It would take very little for Muskoka Algonquin Healthcare (MAHC) to become overwhelmed with COVID inpatients should those with serious infections increase and require hospitalization.
Both the Bracebridge and Huntsville hospital sites are already often at or over overcapacity. According to Vickie Kaminski, interim MAHC president and CEO, on January 27 Huntsville hospital was at 98 per cent capacity while the Bracebridge hospital site was 104 per cent overcapacity.
People are not only living longer, said Kaminski, but the services they require are not readily available which means many—10 to 20 patients at each hospital site—will take up acute-care beds until the service they need becomes available.
“So we have a number of alternate care patients and those, I’m sure you know, are people that no longer need acute care, but they need some form of care that prevents them from just being able to go home independently. So, they’re waiting for that kind of service. It could be a long-term care bed; it could be homemaking services in their home. It could be assisted living. It could be rehabilitation services that are in pretty high demand—so it could be any one of a number of things,” she explained. “That means then that patients waiting to be admitted into those acute care beds get backed up into emerg and they can sit for a day or so waiting for a bed and that puts or occupancy rate over the 100 per cent,” she added.
Both hospital sites serve a population of approximately 60,000 residents in Muskoka and East Parry Sound, not including seasonal influx. Yet between both hospital sites MAHC has a capacity of just 101 inpatient beds. The province, due to the pandemic, allowed MAHC to open an additional 15 beds, bringing the MAHC inpatient bed count to 116.
“So we can actually go up to 116, and we’re able to do that, so that’s part and parcel of how we manage with that capacity,” she explained. “The other thing that the province is doing is they’ve made a really concerted effort across the province to use all of the community care and all of the long-term care resources, so some communities have more of that available, and what they’re saying to us now is they’re going to help us move patients to the resource so that we can free up beds inside systems [that are] sort of log jammed, as well.”
Kaminski said MAHC has been able to access inpatient beds at the regional Pandemic Response Unit (PRU) in Barrie. The field hospital was approved for 70 beds to act as a regional resource, should area hospitals face crippling capacity challenges.
“I don’t think they’ve ever fully opened all those beds because they couldn’t find staffing for them, but we have been able to access PRU beds over the last year or so, on occasion,” said Kaminski, adding that patients have also been transferred to other facilities outside of the community such as the St. John’s Rehab Hospital in Toronto.
“Orillia has been working very closely with us as well,” noted Kaminski. “They were able to do some work with their assisted living providers and so they got additional beds opened up and staffed and so we’ve been able to move… a handful of patients,” she said.
In the meantime, the reintroduction of provincial mandates such as halting all non-urgent and non-emergent surgery procedures and diagnostic imaging to create surge capacity in the system is exacerbating the backlog for non-urgent procedures. “We knew that that would add to the backlog. So, we’re making sure that we get urgent and emergent [procedures] done, and we’re just crossing our fingers that we’ll be able to get back into regular procedures soon,” said Kaminski. “Certainly, the province has indicated that we’d be in this position at least until the end of January, so we’re waiting to hear where we go from here. But the backlog does grow when you do that, so we are keeping an eye on it and we’re looking at ways and means—if there are any available to us, that we’ll be able to take a bite out of that backlog once we get back into doing regular procedures.”
As per provincial mandates blanketing all hospitals regardless of their unique situation, and what hospital CEOs are saying, Kaminiski had this to say: “We have had conversations as CEOs about the ability to do procedures. So lots of ours are outpatients. I mean really and truly the diagnostic imaging and the surgery that we do here doesn’t necessarily take up inpatient beds, so conceivably we could’ve done a few of those things during this round,” she said of the last COVID wave.
But she said being able to move people around the system requires that all the different parts work in unison. “So it was meant to level the playing field and to say we’re all going to be disadvantaged and we will work as a system to recover once we’re out of this current phase.”
On January 27, there were 14 COVID-positive patients at both hospital sites equally split between the two with one patient in the Bracebridge Intensive Care Unit (ICU). “So it is a very different look this time around. So patients are sick, they’re not requiring ICU but they do require hospitalization, and they’re getting better faster, so they’re not here as long as they were in the first three phases [of COVID],” said Kaminski.
Asked what her biggest concern is moving forward during this pandemic, Kaminski said it was hospital staff.
“I guess it’s keeping staff motivated and just giving them that light at the end of the tunnel because they’ve been with us all through this and it has been tough. I mean they’re working differently now. When I came to do this contract I found out I had to wear a mask when I come in the hospital. I should’ve thought of that, but I’ve never had to wear a mask for long periods of time… not a seven-hour, 12-hour shift. You can imagine our staff who are in protective equipment and wearing masks, they’re doing an extra shift because we’re short-staffed. I worry about the staff, that’s my biggest concern. I’m afraid we’re going to see an exodus of people as this starts to ease off they might think: ‘I’m getting out of here before it happens again,’” said Kaminski. And the exodus may get worse as a vaccination mandate for MAHC hospital workers comes into effect in March. Leaving is their choice, noted Kaminski.
As for staff in general, “how do we keep them motivated?” she questioned. “They’ve been great. They are great, and we want to keep them around.”
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Politicians – how about supporting these people with mandated vaccination of the population?
Though I recognize the horse is out of the barn on this one – imagine how health care professionals and workers view the lack of mandated vaccination. Imagine seeing no clear, strong, sound support of their efforts to save lives and provide care to each and every person walking through a hospital door!
Thank you for this picture of healthcare. Regarding staffing recruitment and retention in LTC and Home Care, DF Conservative Government made it’s first really Big mistake following the first wave of COVID by the lack of immediate action in staff training, recruitment in these areas. Quebec identified this need, after Wave 1, though I cannot speak to the outcomes of the actions proposed in Quebec.
Lagging in an immediate response to staff wages in our public healthcare sector, means that healthcare workers have quit altogether or been vacuumed up by for-profit work here and in the US.
The DF Conservatives are slavishly devoted to the for-profit world view and models of care and no taxes (e.g. Alberta, Jason Kenney).
We can help change this in the June 2022 election with a sustained approach to reclaiming a majority in publicly owned and operated health care system that attracts professionals and workers who have a care and who see evidence that the system will support their efforts.