Ontario hospitals allowed to transfer patients without consent

The Ontario government's health agency has issued two emergency orders to help hospitals cope with a surge in COVID-19 hospitalizations and intensive care admissions that is threatening the province's critical care capacity, the Ministry of Health said in a news release Friday. 

One order allows hospitals to transfer patients without their consent if those facilities are in danger of being overwhelmed. This is the first time such an order has been made during the pandemic

The other allows the redeployment of health-care professionals and other staff who work for the province's community care agencies to work in hospitals.

"With Ontario's hospitals facing unprecedented critical care capacity pressures during the third wave of the COVID-19 pandemic, our government is taking immediate action to ensure no capacity nor resource in Ontario's hospitals goes untapped," Minister of Health Christine Elliott said in the release.

In an exclusive interview with CBC News on Friday evening, Elliott said the province is concerned about the increasing number of COVID-19 cases driven by the variants of concern, which are deadlier and result in more hospitalizations and ICU admissions. 

The province reached a record number of 552 people with COVID-19 in ICUs on Friday. 

Boosting capacity

Effective immediately, health-care professionals and other staff with Ontario Health and Home and Community Care Support Services organizations will be provided the authority to voluntarily deploy staff, such as care co-ordinators, nurses, and others, to work in hospitals that are experiencing significant capacity pressures due to COVID-19.

Elliott said these staff members would work primarily as ward nurses to allow nurses currently in those hospitals who have intensive care experience to move to those units. 

She didn't have an exact number of workers who could be redeployed, saying: "We're not looking at huge numbers of people but any assistance that we can get will be most welcome." 

The organizations will also be authorized to deploy staff to backfill redeployed staff within and to another Home and Community Care Support Service organization.

During surges when the demand for critical care threatens to overwhelm a hospital, hospitals will be allowed to transfer patients without obtaining their consent or, when the patient is incapable, their substitute decision maker's consent. 

The attending physician must be satisfied the patient will receive the care they require at the other site, and that the transfer won't compromise the patient's condition. 

After the surge, the other hospital would be required to make reasonable efforts to transfer the patient back to the original site, or to another suitable location, with the proper consent, as soon as possible, the government says. 

Elliott says the non-consenting transfers will only be done in extreme circumstances, adding that no hospital in the province has neared this capacity level yet. However, she noted that it's a waiting game as numbers are expected to increase in the next short while. 

These orders are expected to increase ICU capacity in Ontario by up to 1,000 beds, the news release reads. The orders will remain valid for 14 days unless revoked or extended, the government said. 

Over the last year, the government has created over 3,100 more hospital beds. 

"Now we know that we need to take more steps and increase capacity again," Eliott said. 

She added that these measures will help to ensure that hospitals continue having adequate staffing and resources to care for patients. 

Hospitals have also been told to ramp down all elective surgeries and non-urgent activities in order to preserve critical care and human resource capacity, effective Monday.

"We understand that deferring scheduled surgeries and other procedures will have an impact on patients, their families and on caregivers. We are monitoring the situation and will work to resume as soon and as safely as possible these deferred services and procedures," said Matt Anderson, CEO of Ontario Health.

Elliott said this order will create between 700 to 1,000 more spaces in hospitals that will be used for COVID-19 patients.