'Unprecedented': Halton hospital emergency departments under extreme pressure due to high patient volumes and staff shortage
Hospital emergency departments are stressed across Ontario and here in Halton the situation is no different.
On Monday, July 18, Halton Healthcare took to its Facebook account to advise residents that the emergency departments at its hospitals in Oakville, Milton and Georgetown are under extreme pressure.
We are facing a nursing shortage, while experiencing a high volume of patients needing care," reads the online post.
At times, we do not have enough staff to service all areas of the ED (Emergency Department). This is resulting in longer wait times and the temporary reduction of our treatment areas. Everyone is working tirelessly to ensure patients receive the care they need. Please be kind."
Halton Healthcare staff were unable to provide an average wait time for their emergency departments and monitors within the waiting rooms that normally tell people how long it will be before they can see a doctor are no longer providing this information.
Patients are prioritized based on their needs when they arrive," said Cindy McDonell, senior vice president of clinical operations, Halton Healthcare.
This means the sickest people will be seen first and those with less serious medical concerns may wait longer."
McDonell noted Halton Healthcare emergency departments have experienced unprecedented" staffing and patient volume pressures.
On the staffing side, Sharon Norris, Halton Healthcare's vice president of human resources, noted that while Halton Healthcare continues to attract and recruit staff, there is a limited number of experienced health-care workers available to recruit across Ontario and Canada.
McDonell said COVID-19 continues to play a significant role in the staffing shortage.
The rate of COVID-19 related hospital staff absences is similar to the level of illness that is being seen in our communities and impacting other businesses and services beyond health care," said McDonell.
This number also fluctuates on a daily basis. As of July 22, there are 84 staff across all three hospitals unable to work due to COVID illness or isolation requirements. Absences for COVID-19 in hospital staff results in an extended isolation period and the need to stay home - for safety and to prevent further infections within the hospital - and contribute to the staffing challenges."
Joan Jickling, Halton Healthcare senior vice president of patient engagement and chief nursing executive, said another major problem is that the three emergency departments have seen an increase in the number of sicker patients who require longer stays in the emergency department for diagnosis and treatment.
From April 1 to June 30, Jickling said Halton Healthcare's emergency departments saw a 21 per cent rise in these higher acuity patients, including: an 11 per cent increase at Oakville Trafalgar Memorial Hospital, a 35 per cent increase at Milton District Hospital and a 29 per cent increase at Georgetown Hospital compared to pre-pandemic volumes.
During the same period, the number of patients in the emergency department who have been admitted and are waiting for an in-patient bed has also increased from a daily average of 19 per day pre-pandemic to a daily average of 42 per day across the three emergency departments," said Jickling.
What higher patient numbers and lower staffing numbers means for Ontario's hospitals can be seen in the story of Idalina Lima Matias who responded online to Halton Healthcare's Facebook post.
Two weeks ago, I ended up in the ER on a Thursday afternoon and the waiting room was packed. There was one lovely patient nurse taking blood for all those patients, working swiftly, efficiently and patient with her patients," wrote Matias.
My heart went out to her as her plate was full - I would be surprised if she had time to go to the bathroom. Unfortunately, we were there for 11 hours - not due to the staff but the lack of staff. Our health-care system needs help."
The situation facing Halton Healthcare is reportedly the same at Joseph Brant Memorial Hospital in Burlington.
Staff at that hospital said they too are facing higher than normal patient volumes and a larger number of patients with more serious conditions.
Acute care bed occupancy at Joseph Brant Hospital reportedly exceeded 100 per cent in July.
The hospital's workforce vacancy rate is at 8.82 per cent with 40 healthcare workers off work due to COVID-19 as of Aug. 3.
Hospital staff noted nurses, laboratory and diagnostic imaging technicians, respiratory therapists and many other important healthcare professionals are in short supply at Joseph Brant and in hospitals across Ontario, meaning front-line staff are stretched thin.
On top of this there are approximately 2,655 people waiting for surgery at Joseph Brant Hospital.
Our staff and physicians have been through a gruelling two-and-a-half years. We are so grateful to them for their hard work and unwavering commitment to caring for our community," said Joseph Brant Hospital president and CEO Eric Vandewall.
Our community has also stood behind us throughout the pandemic and their support has meant so much. We thank you and ask for your patience and understanding as we work through these challenges."
When it comes to fixing the problem Jickling noted this is a highly complex provincial and national issue that will require a system response.
In the meantime, she said Halton Healthcare is doing all it can to find more staff, including leveraging programs to integrate internationally educated nurses as well as novice and pre-licensure practitioners (nursing students and students from other health disciplines) through Ministry of Health sponsored initiatives.
Jickling also noted enhanced training for nurses is ongoing so they can work in specialty areas, including critical care, the operating room and the emergency department.
To address patient capacity pressures, we have implemented an innovative remote monitoring program. This program supports the early discharge of patients home where they are provided with Bluetooth enabled, physiological monitoring devices connected to a virtual care team who monitors and supports them through their recovery," said Jickling.
This has been an important strategy to serve patients recovering from COVID as well as patients with chronic medical conditions such as congestive heart failure, chronic obstructive pulmonary disease and other respiratory illnesses."
McDonell said that while Halton Healthcare's emergency departments are busy, as of Aug. 2, it has not been necessary to close any of them completely.
That said, she pointed out people with less serious health concerns should consider all of the health-care options available in the community.
This might include calling a family doctor, talking to a pharmacist or going to an urgent care centre or walk-in clinic.
Telehealth Ontario is also an option where people can speak to a registered nurse 24 hours a day, seven days a week," said McDonell.
When asked what the province is doing to relieve the pressure in Ontario's emergency departments, Oakville MPP Stephen Crawford said the province has built unprecedented hospital capacity since the start of the pandemic, including a $5.1-billion investment to build 3,500 beds across the province.
He also said the province is offering cash incentives to nurses, recruited and trained more than 5,000 nurses and registered practical nurses and 8,000 personal support workers and will add hundreds of medical school positions over the next five years.
We will continue to work with the health-care sector to ensure Ontarians can continue to count on the care they need and deserve," said Crawford.
STORY BEHIND THE STORY: With local hospitals reporting their emergency departments are under extreme pressure, we wanted to talk to local health-care officials to determine exactly what that means and how the problem is being dealt with.