STATE OF EMERGENCY: Hospital congestion a structural issue, ER doctors say

ER doctor says congestion caused by hospitals operating at or beyond their capacity, not by people with minor illnesses

This is part of a multi-story Special Report on Abbotsford Regional Hospital and its emergency department. For more stories, scroll to the bottom of the story or click here.

Politicians and health officials need to stop blaming people with minor illnesses for clogged emergency rooms, according to Dr. Alan Drummond, the point person for the group representing Canada’s ER physicians.

Drummond, who is co-chair of public affairs for the Canadian Association of Emergency Physicians, said the notion that people with ailments better addressed by family physicians or walk-in doctors are to blame for clogged ERs is a “common myth” spread by politicians of all stripes.

While such patients do consume some resources, Drummond said congestion’s main cause is hospitals operating near, or beyond,100 per cent capacity. When a hospital is full – whether because of a lack of beds in acute care wards, or in residential care facilities for those who can be discharged – it falls to ERs to take the brunt of any surge in activity.

Only they can’t close their doors to new patients, he noted.

“When a hospital’s trying to function at 100 per cent occupancy, crowded ERs happen all the time,” Drummond said. “You’re not going to solve crowding by telling people not to go to the ER in the first place.”

In the third quarter of 2013/14 – the most-recent time period for which hospital occupancy rates are publicly available – only one of Fraser Health Authority (FHA) hospital was operating below 100 per cent capacity.

Those figures are found within a three-year strategic plan created at the behest of the B.C. government. In 2013, the province had taken the rare step of ordering a full review of Fraser Health after the region failed to meet its budget in three consecutive years. The region was also beset by major quality-of-care issues at several hospitals. Several sites – but not Abbotsford’s – were ranked among the worst in the country on measures of patient safety.

View the whole plan here.

The 90-page strategic plan issued in June 2014 was meant to address the issues, and called for a shift of resources towards residential and community care.

The News has spent more than two months examining the report and its outcomes and has found that while some areas – including quality of care – have shown improvements, the region has fallen even further behind on other important measures.

That report noted that “hospital overcrowding creates inefficient processes of care and compromises clinical care.” Those issues make it difficult to implement system-wide strategies, the report said.

Since then, the overcrowding figure cited in the report – the rate of patients being admitted within 10 hours – has grown even worse, with Abbotsford the second-most congested in the system.

The issues are not confined to the emergency room.

Over the last two years, FHA hospitals have also seen an increase in the number of beds tied up by people waiting to be discharged from elsewhere in the system.

FHA opened more than 400 residential care beds last year, but the number of beds-per-capita for seniors is lower than three years ago. A report by the Senior’s Advocate earlier this year showed increases in wait times to get a residential care bed in the region.

FHA CEO Michael Marchbank told The News Thursday that he was confident that conditions in the health authority were improving and that congestion would ease in the spring.

He said increased capacity can be found by being more efficient and caring for patients in their homes. He also said the opening of 10 hospice beds last year has helped.

Marchbank said the public has a right to continue to demand progress toward the goals set out in the strategic plan.

“I think the public has absolutely a right to ask those questions and they need to see progress on a regular basis.”

• • • • •

Drummond linked Canada’s congestion issues to cuts to federal health transfers in the 1990s, which left provinces scrambling to reduce costs. He said ER doctors would like to see other wards take emergency room patients waiting for admission.

Drummond said it would spread the burden of overcrowding across an entire facility, rather than concentrate it in the emergency department.

BC Nurses’ Union president Gayle Duteil isn’t in favour of any approach that doesn’t increase hospital capacity, which she said can be accomplished by opening up other areas of the hospital and hiring more workers.

Fraser Health says it can place beds in inpatient and outpatient areas outside of the emergency department to ease pressure and that other locations were “inappropriate” for such care.

Drummond agreed that stopgap measures won’t solve the underlying problems, but he noted it could spread the increasing burden until long-term solutions are found.

“The demand for hospital beds will never diminish,” he said. “They have to acknowledge that, like it or not, we are going to have to increase bed capacity for the aging population.”

• • • • •

Asked about the recent issues at ARH, Abbotsford Mayor Henry Braun said he’s been in contact with Fraser Health and was satisfied it was taking the concerns seriously.

Braun – who is chair of the Fraser Valley Regional Hospital District, which provides some capital for local hospitals – said the city has raised issues in the past regarding waiting times for police who bring mental health patients to the facility.

