Friday, January 27, 2017

Running overcapacity during flu season costs hospital $28K per day


Windsor Regional Hospital CEO David Musyj Nick Brancaccio / Windsor Star
Windsor Regional Hospital’s tab to run overcapacity for the last 53 days of flu season is at $1.5 million and growing.

It’s a cost the hospital is hoping the Ministry of Health will pick up, CEO David Musyj said on Wednesday, when there were 36 overflow patients above and beyond the 543 beds the hospital is funded for at its two campuses. Over the last 53 days, the hospital has averaged 32 patients above capacity each day. 

At a cost of $877 per bed, per day, the overcapacity works out to an extra $28,053 per day, $196,374 per week and $1.5 million over the 53 days, Musyj said. He said the health ministry has asked the hospital to keep track of the extra costs — a hopeful sign it will pay for them. 

But in the meantime, surgeries are being cancelled to cope with the overflows, meaning people who’ve waited months and sometimes more than a year for a surgery, are learning they’ll have to wait even longer, said MPP Lisa Gretzky (NDP—Windsor West), who has asked to meet with Health Minister Eric Hoskins as soon as possible to talk about the challenges at Windsor Regional. 
Very sick patients admitted to the hospital may not be getting the attention they need, she said, because staff have so many patients to deal with. The situation is worsened by the fact the hospital laid off RNs last year, she said.

“Not only have we lost front-line staff, but those who are there are being run ragged trying to keep up with patient needs.”

Patients are “bulging at the seams everywhere,” said Sue Sommerdyk, the co-ordinator for the Ontario Nurses Association Local 8, representing RNs in the Windsor-Essex region. She’s heard of nurses working 16 or 17 days straight to cope with the surge at the hospital. People are called to work extra shifts every day, working copious overtime. They’re giving up their coffees, their lunches and staying after work to complete their charting, just to keep up, she said. 
She said the government isn’t providing the funds needed to care for rising needs of the aging population, and the restructuring of local hospitals during the last two decades has left fewer capacity to cope when flu season hits.
“It’s the reality when you take four hospitals and turn them into one acute-care centre (at two sites), these people have to go somewhere and we just don’t have capacity.”

Musyj expects the capacity problems will continue through the next several weeks as the number of influenza cases peaks and subsides. These extra beds are opened up in about eight different areas in the Ouellette and Met buildings, sometimes in rooms that are usually not used because they’re even smaller than the ones in use. 

He said it’s not that there are substantially more patients coming in. Rather, the patients who are coming are sicker, meaning they stay longer and require more intensive care.
“When you’re running the system to start with at 95 per cent, close to 100 per cent, it doesn’t take long for those half-day, one-day, two-day, three-day longer stays to add up,” he said.

On Wednesday, the Met campus was running at 105 per cent capacity and Ouellette was at 106.
But Musyj said that rather than simply give his hospital funding for more beds, the entire local system needs to be streamlined, so that it’s not just the acute hospital that runs overcapacity. If the government would allow long-term care homes to take in some extra patients during these peak times, they could take patients from Hotel-Dieu Grace (which currently has 58 alternative level of care patients who don’t need the level of care HDG provides), freeing up room for the 28 ALC patients at Windsor Regional.

“The solution to this is you need everyone to share in the capacity issues,” Musyj said.
The new hospital being proposed to replace Windsor Regional’s two campuses is projected to open with 500 beds, expanding to as many as 700 in future years. While it appears that the new hospital will have less than Windsor Regional’s current 543, Musyj said 60 of the current beds — for acute mental health patients — will be moved to Hotel-Dieu Grace, meaning the local system will have 17 more beds. 

Monday, January 23, 2017

Bed shortage at Windsor Regional Hospital puts strain on nurses

http://www.cbc.ca/news/canada/windsor/windsor-regional-hospital-crowded-1.3947834

For the past three weeks, the hospital has had - on average - 40 more patients than beds

CBC News Posted: Jan 23, 2017 10:41 AM ET Last Updated: Jan 23, 2017 3:43 PM ET
(Windsor Regional Hospital) 

The union representing Ontario nurses is raising concerns about staff burnout and quality of patient care as Windsor Regional Hospital enters a third straight week dealing with a bed shortage.
Several surgeries have been cancelled as the hospital grapples with overcrowding issues caused by an influx of patients throughout the hospital system.
The number of patients admitted over hospital capacity continued to climb Monday. Met campus was running at 109 per cent capacity while the Ouellette Campus was at 102 per cent, according to the latest figures.
Staff have been working overtime every day, according to Vicki McKenna, vice-president with the Ontario Nurses' Association.
mi-vickimckenna-300
Vicki McKenna, vice-president of the Ontario Nursing Association. (CBC)

"At the front line, what the nurses are most worried about is their ability to continue to care for people properly," she said. "You have nurses working excessive overtime, trying to cover the bases."
Surgeries were cancelled due to the backlog of beds last week and McKenna said burnout has become a legitimate concern for staff.
"There comes a point when it's a risk situation, and that's what they're most worried about," she said.
Admitting Desk at Windsor Regional Hospital Metropolitan Campus
Admitting Desk at Windsor Regional Hospital Met Campus (Amy Dodge/CBC)

In a statement sent to CBC, a spokesman for the Ministry of Health and Long-Term Care highlighted investments the government has made to increase hospital funding and reduce wait times.
"We will continue to work with hospitals and communities to keep improving the level of care we provide to patients in Windsor and across this province," wrote David Jensen.

Monday, January 9, 2017

Ontario Nurses’ Association Calls a Code on Health-care Funding, RN Cuts, Workplace Violence Against Nurses

TORONTO – The Ontario Nurses’ Association (ONA) is getting loud about the health-care system concerns of front-line registered nurses, calling a code to highlight issues with health-care funding, registered nurse cuts and the violent attacks on registered nurses and allied health professionals.

“ONA has launched public awareness campaigns: Code Blue – to signify our concern that inadequate funding is risking the survival of our publicly funded, publicly provided health-care system, and Code White – to reveal the painful reality of workplace violence against nurses, whenever and wherever they are providing care,” said ONA First Vice-President Vicki McKenna, RN.

“In health care, a Code Blue indicates a cardiac arrest,” she explains. “We are concerned that years of inadequate funding and the resulting RN cuts are flat-lining patient care. A Code White indicates that violence is imminent or occurring and that nurses – and their patients – are at risk of being injured.”

Codes Blue and White are being called in movie theatres, on radio and transit and through social media across Ontario.

McKenna says that, “we simply cannot continue to cut our highly skilled front-line RNs, or allow health-care professionals to be beaten, punched, kicked, scratched or stabbed while working to provide the care our patients rely on. As funding remains inadequate and RN positions are cut from hospitals, attacks on nurses rise. The vast majority of ONA’s 62,000 members report having experienced physical violence in the workplace.”

McKenna notes that there was an 11-per-cent increase in lost-time injuries due to violence in 2015. Injuries due to workplace violence occur eight times more frequently in the health-care sector than in manufacturing and 68 times more than in the construction industry. Ontario cut more than 1,600 RN positions in a two-year period, the loss of more than three million hours of RN care.

McKenna says, “The truth hurts – when nurses aren’t safe, their patients and families aren’t safe either. We need adequate funding, appropriate RN staffing levels, and accountable leadership among health-care employers. This would go a long way to curing what ails the system.”

“The public can answer these codes by speaking out at http://nursesknow.ona.org.”

ONA is the union representing 62,000 registered nurses and allied health professionals, as well as almost 16,000 nursing student affiliates, providing care in hospitals, long-term care facilities, public health, the community, clinics and industry.