How Ontario’s next government could relieve overcrowded hospitals

By THERESA BOYLE Health Reporter Sun., June 3, 2018

[Excerpts] The number of patients who occupied hospital beds even though they no longer required hospital care hit a record level in Ontario this past winter, the Star has learned.

As a result, emergency room wait times also hit an all-time high.

Almost 5,000 patients, most of them frail and elderly, were stuck in hospital beds because long-term-care homes were full or because it was unsafe for them to return home without more support, according to newly audited data from the Ontario Hospital Association (OHA) and the province’s Health Ministry.

This caused a bottleneck for patients admitted to hospitals through emergency departments. The 90th-percentile wait time for transfer to an in-patient bed was 40.9 hours, meaning 90 per cent of patients waited less than that time before being admitted.

It’s not surprising then that “hallway medicine” has become a major theme in the June 7 provincial election. There has been a lot of talk on the campaign trail about hospitals housing patients in “unconventional spaces” such as bathrooms and storage rooms. Health care always ranks as a top concern among voters, but rarely gets this kind of attention.

While health-care leaders are pleased that the topic is being debated, they are disappointed by the simplistic solutions being offered. The health system is struggling to meet today’s demands and is nowhere near prepared for the challenges that will come in 20 years, when the number of seniors will double, they warn.

“It is refreshing that for the first time in a political election we are talking about bed capacity,” said Alan Drummond, an emergency doctor from Perth, Ont., and spokesperson for the Canadian Association of Emergency Physicians. “But we’re just reacting. We’re not planning.”

Dr. Danielle Martin, vice-president of Women’s College Hospital, says Ontario’s health system is built upon a “20th-century model” and requires “21st-century solutions” to work better. She said there are many demonstration projects and areas of excellence that should be scaled up. They achieve the triple aim of reducing costs, improving patient outcomes and enhancing patient experiences, she said. One solution to improving hospital wait times is, interestingly, not investing in hospitals but instead building community resources such as “transitional spaces” for patients who no longer require hospital care and are waiting to move into long-term-care homes or other settings.

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