January 8, 2009

A lack of long-term care accommodations in the region has resulted in overcrowding at Renfrew Victoria Hospital, with newly-admitted patients receiving care on gurneys in the emergency department.

“Patient safety continues to be our first priority, and we are doing everything we can to provide appropriate health care while maintaining our patients’ comfort and dignity,” says CEO Randy Penney. “However, we are facing unprecedented demands with limited resources, and the emergency department is invariably where the pressure builds.”

Penney adds that the overcrowding is affecting every area of the hospital’s operations, and limiting the hospital’s capacity to maintain its high standards of care for patients throughout the facility.

“Our ability to deal with urgent situations in areas like dialysis and oncology is affected,” he says. “Every department is feeling this stress.”

The root of the problem is a shortage of long-term care accommodations. Patients who are ready for discharge from hospital, but who are unable to return to an independent living arrangement, have nowhere to go. For a variety of reasons such as confused mental states, incontinence, or inability to move without assistance, these patients cannot take advantage of community-based programs that have been developed through previous government investments.

“The hospital sector gets caught in the middle,” explains Nancy Kelly-Moore, vice-president of patient care services at RVH. “These patients have come to us for necessary health care, but they no longer need care in a hospital setting. However, their situation is such that it would be unsafe for us to discharge them, so they stay with us until a long-term care placement is available.”

That wait can be several months. Patients and families are advised to apply for long-term care six months in advance of their actual need for a placement, but the wait often takes two to three times longer than that. One patient at RVH, for example, was put on the list for long-term placement last July. As of January 6, there were still 51 candidates ahead of her on that list.

On the same day, 50 per cent of RVH’s acute care beds were occupied by similar patients waiting for an opening in a long-term care facility.

“With those beds full, we have no place to appropriately accommodate patients who are being admitted to the hospital because they are in need of acute care,” Kelly-Moore notes.

Those newly-admitted patients end up on stretchers in the hallway or in the emergency department.

Hospital administrators are exploring all options to alleviate the situation. With other hospitals throughout the province facing the same crunch, there are no easy solutions. Attempts have been made to transfer acute care patients to Ottawa facilities, but they are also overcrowded and respond by pressing community hospitals to take back other patients who have previously been sent there.

The only potential solution may be to cancel some elective procedures in order to free up equipment and space for patients in need.

“We are weighing all the options and doing everything in our power to reduce the level of stress and inconvenience,” says Penney. “Our staff are continuing to provide excellent care under very trying circumstances, and we commend them for their poise and perseverance.”

“The only real solution to this problem is to develop more long-term care accommodations,” he concludes. “The government has invested heavily in community-based care to alleviate the pressure on long-term care facilities, but more investment is needed. Our hospital leadership will continue to work with our health care partners and the Champlain Local Health Integration Network to ensure that these needs are recognized and our area gets the support it needs to provide the care our community requires and deserves.”

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(For more information contact Randy Penney, CEO,
Renfrew Victoria Hospital, 613-432-4851, ext. 260.)