HHHS accepting patient transfers to help free up hospital capacity

By Sue Tiffin

Two patients from Campbellford Memorial Hospital were transferred to Haliburton County in April as hospitals throughout the province deal with critical care capacity challenges during the third wave of the COVID-19 pandemic.

“Campbellford, they were having a significant surge and needed some help, and that’s one of the roles that we play,” said Carolyn Plummer, Haliburton Highlands Health Services CEO. “We all basically play that role – in the healthcare system and in our regional system – is that we support one another when there’s surge happening. It was something we were able to do to help out so that Campbellford could function safely and that we could support to keep the system whole and operating.”

As hospitals around the province have dealt with an influx in patients during the third wave of the pandemic, some patients have been transferred to other hospitals to help manage capacity. Typically, Haliburton hospital has 15 beds, but has added an additional six “surge” beds, two of those being in the regular acute care unit, and another four in-patient beds set up temporarily in what used to be the building’s physiotherapy clinic. There are eight beds prepared in Minden in case of surge as well.

“The biggest challenge we have right now, if we have a surge, is staffing,” said Plummer. “I know that’s not unique to us at all, other hospitals are experiencing the same kinds of challenges with staff availability. We have all these spaces in which we could put people. Some of them are unconventional, so we have to be mindful of what type of patients we put in which spaces, and what kind of needs they have … If we had a surge, we would have to get creative in how we staff those areas, similar to what’s happening in many other hospitals right now. It certainly wouldn’t be easy and we’re hoping we don’t have to go down that path. We’re ready to in the event that we need to, but hoping it doesn’t come to that.”

Haliburton County’s hospitals do not have an intensive care unit, and so patients with COVID-19 would not be transferred to area hospitals here because their condition can deteriorate rapidly.

“Even to be an hour transfer away from a hospital [with an ICU] is too far for these folks,” said Plummer. “So they’re being transferred to hospitals with ICUs.”

Plummer said the HHHS team has been attending weekly meetings for updates on the situation in surrounding hospitals, and are “closely monitoring” those situations on a daily basis, preparing to accept more patients from elsewhere if needed.

“It’s like a ripple effect,” she said. “We’re a further out ripple, but we’re still a ripple.”

Earlier in April, emergency orders were put in place by the provincial government allowing Ontario hospitals dealing with a surge of COVID-19 hospitalizations and intensive care admissions to transfer patients without consent if those hospitals are experiencing full capacity, and to redeploy healthcare professionals who work for community care agencies to hospitals if need be. At that time, more than 500 people with COVID-19 were in ICUs. As of April 30, just under 900 people with COVID-19 were in ICUs.

On April 28, the provincial government announced that in order to ensure hospital beds are available for COVID-19 patients in need of urgent care, it was initiating a temporary emergency order because of the third wave of the pandemic.

“This temporary emergency order will provide hospitals with the flexibility to transfer patients whose doctors have determined no longer require hospital care to long-term care or retirement homes without obtaining the consent of the patient or, where the patient is incapable, their substitute decision maker,” reads a press release from the Ministry of Health.

The Ministry of Health’s press release notes “hospitals may rely upon this order only when necessary to respond to a major surge event, when the attending physician is satisfied that the patient will receive the care they require at the long-term care or retirement home. Transfers will only be made when medical professionals are confident they will not compromise the patient’s medical condition, and where all of the other conditions specified within the order have been met, including agreement by the home that they can meet the patient’s needs. Every effort will be made to ensure these patients are fully immunized from COVID-19 before moving.”

Plummer said anxiety faced by staff has been heightened for well over a year now, and that it is weighing on people.

“Staff are tired, they’re getting burnt out,” she said. “There’s a lot of extra pressure and anxiety. Everybody has a lot of extra steps they have to take just to do basic care right now. Just having the pandemic kind of constantly in your face, and the constant worry about not knowing, because you never really know who might be positive, who might not be positive.”

Though a break is needed, Plummer said instead, staff is trying to figure out how they might manage in a surge when they are already being asked to work beyond what they would typically be working.

“For now, it’s not letting up, hopefully that time will come soon,” she said. “That’s one of the things that, for me personally, kind of keeps me up at night, is knowing how tired and frustrated our team is, and knowing that the majority of it has to do with pressures that are beyond our control. It’s a tough place to be when there’s not a whole lot you can do to help.”

To date, HHHS staff has not been redeployed to other hospitals in need outside of the area.