Referrals of rural Sask. patients to city hospitals causing ER backups in urban centres: SHA report

Emergency rooms in Saskatoon and Regina are clogged due to high volumes of traffic from people seeking care in larger urban hospitals, rather than the hospitals closer to their homes.

That was one of the main findings in a report compiled by the Saskatchewan Health Authority, released Thursday, which looked at issues around patient flow and capacity at the province's major urban hospitals.

The report included reviews by the American health-care company GE Health Care, which did a recent review on the challenges creating capacity issues in the Saskatchewan health system, and Accreditation Canada. That not-for-profit, which works with policy makers to improve the quality of health care, completed a recent survey and on-site evaluation of emergency department and critical care services in Saskatchewan.

The report found that "all roads lead to tertiary hospitals," or those that provide care by specialists after referrals from smaller hospitals, as patients are often referred to Saskatoon, Prince Albert and Regina, even if appropriate rural or community alternatives are available.

Saskatchewan Health Authority CEO Scott Livingstone said at a Thursday news conference that the report "highlights one of the areas that we're going to be focusing on over the next few months … how we ensure that the provincial capacity that's already available, both in acute care and in other areas, is utilized to its maximum."

Livingstone said right now, there are patients literally driving by facilities with open beds to seek care in Saskatoon and Regina.

In the past, prior to their amalgamation, Saskatchewan's health authorities focused more on who attends emergency rooms as they attempted to relieve issues around patient capacity, Livingstone said. But now that the province's health-care system operates under one authority, the SHA has a better sense of what's behind the delays, he said.

"What is it that's driving those people to emergency rooms? What are their care needs and how do we, as an organization, better serve them?" Livingstone asked.

"Obviously, they're going [to urban emergency rooms] for a reason. We want them to receive care, but we know that based on how they're being triaged … that's not where the care should be provided."

The health authority has already started working to address the issues outlined in the report, Livingstone said, and one of its main priorities is the Connected Care Strategy, which will create health networks across the province.

The networks will be made up of multi-disciplinary teams, both in acute care and in the community, with the aim of eliminating barriers in rural Saskatchewan around the recruitment and retention of skilled medical staff.

Currently, there are vacancies all over the province.

Livingstone said the strategy should result in a "levelling out" of staffing levels in smaller communities, because although part-time positions for things like respiratory therapists are usually "virtually impossible" to fill in rural areas, health networks would see full-time resources dispatched to communities in need.

"If a community that is covered under the network needs that type of resource, they can pull it down from the network level without having to try to recruit it, and it will be a way for us to serve those communities better," he said. 

Saskatchewan Health Minister Jim Reiter thanked the health authority for its review, saying he received the document on Thursday. 

"I will be discussing the review with senior officials in the coming days," Reiter said in the statement. "Our government supports the efforts of the SHA in addressing overcapacity issues."

He also the province plans to make an announcement about additional hospital beds for Saskatoon on Friday, which will help address capacity issues in the city.