Hallway medicine continues to be a reality in Fraser Health hospitals despite successive initiatives and promises to tackle hospital congestion.

Hospitals stay clogged despite repeat promises

Fraser Health CEO says it will take time, hard work to 'move the needle' on hospital congestion

Hospitals remain severely congested in Fraser Health and by some measures the problem has worsened despite repeated vows in recent years to improve conditions.

Three years ago this month, a 2012 congestion review warned hallway medicine was so rampant in Fraser that staff were resigned that the jammed conditions would remain “intractable.”

At that time, just 51 per cent of patients admitted through emergency were getting a bed within 10 hours.

Fast forward to April 2015 and that measure has worsened to 35.1 per cent of patients getting a bed within the 10-hour benchmark, down from around 40 per cent for most of the last year. It means two-thirds or more of patients now wait longer than 10 hours at hospitals such as Surrey Memorial, Abbotsford Regional and Ridge Meadows.

The target for timely access to a bed has actually been lowered over the years.

Today, Fraser is only aiming to get 55 per cent of patients into a bed within 10 hours. Back in 2011, the health ministry gave Fraser a goal of 67 per cent rising to 90 per cent by 2013, but – with the health region falling far short – the province eliminated those targets from subsequent health authority service plans.

Fraser is currently averaging 222 patients across its hospitals who’ve been admitted but not yet given a proper bed and are instead being treated in ERs, hallways, lounges or other non-acute care areas. That’s the highest level since 2011 and well above a target of 165 or less.

The health authority’s May report card shows other measures of how long patients stay in hospital are also much worse than the region’s goals.

Fraser’s new strategic and operational plan, completed last year on orders of Health Minister Terry Lake, was supposed to find new ways to decongest hospitals.

Fraser Health president and CEO Michael Marchbank said he expects to see some improvement by fall but he is not banking on swift change.

“It’s going to take a lot of hard work and a lot of time to begin to move that needle,” he said in an interview.

Marchbank noted Fraser added $5 million this year for more staff to help move patients through the system more quickly or divert them from emergency to other options when appropriate.

He insisted acute care decongestion “is definitely a focus and a priority for us.”

Much of the region’s current strategy is aimed at areas outside of hospital: providing more community support, home support and increasing home nursing where required.

As more capacity in the community comes on stream, it’s hoped there will be fewer people in hospital occupying beds and clogging the flow of incoming patients.

“Somebody might get an extra hour or two a day of support in their home and it might prevent them from going to an emergency department or moving to higher levels of care,” Marchbank said. “I think that’s the area that will show some of the greatest return.”

A report released last week by the Integrated Care Advocacy Group argued government claims of shifting the emphasis to community care has so far been mainly talk rather than action, with the number of seniors receiving home support virtually unchanged in a dozen years, despite a doubling in the number of B.C. seniors.

Marchbank had no comment on the findings.

“What I’m concentrating on is really the future and moving forward,” he said. “We recognize in Fraser Health that we are going to have to invest more in the community sector.”

 

HOSPITAL CONGESTION INDICATORS

Percentage of patients admitted within 10 hours between January and April, compared to a target of at least 55 per cent:

Abbotsford Regional – 32.8 %Burnaby – 59.8 %Chilliwack General – 32.9 %Delta – 22.0 %Eagle Ridge – 29.7 %Fraser Canyon – 50.3 %Langley Memorial – 33.7 %Mission Memorial – 36.6 %Peace Arch – 35.0 %Royal Columbian – 47.3 %Ridge Meadows – 27.3 %Surrey Memorial – 32.2 %Fraser region average – 36.6 %Vancouver Coastal average – 51.8 % (Jan-Feb)

Number of admitted patients awaiting a bed, on average, in April:

Abbotsford Regional – 48Burnaby – 12Chilliwack General – 9Delta – 13Eagle Ridge – 9Fraser Canyon – 0Langley Memorial – 13Mission Memorial – 2Peace Arch – 11Royal Columbian – 33Ridge Meadows – 17Surrey Memorial – 54Fraser region average – 222Fraser target – 165 or less

Source: Fraser Health May report card.