Hamilton Health Sciences has 270 patients stuck in hospital awaiting other types of care

Hamilton Health Sciences (HHS) has more patients stuck in hospital while waiting for other types of care than any time in the last seven years.

They keep redefining who should be moved out of hospital to be more and more complex patients," said Natalie Mehra, executive director of the Ontario Health Coalition. There's nowhere for them to go."

About one in five of the hospital network's beds are taken up by those ready to be discharged - patients known as alternate level of care (ALC) - but unable to leave because they are on long wait lists for services in the community such as long-term care, home care, rehabilitation, complex continuing care and mental health care.

It's a chronic problem that has now climbed to 270 patients stuck at HHS alone, according to a statement by the hospital network. It's such an issue that HHS and St. Joseph's have been using the former Crowne Plaza Hotel at 150 King St. E. as a satellite health facility for ALC patients since October 2020.

The satellite health facility expanded beyond its 150-bed limit in September and still doesn't come close to housing all of the ALC patients at HHS and St. Joseph's.

A controversial bill meant to move seniors waiting for long-term care into the first available bed - even as far as 70 kilometres away in southern Ontario - hasn't appeared to alleviate the ALC issue in Hamilton.

The Conservative government passed Bill 7, the More Beds, Better Care Act, that allows hospitals to charge ALC patients who refuse to go to long-term care $400 a day starting Nov. 20.

It was never going to work," said Mehra. What it did do was strip the fundamental rights to consent away from the elderly in hospitals - just appalling."

HHS did not respond by deadline to questions about whether it has used the bill and how often. The Ministry of Long Term Care also didn't provide answers by deadline about why ALC has become worse in Hamilton since the bill was enacted.

A Spectator investigation in September showed long-term care homes in Hamilton, Burlington, Haldimand, Norfolk, Brant and Niagara all had long waiting lists, raising questions about where ALC patients would be sent.

It doesn't address the core problem," said Mehra. The hospitals have been downsized beyond all reason. They're too small to meet the population need. The other problem is we don't have enough long term care beds ... There are severe problems in home care as well."

All of these issues are set against a back drop of an unprecedented staffing crisis in all parts of the health care system.

The provincial government has to step in and do a massive recruitment," said Mehra.

The results of these long standing gaps that have been exacerbated by the pandemic can be seen in the current strain at HHS.

Occupancy was 113 per cent at Juravinski Hospital, 104 per cent at Hamilton General Hospital and 102 per cent at McMaster Children's Hospital as of Friday. Hospitals are full at 100 per cent so anything above that requires opening beds not funded by the province and finding a way to staff them.

Frontline teams across HHS continue to face inordinate pressures, which are affecting services," the hospital network said in a statement. Sicker patients, with more complex health issues, combined with ongoing workforce and capacity pressures, are resulting in longer wait times for care and limiting our ability to return surgical activity to pre-COVID levels."

HHS is doing 85 per cent to 90 per cent of the number of operations it did pre-pandemic despite having a backlog of more than 8,000 surgeries as of March 2022.

The overcrowding is also affecting the intensive care unit (ICU) which was at 110 per cent occupancy at Hamilton General on Feb. 8.

The ICU numbers are pretty alarming," said Mehra.

HHS has implemented a number of measures to try and deal with the most recent strain including:

• Caring for patients overnight in units normally only open during the day and in off-service areas such as the Regional Rehabilitation Centre;

• Opening beds and maximizing physical space;

• Doing fewer planned surgeries that require a hospital stay in favour of those that don't. Emergent and urgent cases remain a priority;

• Increasing physician support in general internal medicine and emergency departments.

We are also working hard to recruit staff needed to fill vacancies in our hospital, and continuing to work with our internal teams and external partners, including government, on a daily basis to further address the persistent capacity challenges in our region," said HHS.

Mehra also questioned whether public health should be doing more around measures like masking during viral season to take the load off of hospitals.

If it's jeopardizing surgeries for people in need, surely we can explain to the public in a way that people understand and would do it," she said.

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