Thunder Bay Regional breaks gridlock record

Thunder Bay Regional Health Sciences Centre has established a new record for overcapacity.

For five straight weeks and counting, the hospital has been in gridlock, meaning there are at least 10 patients in the Emergency Department who have been admitted, but there are no beds available for them in the inpatient units

Rhonda Crocker Ellacott, executive vice-president of Patient Services and chief nursing executive, told CBC News that Wednesday was an especially challenging day, with close to 30 admitted patients in the Emergency Department waiting for beds. 

"It is very, very tight right now," she said. "Essentially, we're using every available space... not hallways, but every other available space to manage our patient care needs."

Crocker Ellacott said for months, the hospital has taken several measures to manage the gridlock, including converting family waiting rooms into patient rooms, establishing additional short-stay beds and treating patients with Chronic Obstructive Pulmonary Disease [COPD] in their homes through telemedicine. 

But hospital management has repeatedly said that the only permanent solution to the gridlock problem is to free up dozens of inpatient beds occupied by alternate level of care [ALC] patients. Those are patients who no longer require medical treatment in an acute-care hospital, but can't be discharged until other care facilities — usually long-term care homes or rehabilitation facilities — have space for them. 

Cancelling elective surgery 'a last resort'

Crocker Ellacott said a shortage of long-term care beds in Thunder Bay is creating "somewhat [of] a domino effect" because when ALC patients have to stay in hospital beds, there isn't enough room for new patients coming from the Emergency Department.

She said on Wednesday, there were 77 ALC patients in the hospital waiting to be discharged to other care services in the community.   

The NorWest Community Health Centre in Thunder Bay is trying to help relieve the pressure on the hospital. 

In December, it opened its urgent care clinic on weekends to take on patients who might otherwise go to the Emergency Department. 

NorWest's director of clinicial services, Juanita Lawson, said most weekends, the clinic has been full. 

"[We see] the standard walk-in issues: colds, coughs, flus, sore backs, wounds, suture removals," Lawson said. "There definitely is a demand." 

Crocker Ellacott said it's too early to tell if the clinic's extended hours are making a difference in the hospital's Emergency Department traffic, but any additional primary care service that patients can go to in the community is helpful. 

But she added that the overcapacity crisis is due more to the ALC patients who can't leave, rather than the volumes of people coming in. 

Crocker Ellacott said two weeks ago, the hospital had to cancel some elective surgeries to free up some beds — a move she said staff try very hard to avoid.

"[Cancelling surgery is] really a last resort," she said. "It's days where we end up doing patient surgeries and then patients wait in the recovery room for a very, very long time ... because there are no beds on the inpatient units to move these patients to."