Hospital struggles with large population of nursing home candidates in beds

Posted May 3, 2012 By EMC News

EMC News – The Perth and Smiths Falls District Hospital (Hospital) has been experiencing intense pressure attributed to approximately 30 plus Alternate Level of Care (ALC) patients who are awaiting beds in nursing homes.
ALC is the term that refers to patients who no longer require acute care. Because these ALC patients occupy over 30 per cent of the hospital’s total bed complement, regular acute care patient flow has at times been “gridlocked”. In some cases, ALC patients have occupied a bed for up to eight-months. An occupied bed in the hospital costs approximately $900 per day. Legislation imposes on a hospital that an ALC patient co-pay to cover a small portion of the costs. The balance of the costs hinder the efforts of the Hospital to achieve the provincially mandated balanced budget.
“As an acute care hospital, we are not equipped, financed, or are we the appropriate setting to provide care for ALC patients,” stated Dr. Peter Roney, Chief of Staff. "We look forward to the day when we can count on one hand the number of ALC patients waiting for long term care."
The Hospital more than ever before, in collaboration with the South East Community Care Access Centre (CCAC) and the South East Local Health Integration Network (LHIN) is focussed on the same goal. The number of patients in hospital waiting for placement to a long term care home or other appropriate care location needs to be reduced. Together, the CCAC, LHIN and the Hospital are working on creative and coordinated solutions to alleviate the ALC burden. “We are working closely with all partners to have a coordinated approach. Everyone is pulling together and we look forward to sustained progress,” stated Todd Stepanuik, President & CEO.
The impact of the ALC issue has escalated in recent past and is paralyzing the Hospital by placing on it a significant operational burden on the organization. Hospitals do not provide the same assistance and social programming as long term care homes. There is a likelihood of the patient deteriorating while waiting for placement, including loss of mobility and incontinence. Staying in hospital for prolonged periods of time also increases the chance of contracting hospital borne infections. Simply put, the acute care hospital is not designed to meet a patient’s restorative, supportive or rehabilitative needs.
The proportionately large number of ALC patients in the hospital is affecting the Hospital’s ability to continue to move patients from the Emergency Department or for elective surgery to an in-patient status. Each morning, the Hospital’s interdisciplinary team reviews the bed situation. On one day recently there were 16 patients awaiting admission from the Emergency Departments. Further, some patients who were scheduled for elective surgery unfortunately had their surgeries cancelled and rescheduled due to a lack of available beds.
"This type of stress on our Hospital beds also places stress on our staff, physicians, patients in the Emergency Room awaiting beds, families who are concerned about their loved ones as well as the ALC patient who is waiting appropriate placement to better meet their needs,” said Linda Bisonette, Vice President, Patient Care Services & CNE.
"We are fortunate to have community partners with programs intended to minimize hospital stays and support people in their homes, such as the CCAC's “Home First” approach" adds Linda Bisonette. “Our goal is to help facilitate the best outcome for everyone in the continuum of care.”
Placing a loved one in a care setting other than their home is a significant family decision. The Perth and Smiths Falls District Hospital does not have a program related to long-term care. The CCAC and other community support services are designed, mandated and staffed to provide adequate care and support to patients and families in their homes.