Hallway medicine may be a thing of the past. Fraser Health officials say their efforts to decongest local hospitals are working.

Fraser Health hospital congestion easing: report card

Too many patients still awaiting beds, but FHA officials say trend is improving, hallway medicine now over

Hospitals in the Fraser Health region have improved slightly from the spring on key indicators of congestion, but large numbers of incoming patients continue to wait too long to get a bed.

Fraser’s latest report card suggests that remains a persistent problem despite repeated initiatives to improve patient flow.

As of September, it shows just under 40 per cent of admitted patients got a bed within a 10-hour benchmark so far this year. That’s far below a target of 55 per cent, which is itself lower than more ambitious targets that had been set in previous years and subsequently discarded.

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.

The 39.8 per cent rate for 2015 is up from 35 per cent last May.

Just two hospitals – Burnaby and Fraser Canyon – are currently meeting the 55 per cent target for admission within 10 hours.

The majority of incoming patients wait longer than that at every other Fraser hospital.

And two thirds or more of the patients are waiting longer than 10 hours at Abbotsford Regional, Chilliwack General, Delta, Eagle Ridge, Ridge Meadows and Surrey Memorial hospitals.

In contrast, neighbouring Vancouver Coastal health authority reported it’s essentially meeting the same target with more than 54 per cent of its patients getting a bed within 10 hours.

From April to August, Fraser averaged 204 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 down from 222 in the spring, but still in excess of a target of 165 or less.

However, Fraser Health spokesperson Tasleem Juma said the latest data available shows a further drop in October to 199 and all of those patients are now in ER beds, not hallways.

Juma credited the improving trend to Fraser’s decision to use $5 million to hire more staff to prevent unnecessary hospital admissions, support weekend discharges and speed transfers from emergency to inpatient units.

“That investment that we had made earlier in the year is starting to pay off,” she said. “We are starting to see that number now come down and are effectively no longer using hallway beds to provide the care to the patients.”

Another bright spot in the report card is that the average length of stay in hospital is down to 8.2 days, within 10 per cent of the target of 7.8 days, also indicating improving patient flow through wards to residential care or home care.

But too many “long-stay patients” are still occupying hospital beds for more than 30 days.

And too many extra days that don’t need to be spent in hospital happen while patients that could be discharged wait for transfer to a care home or to home care or other specialized care with supports.

Fraser says it plans to open 34 new residential care beds soon to help improve that flow.

Juma predicted the ongoing work to add residential beds and improve community capacity “is also going to have impact as we start to move people out of the hospital into the places they need to be in the community and then out of those emergency beds into those inpatient beds.”

Overall, the eight out of 30 indicators on the report card are meeting target, 16 are within 10 per cent of targets, and six are well off-target and a priority for improvement.

Fraser is beating the provincial target for speedy repair of hip fractures.  And the rate of C. difficile antibiotic-resistant infections is now below the provincial target.

Hand hygiene is also strong with 88 per cent of staff washing correctly in audits, compared to an 80 per cent provincial target.

The two Lower Mainland health authorities both publish report cards but don’t report all the same indicators.

Vancouver Coastal has a target for keeping surgery wait times in excess of 52 weeks to no more than two per cent of cases, and its report card shows that was 1.1 per cent as of August.

Fraser does not report that statistic – Juma said it is redundant because the details are available on the province’s surgery wait times website.

She said the proportion of surgeries in Fraser waiting longer than 52 weeks was 2.4 per cent in 2014-15, down from 5.7 per cent in 2010-11.

The average wait time for surgeries in Fraser has declined from more than 14 weeks in 2010-11 to 11 weeks as of last year, while the number of surgeries performed increased about 2.4 per cent to 85,000 procedures.

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