‘Perfect storm’ leads to cancelled surgeries and long waits at Hamilton’s overcrowded hospitals

Hamilton's hospitals are cancelling surgeries, pausing programs and warning about increasing wait times as they struggle to cope with an unprecedented staffing shortage, significant spikes in demand and the ongoing pandemic.

It's a perfect storm leading to a situation we haven't seen in the past," said Dr. Greg Rutledge, chief of emergency medicine at St. Joseph's Healthcare.

The hospital crisis is provincewide, with union leaders sending open letters Thursday to Premier Doug Ford, and the Ontario Hospital Association calling for transparency and immediate action.

We are alarmed that to date we are seeing no sense of urgency from the provincial government in the face of an unprecedented threat," said Michael Hurley, president of the Ontario Council of Hospital Unions, which is part of the Canadian Union of Public Employees. It's not acceptable that ER wait times in major urban centres are skyrocketing or that other vital patient services are being closed to sustain emergency operations ... We are very concerned that without a meaningful action plan conditions will deteriorate further in our hospitals."

A registered practical nurse with 35 years experience got emotional when she talked about what it's like for hospital staff at a media conference put on Thursday by CUPE and SEIU Healthcare to bring attention to the precarious situation.

While still dealing with a pandemic in the seventh wave, my hospital and a majority of hospitals across Ontario are in full-blown crisis mode," said Pam Parks. We are on life support because there just aren't enough of us to deal with patients coming into the hospitals."

Hamilton Health Sciences (HHS) and St. Joseph's gave a stark description of the pressures they face in the emergency department alone:

• Hamilton General Hospital was designed to accommodate 100 patients per day, but currently sees about 121;

• Juravinski Hospital has capacity for 85 patients a day but is getting 108 instead;

• St. Joseph's had 5,127 patients come to the ER in May and June compared to 4,663 during the same time in 2019 - an increase of 464 patients;

• The King's Campus urgent care saw 6,182 patients in May and June compared to 4,707 during the same time in 2019 - a rise of 1,475 patients.

St. Joseph's also reports referrals to mental-health care have shot up 44 per cent from December 2019. Self-referrals are up 82 per cent. The wait for an assessment has increased by 55 per cent.

We're having more and more patients showing up," said Dr. Khalid Azzam, physician-in-chief at HHS. These patients have been struggling through the pandemic ... and not having, at times, access to care with all of our reducing services in previous waves. Patients are sicker, the surgical backlog is huge."

At the same time, Hamilton's hospitals have 675 job openings they can't fill despite aggressive recruitment efforts. In addition, there was 341 staff self-isolating due to COVID as of Thursday.

It's such an extreme shortage of human resources," said Rutledge.

It has left the remaining staff feeling demoralized, exhausted and undervalued," said Parks.

The result of the crisis was 16 cancelled surgeries in four days as of Thursday at HHS. It comes at a time when Hamilton's hospitals have a pandemic backlog of over 12,000 procedures. At HHS alone, 1,396 kids and 6,053 adults were waiting for surgery as of June.

Things are compounding," said Azzam. We are stuck in a situation we have never seen before. The uncertainty we feel currently is similar to what we felt two and a half years ago when the pandemic started, because we're not sure where we are going from here or how we can fix it."

The pressure building in the system is not limited to hospitals. St. Joseph's has one in four beds taken up by patients ready for discharge but waiting for care in the community - such as long-term care, complex continuing care, rehabilitation or home care. At HHS, it's about one in six adult beds.

It leaves the hospitals with no surge capacity to cope with the ongoing waves of the pandemic. Occupancy has been around 125 per cent at Juravinski Hospital, 112 per cent at Hamilton General and 100 per cent at St. Joseph's. Ideal is 85 per cent.

As a result, HHS has been operating 82 beds that are not funded by the province - it's equivalent to a medium-sized hospital.

All of these issues have been a problem for more than a decade, but the pandemic - now in an earlier-than-expected seventh wave - has brought the situation to a head.

The pandemic has exacerbated what we've had as a problem in our health-care system and it's actually exposed more issues," said Azzam.

Rutledge says COVID has made clear the precariousness" of hospitals that run so tight to the edge.

Both doctors plead for Hamiltonians to be patient and understanding when they encounter long waits, cancelled procedures and paused services.

Every day, we're caring for more patients than our staff have the capacity to care for," Sharon Pierson, chief operating officer at HHS, said in a statement. Hamilton's health-care system, like all hospitals in the province, is in a very precarious position."

Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com