'We have now reached what is truly a critical level': Horizon adds 36 beds, but hospitals still over 100 per cent capacity

In an update on their hospital situation, Horizon Health CEO Margaret Melanson said some moves have been made to alleviate the strain on its system – but said their five regional hospitals are still averaging 106 per cent capacity.

Melanson said over the holidays, 10,000 healthcare professionals worked more than 350,000 hours across their locations.

But despite that, with the overwhelming respiratory illness season and hospitals that are already over capacity, the last month has been “especially trying.”

“This situation is representative of ongoing challenges facing our health care system right now,” she said.

Doctors and patients alike at the Dr. Everett Chalmers Regional Hospital have described a chaotic emergency department where inpatients are having to be placed in beds all over the hospital.

Melanson said wait times are now stabilizing, but the situation is still challenging. Horizon’s estimated emergency department wait time system on its website is undergoing maintenance, so we don’t know the approximate wait times right now.

“Patients that are treated in the emergency and require admission for acute care services remain then in the emergency department until an inpatient bed is available. This means longer wait times for people experiencing non-urgent medical issues,” she said.

One of her top priorities is to move alternate-level-of-care (ALC) patients – often elderly people who are waiting in hospital for a long-term care bed – to be moved to nursing homes or special care homes.

Right now, she said there are 542 of those people waiting in hospital, which is about 33 per cent of their beds total.

Melanson says it’s time for quick action on that issue.

“We have now reached what is truly a critical level, and I believe that that has now been brought to the attention of our Department of Health and Social Development, and I believe that they recognize now more than ever that action needs to be taken as expeditiously as possible. I will say up until the last several months, we have been coping as a system,” she said.

“And I would say now our ability to continue to do that is reducing because of the greater needs of the acute care system, and I believe that's been prompting now a level of action and focus that perhaps was not there previously.”

Some ALC patients are waiting for beds that are in or near their homes. Melanson clarified that unlike during the COVID-19 pandemic where they had emergency powers to move patients, she cannot force a patient to accept a long-term care placement at this time.

New Brunswick’s official opposition leader Susan Holt says she’s been hearing the situation is as “bad as it’s ever been,” but says that’s not because people don’t have an urge to help.

“Have we reined in every home care resource? Have we looked at our caregiver benefits programs to see if that could help free up one more bed? And have we talked to our leaders in long-term care? Because I got messages today from folks who run long term care facilities saying, ‘Hey, we're doing these things in other provinces with transitional beds to get people out of the hospital and get homes ready to receive them, and we can help,’” she said.

“And so why hasn't that emergency meeting been called to get everybody around the table to say, what are we going to do to address this problem right now?”

The CEO did mention the authority is working on a primary-care strategy, and is hopeful the province will provide more funding so they can move it forward, specifically opening more collaborative care clinics.

Melanson received a question on increasing the number of emergency room physicians in the evening and overnight, specifically at the Chalmers Hospital. Right now, there’s only one physician in that emergency department overnight.

She said she’s received approval to make that happen, but finding the staff is the issue.

“In speaking to a number of physicians, they have felt actually it may be better to increase physician availability during the evening hours as opposed to overnight. They feel that that might be a better place to insert additional physician time,” she said.

“If at this time there is a need for additional physician hours to be available within emergency departments or within other areas within our system, we have certainly received the approvals to engage with that. The issue has honestly been the availability of physicians to be able to accept the additional hours and to come to work because of course of physician vacancies as well.”

Department of Social Development initiated “critical state prioritization” in Saint John

CTV Atlantic requested an interview with either the ministers of health or social development. Instead, the department of social development sent information outlining a protocol that’s been initiated at the Saint John Regional Hospital.

A spokesperson said on Jan. 4, the department sparked a “critical state prioritization” of nursing home placements.

“Under normal circumstances, nursing home admission is done chronologically, however, during critical state circumstances as defined by regulation, the minister of Social Development has regulatory authority to prioritize the admission of ALC patients waiting in hospital for nursing home placements, when requested by a Regional Health Authority,” said spokesperson Rebecca Howland.

That change in priority can last 30 days at a time, specifically when the ER and acute care units are overcapacity, and critical surgeries have been cancelled due to a lack of beds.

“The decision to enact the critical state measure is not taken lightly,” Howland said. “However, this flexibility is necessary to deal with exceptional circumstances such as the one being experienced at Saint John Regional Hospital.”

It will be reevaluated on Jan. 18. 

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