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.