The growing strain on Ontario’s health care system represents a true “crisis,” the province’s top health chief said Wednesday, even as the Ford government tried to play down the seriousness of the situation.
“The business of health care continues, but the pressure and the crisis that we feel, I think we all feel on the front lines, is very real. So the crisis is fair,” Ontario Health Executive Vice President Dr. Chris Simpson said in an interview with CP24.
Simpson said many of his experienced colleagues have consistently said they have never seen anything like this in their careers, given the severe strain on the health care system.
“We can’t really state strongly enough the extraordinary pressure that the system is under,” he said. “The pandemic kind of ripped and ripped and ripped and exposed problems that have been coming for many, many years in the system.”
Hospital shortages have been reported across the province over the past few months, causing emergency and intensive care units to temporarily close at or dangerously close to capacity.
“We’re at a point now where I think everybody feels it very, very acutely and the system is functioning now, frankly, through the extremely hard work and professionalism of the people working in the system and the leaders in hospitals and other health organizations across the province.” , Simpson said.
AVERAGE ED WAIT TIME IS OVER 20 HOURS IN MAY
Ontario Premier Doug Ford finally addressed the situation Wednesday at a news conference in Stratford, but downplayed the seriousness of the problem.
Speaking to reporters, Ford said “Ontarians continue to have access to the care they need, when they need it.”
He said “we can always strive to be better,” but pointed to the fact that nine out of 10 patients who visit Ontario emergency rooms for acute care complete their visit within the target time of eight hours.
However, this figure only tells part of the story.
According to the most recent data (May 2022) on provincial emergency rooms from Ontario Health, 89 per cent of those who require highly urgent care and are not admitted to hospital actually complete their visit within eight hours.
But of all patients admitted to hospital from emergency departments, only 24 per cent were admitted within the target time of eight hours. Those people — many of the sickest patients — spent an average of 20.1 hours in the emergency room.
Among low-urgency patients who were not admitted to the hospital, 74 percent completed their emergency department visits within the target time of four hours.
Wait times for those who need to be admitted are worse in Toronto hospitals.
Only 10 per cent of patients admitted to hospital from Toronto General’s emergency department completed their emergency department visit within the target time of eight hours. That figure is 11 percent at Toronto Western and Michael Garron Hospital; 22 percent in St. Michael and 16 percent in St. Joseph.
Data for June and July were not yet available as of Wednesday, Ontario Health said when asked for more recent data.
“This is not the performance we want to see from our system. Absolutely not,” Simpson admitted. “You know, patients deserve to be treated on time. It all comes down to providing safe care, we all want to provide safe care to our patients.”
He said emergency health care leaders from across the province agreed on a call Wednesday that “this is a very serious situation where they can’t do the job the way they want because of these long waits.”
However, he said he wanted to reassure people that in situations where people need the most urgent care, such as a heart attack or a motor vehicle accident, care is not affected.
“This is not to diminish the importance of other care, but simply to reassure people that in an emergency, the system is still set up to provide appropriate prompt treatment for those people.”
TORONTO GENERAL NEAR 2 WEEKS IN CRITICAL CARE BED ALERT AMID BURNOUT
Most stakeholders agree that staff shortages are at the root of the current crisis.
The president of Toronto’s University Health Network (UHN) told CTV News Toronto on Wednesday that burnout among health care workers is a factor as Ontario hospitals face dire staffing shortages that have left Toronto General Hospital under a bed alert for critical care for weeks.
In an interview Wednesday, UHN president and CEO Kevin Smith acknowledged that Toronto General currently has “more vacancies than usual,” although exact numbers are not available.
UHN confirmed Tuesday that the hospital is on critical care bed standby, meaning the hospital’s three intensive care units are at or near capacity and triaging patients.
While such alerts are not entirely uncommon, Smith said, the one currently in effect at the Toronto General is unusual in that it has lasted nearly two weeks.
“What is unusual is the longevity of this critical care bed alert. It’s been on for many days,” Smith said. “Usually one would see this in two or three days. This has been going on, I think, since (July) the 22nd. So we definitely have a systemic challenge around capacity, and capacity is directly related to staffing.”
He said the current shortage is the result of “a bit of a perfect storm” that includes a number of factors, such as capacity, COVID-19 patients who continue to need beds, higher numbers of patients presenting to emergency rooms, often sicker, and “a general shortage of human resources, especially in nursing, but not only in nursing.”
Smith said a number of nurses have told him they are looking to transition from intensive care to less stressful environments after more than two years on the front lines of a pandemic.
“Understandably – these are very challenging times – and working as long and as hard as these people have worked, they are very, very challenged and their resilience is really at a low point.”
He said Toronto General was “Canada’s most emergency hospital” and said they needed to find alternatives for staff “to improve the quality of their work lives, but also to continue to protect our patients and provide the standard of care that Canadians expect.”
He said summer vacation is also a factor in the interim period as overworked health care workers try to get much-needed rest.
“People are trying very hard to get a much-needed and well-deserved break. Our staff was very clear about their own sustainability and their own well-being,” Smith said. “We need to care for caregivers as well as our patients.”
He said this shortage is particularly felt in intensive care units, where a high degree of specialization is required.
“You can’t just take a recent graduate and make them feel like they’re on their own and working in their full scope of practice in some of the sickest and most complex environments in the country or the world,” Smith said. “And then, of course, there’s just a large number of people working more hours than is healthy for them and creating trauma in their own lives.” As you know, in ICUs, unfortunately, we see very sad outcomes, and that affects both providers and families.”
Smith said “the system is desperately trying to meet” patient needs, but that ultimately longer-term solutions are needed, such as possibly fast-tracking international registered nurses to work in Ontario, expansion programs of workers such as PSWs to enable them to do more tasks, and providing a full number of places in colleges and universities for health workers.
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