Asked about congestion issues, Braun said: “It concerns me, but I think it’s a concern that is shared by many, many hospitals as well.”

Braun said he is also cognizant that other jurisdictions are also frequently requesting more services and facilities as the population ages.

“The asks keep getting bigger and bigger.”

• • • • •

The News requested to speak with Health Minister Terry Lake on Tuesday, but was told Wednesday he was not available for an interview. The News has requested to speak with Lake at any later date that can be arranged.

tolsen@abbynews.com

 

Just Posted

Photo by Dale Klippenstein
Death of man found on road in Abbotsford now deemed suspicious

Body found May 8 on North Parallel Road was initially labelled hit-and-run

A pair of rare peregrine falcons have returned to their nesting site at an Abbotsford quarry, resulting in increased concerns from opponents about their safety. (PHOTO: #savebcfalcons Instagram page)
Concerns escalate about rare peregrine falcons as blasting set for Abbotsford quarry

Opponents worried after birds return to nesting site at quarry on Quadling Road

Todd Richard sings “Green and Blue” as HHSES students get ready to belt out the chorus during the school’s Music Monday on May 3. He is currently in the running for a top 100 spot in the 2021 Toyota Searchlight competition. (Adam Louis/Observer)
Top 100 bound?: Harrison country artist Todd Richard vies for Toyota Searchlight prize

First round ends on May 20, votes can be submitted every day

The Abbotsford Law Courts (John Morrow/Abbotsford News)
Abbotsford man sentenced second time for sexual offence involving child

Bradley Roan Smith, 60, was previously convicted in 2016 of sexual interference

The mighty Fraser during freshet on May 2, 2021 at Island 22 Regional Park. A new B.C. coalition representing 25 organizations, and 273,000 people, is calling on B.C. to reverse decades of wildlife and habitat declines. (Jennifer Feinberg/ The Chilliwack Progress)
Coalition calls on B.C. to invest in wildlife stewardship and habitat protection

Representing 25 organizations, and 273,000 people, they seek to reverse decades of declines

Prince Rupert was one of the first B.C. communities targeted for mass vaccination after a steep rise in infections. Grey area marks community-wide vaccine distribution. (B.C. Centre for Disease Control)
B.C. tracks big drop in COVID-19 infections after vaccination

Prince Rupert, Indigenous communities show improvement

The bodies of Carlo and Erick Fryer were discovered by a local couple walking on a remote forest road in Naramata on May 10. (Submitted)
Kamloops brothers identified as pair found dead near Penticton

The bodies of Carlo and Erick Fryer were discovered by a local couple walking

Municipal governments around B.C. have emergency authority to conduct meetings online, use mail voting and spend reserve funds on operation expenses. (Penticton Western News)
Online council meetings, mail-in voting option to be extended in B.C.

Proposed law makes municipal COVID-19 exceptions permanent

A nurse prepares a dose of the COVID-19 vaccine in Kelowna on Tuesday, March 16. (Phil McLachlan/Black Press)
British Columbians aged 20+ can book for vaccine Saturday, those 18+ on Sunday

‘We are also actively working to to incorporate the ages 12 to 17 into our immunization program’

The AstraZeneca-Oxford University vaccine. (AP/Eranga Jayawardena)
2nd person in B.C. diagnosed with rare blood clotting after AstraZeneca vaccine

The man, in his 40s, is currently receiving care at a hospital in the Fraser Health region

Brian Peach rescues ducklings from a storm drain in Smithers May 12. (Lauren L’Orsa video screen shot)
VIDEO: Smithers neighbours rescue ducklings from storm drain

Momma and babies made it safely back to the creek that runs behind Turner Way

Signage for ICBC, the Insurance Corporation of British Columbia, is shown in Victoria, B.C., on February 6, 2018. THE CANADIAN PRESS/Chad Hipolito
$150 refunds issued to eligible customers following ICBC’s switch to ‘enhanced care’

Savings amassed from the insurance policy change will lead to one-time rebates for close to 4 million customers

Lorna Seip touches up the mural on the wall at MRSS, working with students from the Rainbow Club. (Neil Corbett/The News)
Rainbow club puts message of inclusion at Maple Ridge School’s main entrance

Maple Ridge secondary grad says SOGI symbols are powerful

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

Most Read