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Windsor Regional Hospital Patient Volumes Over Capacity

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The following memo was issued by President and CEO David Musyj to hospital staff and physicians today concerning patient volumes at Windsor Regional Hospital

Everyone

As all of you are aware since late 2016 and starting 2017 the incidence of influenza and associated respiratory and gastrointestinal illnesses has increased in Windsor-Essex.  We continue to experience high numbers of admitted patients and high acuity in our Emergency departments (ED).

Currently every bed at Windsor Regional Hospital is full and we have open approximately an additional 37 “over flow” beds throughout both campuses.

Hospitals throughout Ontario are experiencing similar volumes and acuity levels.  A couple days ago the Ontario Hospitals Association sent a letter on behalf of all hospitals to the Minister of Health and Long Term Care asking for immediate support for this issue. The letter can be found here.

This letter clearly indicates we are not alone.

This is important because the funding we receive today is NOT based on the volume or acuity of patients we see today. There is a two-year lag in funding.  Meaning the work we did in 2014-15 is what we are funded on for 16-17.  

This was described in the recent Auditor General’s report, which stated

Hospitals generally are funded based on the number of patients treated, their acuity, and the expected cost of providing services, rather than the number of beds that they have. However, there is a time lag on the funding; hospitals would be funded for the overflow after two years. This means that hospitals often have to divert funding from other areas to cover the operating costs of overflow beds during the current fiscal year in order to balance their budgets. 

One hospital we visited, for example, operated the equivalent of nine overflow beds when it was over 100% occupancy during the 2014/15 fiscal year. These beds are located in other units dedicated for overflow beds. The direct costs of operating these beds totaled $1.45 million for the year ($733,000 for diagnostic and therapeutic services, $587,000 for direct patient care and $128,000 for food). 

The “one hospital” referenced above is us. Remember the cost above is for 9 of these overflow beds.  Yes it is over a longer period but 37 plus beds will be approximately $600 a day to operate.  It total, 37 beds will be $22,200 a day – $155,400 a week. 

The increased volumes, and the ongoing challenge to place patients on inpatient units, means ED wait times will be longer.  Adding to this is the approximate 20 long term care homes and nursing homes with outbreaks.  This not only results in sick residents that might need hospital care but also limitations on admissions to their facilities.

We will publicly continue to educate our community

  1. If their health condition is not urgent, patients should consider other options before going to the ED, including a visit to your family doctor, nurse practitioner or a walk-in clinic. If they are unsure if a trip to the ED is required, they can call Telehealth Ontario at 1-866-797-0007;
  1. There is a great new “app” called ClinicSeeker.  It identifies local clinics, their services, locations and operating hours.
  1. The Windsor/Essex Health Unit predicts influenza activity will peak in possibly four weeks, so there is still time to get a flu shot, which will also protect against a potential second wave of flu that often comes between February and April. The flu vaccine is available through most local pharmacies and healthcare providers. To find the nearest pharmacy giving the flu shot, visit the website.

As an organization, all of you have done amazing work on reducing the number of ALCs across both campuses.  A couple years ago we would have north of 100 ALC patients.  Now we are at 50.  This summer we were down to 30.  This helps greatly.  We need to continue this work.

Also, discharge by 1100 and 1400 hours is critical.  These are international best practice targets that ensure patient care and flow are maximized. We have made great progress across the system in this regard. We need to continue this as well.

I will keep you up to date on these issues over the next couple of months. I truly appreciate all of the hard work all of you are doing for our patients and community. We will continue to try to indicate to our community that the system is under stress right now and we are doing our best but they need to help as well and take advantage of the resources available in our community outside of the hospital for their care.

DAVID MUSYJ | WINDSOR REGIONAL HOSPITAL

President and Chief Executive Officer