of nursing for the Vitalité Health Network. "It all depends on what's coming into our facilities."

Across the health network, 26 per cent of patients were waiting for nursing homes in the first quarter of last year, and 29 per cent of services were waiting in the second quarter. Vitalité said results from the third quarter are not yet available.

The overcrowding within Vitalité can be attributed to waits for nursing-home beds and to the number of people who need admission to hospitals. 

"The patients that are waiting for nursing home beds are patients that we can't discharge because we don't have any area to discharge them," White said. "They have to stay within our facilities until there is a bed available."

According to Vitalité, the number of patients waiting for nursing homes each month will vary across the province. The most recent figures:

• Chaleur and Acadian Peninsula: 63 patients
• Moncton: 46 patients
• Restigouche: 35 patients
• Edmundston: 19 patients

Most of the time, patients needing nursing home beds wait three to six months, but some wait longer, officials said. 

Both New Brunswick health networks have been working with the province to increase the number of nursing home beds and acute care beds in hospitals. 

Overcrowding occurs in other parts of Canada as well.   

"It's an issue that is going on across Canada and not just typical to New Brunswick," White said.