‘A horrible way to experience health care’: Hallway medicine not going away, despite political promises

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Patients are spending more time in hallways and “unconventional spaces” at some Ottawa hospitals than they were in 2018 when Ontario Premier Doug Ford vowed to end hallway medicine.

In Ottawa, that includes dozens of patients spending nights in emergency departments or other unconventional spaces every day, something that can increase patient harms and stress on health workers.

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At the Queensway Carleton Hospital, 3,779 patients spent the night in the emergency department during the 2023/24 fiscal year compared with 2,513 in 2017/18 – a 50 per cent increase.

Natasha Curley, a spokesperson for QCH, said addressing hallway medicine is a priority for the hospital and it “continues to look for innovative ways to ensure every patient receives timely and appropriate care.”

Martin Sauvé, director of communications at Montfort Hospital, said surge beds are now required to be open on a regular basis. “This used to be needed mostly during viral season and winter months, when the number of hospital admissions is typically higher, but we now tend to see such volumes throughout the year.”

Michaela Schreiter, spokesperson for The Ottawa Hospital, said it prepares for higher volume periods “and has plans in place to ensure that everyone receives the care they need in a timely manner.”

According to a recent report from the news outlet The Trillium, The Ottawa Hospital had an average of 75 patients in unconventional spaces, including the temporary care unit in the former ambulance bay at the General campus, last January. The media outlet obtained the information through access to information.

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Hallway healthcare is a complex and worsening problem that CUPE, which represents hospital workers in Ontario, says will not improve without a significant provincial investment in new hospital beds and staff over the next decade. CUPE recently released a report on the hospital capacity crisis in Ontario.

“It is a horrible way to experience health care,” said Michael Hurley, president of CUPE’s Ontario Council of Hospital Unions, who himself spent 55 hours in the emergency department at the General campus of The Ottawa Hospital a couple of years ago when he was ill. “It is symptomatic of the lack of capacity.”

While Health Minister Sylvia Jones has talked about adding 3,000 hospital beds over the next decade, the union says Ontario will need 13,800 hospital beds during that period – based on data from the Institute for Clinical Evaluative Sciences (ICES) and Statistics Canada. Those resources will be needed to maintain the current level of care amid population growth and the demographic bulge of aging Boomers. The union says Ontario needs to invest an additional $2 billion a year to meet the needs.

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In Ottawa that would translate to 1,400 new beds over the next 10 years as well as 10,000 additional staff in order to maintain services, according to the CUPE report.

The Ontario government has been investing in new hospital beds and building new hospitals, including a new Civic campus in Ottawa, scheduled to open in 2028.

Hannah Jensen, a spokesperson for Health Minister Jones, said the Ford government has made record investments in health care, including increasing the health care budget by more than 31 per cent since 2018 and investing $85 billion into the health system this year. She added that the province is also “getting shovels in the ground” for 50 hospital projects, including in Ottawa, and has introduced initiatives to help people get care outside of hospitals.

The minister’s office did not directly answer a question about the trend in hallway medicine in Ontario since 2018.

Natasha Curley, a spokesperson for QCH, said addressing hallway medicine is a priority for the hospital and it “continues to look for innovative ways to ensure every patient receives timely and appropriate care.”

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Among other things, the hospital has opened additional beds, developed a “robust” surge plan and launched a program to improve the efficiency in the transfer of patients from the emergency department to inpatient acute care beds. Last year, the hospital decreased that time by 7.7 hours.

She said all the hospitals in the city are working together, including with Ottawa paramedics, to address long wait times for the community.

Montfort has also added programs to address the issue, including a remote monitoring program, including a post-surgical program, allowing some patients to be discharged sooner, and a post-discharge assessment clinic for follow-up. Montford, like other hospitals, has also opened transitional care beds.

The report from CUPE notes that Ontario is already behind other provinces and most developed countries when it comes to the number of beds and health care staff per population. A number of Ontario hospitals – including The Ottawa Hospital – are running deficits.

CUPE also says the province’s claim that it added 3,500 new hospital beds since 2020 contradicts information the unions received from the hospitals, which say there has been an increase of 2,161 beds since the pandemic. CUPE’s report also says more than double that many new beds are needed for hospitals to cope with demand.

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“Based on the most recent CIHI data, Canada as a whole has 7.7 per cent more hospital beds per capita than Ontario. The result is very high hospital bed occupancy, cancelled surgeries and increased usage of unconventional spaces to treat patients with a 22 per cent increase in ‘hallway healthcare’ since Ford’s election in 2018,” according to the CUPE report: No Respite: Ontario’s failure to plan for patients.

The media outlet The Trillium reported this week that during January of 2024, there were, on average, 2,000 patients a day being cared for in hallways or unconventional spaces in Ontario hospitals. That is double the number in 2017, according to The Trillium, which obtained the data through access to information.

Hurley of CUPE said the growing number of people on stretchers in hallways and elsewhere is causing frustration, anger and sadness among staff.

“They are seeing all these people languishing on these stretchers waiting for care and knowing that the impact it has on them is really significant.”

Hurley said some operating room nurses have expressed shock at the state of some patients who have been on stretchers for prolonged periods of time and may have developed bed sores or soiled themselves. Operating room nurses are spending more time “cleaning them up” before surgery, he said.

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