High bed occupancy rate combined with peak flu season, staff shortages could mean service cuts at Bracebridge and Huntsville hospitals
Nurses at the Bracebridge and Huntsville hospitals posted a combined 1,200 hours of overtime in November alone, according to Muskoka Algonquin Healthcare seniors staff.
Muskoka Algonquin Healthcare chief executive officer, Natalie Bubela, at a regular meeting of Township of Lake of Bays council, Tuesday, July 18. – Paige Phillips/Metroland
MUSKOKA — Muskoka’s hospitals have too many patients and not enough nurses.
Muskoka Algonquin Healthcare board members heard in December the Bracebridge and Huntsville hospitals had more patients than beds with an average bed occupancy rate of 100.8 per cent putting pressure on both finances and staff.
The bed crisis happened at the same time the Muskoka hospitals posted a combined 17 registered nursing vacancies — and while the hospitals were preparing for peak flu season, which traditionally forced a wave of additional patients into hospital.
The three issues are affecting hospitals across the province.
Esther Millar, chief executive of clinical services for MAHC, said MAHC had been working for months on strategies to cope. But budget pressure related to overtime and other expenses seemed inevitable, which could lead to temporary service cuts.
“Our elective services may be impacted,” said Millar.
She noted, as an example, other hospitals had already cancelled elective endoscopy days to move nursing staff to other areas of the hospital, while other staff are asked to assist as well.
One major problem was having patients stuck in hospital because community-based services such as long-term beds, personal support work and home care were on wait list.
Board members debated solutions such as contracting motel and hotel rooms to house overflow patients, but infection control issues and equipment investments seemed to pose a challenge to that option.
And, as Harold Featherston, chief executive of diagnostics, ambulatory and planning for MAHC, noted, the hospital had enough trouble trying to manage staff levels for the patients inside the hospital walls.
Natalie Bubela, CEO for MAHC, noted there were several reasons nursing shortages and recruitment challenges were affecting Muskoka, including unavailability of affordable housing here.
But she noted rural Ontario, in general, was losing nurses to the Greater Toronto Area, as the province opened more beds in major urban centres to battle the provincial bed crisis.
“Some of our staff have actually resigned to take positions in those hospitals,” she said, as she referenced newly expanded Royal Victoria Regional Health Centre in Barrie as one hospital to which staff had relocated.
Moreen Miller, a hospital board member and president of Fowler Construction, noted MAHC was not alone in its challenges related to recruiting skilled labour.
“This is not just nurses,” said Miller. “This is a comprehensive shortage of employees of all sorts. Skilled, unskilled. It’s quite scary. And we will continue to lose people to the south.”
Karen Fleming, chief quality and nursing executive for MAHC, told board members bed occupancy had reached crisis levels at other hospitals.
“Hospitals are ranging 125 to 150 per cent occupancy,” she said. “I know people here think we are really busy, but we haven’t seen anything yet.”
Southlake Regional Health Centre in Newmarket, as an example, had 100 overflow patients packed in its seminar auditorium and patient rehab gymnasium even after relocating patients to temporary beds at a formerly closed Humber River Regional Hospital branch, which the province had reopened to address the provincial bed crisis.
Michael Walters, a MAHC board member, noted the Ontario Hospital Association had reportedly planned to petition Queen’s Park for an additional 4.55 per cent, or $815 million, in operating funding for provincial hospitals in 2018-19.
But he argued that seemed like a temporary solution.
“It seems like a Band-Aid for that problem,” said Walters. “They’re still not talking about what the plan is to get people out of the hospital and into the community … They’re still stacking up people in the hallways.”
The province had announced plans to invest $100 million in 1,235 hospital beds and increase home care spending by 1.4 per cent or $40 million, while opening another 5,000 long-term care beds over four years, to ease hospital pressures.
Critics argued it would not be enough.
Robert Alldred-Hughes, chief executive of human resources and support services for Muskoka Algonquin Healthcare, later told muskokaregion.com MAHC had roughly 250 registered nurses on staff with 17 vacancies.
He said, however, the number of vacancies was actually fewer than in past years.
But the staff shortages were taking their toll on the nurses on staff, regardless.
Alldred-Hughes said nurses in Bracebridge and Huntsville had posted 1,200 hours of combined overtime in November.
“They are consistently being called to come in and fill vacant shifts,” he said.
He noted the hospitals are actively recruiting to fill the vacant positions, but since most are temporary positions to backfill for pregnancy or parental leaves, they are less appealing.
“It is a challenge to recruit people to Muskoka for a temporary position with no guarantee of continuing employment,” he said.
He added, though, that patients should not worry.
“We have all of our great people here ready to provide outstanding care,” he said.
NEWS Dec 28, 2017 by Alison Brownlee Bracebridge Examiner