Campbellford Memorial Hospital (CMH) continues to see high patient volumes in its Emergency Department leading to longer than normal wait times. Over the past few months, more than 50 people a day have been seeking care in Campbellford’s ED, peaking at more than 70 people one day over the May long weekend. While this number may seem small when compared to larger hospitals that often see hundreds of patients a day, it represents more than a 25% increase in ED visits for the 34-bed rural hospital.
Over the past several weekends, CMH has issued statements informing the public to expect longer than normal wait times in the ED due to higher patient volumes. “Increased visits to the ED on holiday weekends is nothing new, nor is a busy day here and there, especially in the summer,” commented Dr. Eshay Elia, Chief of the Emergency Department and Acting Chief of Staff, “but what is different over these past few months is how busy it is almost every single day.”
“We certainly don’t want to discourage people from coming into the ED if they need to,” explained Dr. Elia when asked about patients seeking care, “but we encourage those who do have alternative options, such as their family health practitioner, to consider them first for non-urgent issues.” Health Connect Ontario, formerly Telehealth, is another way patients can seek non-urgent care. The free program allows patients to speak to a Registered Nurse, either online, Chat online | Health Connect Ontario (gov.on.ca), or by calling 811, to discuss their condition and determine whether a trip to the ED is necessary.
While increased patient volumes continue to put a strain on CMH’s ED, so to is the acuity level of the patients being seen and the number of admissions that result. At one point last week, CMH’s 34-bed inpatient unit was operating at 141% capacity with 48 patients. “We’ve had to repurpose areas of the hospital to accommodate the increased patient volumes,” stated Nicole Wood, VP Patient Care and Chief Nursing Officer. This has led to the need for CMH to temporarily turn the day surgery unit into patient rooms and develop plans to repurpose other clinical areas if needed. “It’s certainly not easy,” Wood continued while noting the hospital operating at near, or over capacity has been the norm since she came to CMH in February, “but our dedicated team of healthcare professionals are doing everything they can to ensure patients receive the care they need.”
Increased patient volumes are only part of the issue facing hospital Emergency Departments right now. Staffing shortages are also taking their toll and various hospitals across Ontario have had to close their Emergency Departments, sometimes for days at a time, due to staff shortages. It is something Campbellford has dealt with before. Last December, CMH had to close its ED overnight on Christmas Eve due to a nursing shortage. When asked about staffing issues, and how they are currently affecting CMH, CEO Eric Hanna commented, “we are certainly not immune to the staffing shortages being seen across the Province, and there are times where we’ve struggled to fill shifts. But we are doing everything we can to ensure an ED closure does not occur.” Hanna did note however that the hospital is prepared in case a closure is necessary. “We do have plans in place in case a closure is needed;” stated Hanna, “as well as great local partners in both EMS and neighbouring hospitals to ensure the impact on patient care would be minimal.”
One of the issues at smaller hospitals like Campbellford is missing one or two healthcare workers from any given shift can cause a closure. “You see stories from larger hospitals struggling to keep departments open due to staff vacancy or absentee rates of 20-30%,” explained Hanna. “At Campbellford, depending on the department or shift, a 30% staff reduction can be just one person. So one person gets sick, has car trouble, or has a child they need to care for, and we have a staffing crisis.”
When asked whether he thought this was the new normal for health care in Ontario, Hanna explained, “I don’t think so. I’ve been in health care for over 30 years and the challenges we face now are significant, but, they are not insurmountable.” One thing that Hanna mentioned would help locally is a new hospital. CMH has applied for a Capital Planning Grant to redevelop the hospital as part of a Campus of Care co-located with a new Long Term Care facility. Over time, the site would be expanded to include supportive senior housing, primary care, and community mental health services.
According to Hanna, not only would a new, state of the art facility, help attract more top tier talent, but it would also greatly improve patient care. The current hospital was built in 1953 and was not designed to meet the needs of modern healthcare. Hanna noted that a new facility would be more efficient with a more modern layout designed to improve patient flow and quality of care. It would also have work and treatment settings sized to both accommodate modern technology and best practices related to infection prevention and control. Last November, Campbellford was forced to halt admissions for ten days due to a COVID-19 outbreak. While renovations have been made since, allowing admissions to continue during subsequent outbreaks, Hanna explained, “our current facility was not designed in a way that allows us to isolate patients the way newer facilities can, hospitals just weren’t built that way in the 1950’s.”
While the hospital waits for approval of its Capital Planning Grant, the work preparing for redevelopment continues. “We know what we want to do,” said Hanna, “we just need the Government to approve it.”