A staff-only memo is warning of "unprecedented site congestion" at Surrey Memorial Hospital.
The Jan. 16 site alert calls it an "all hands on deck" situation as the hospital grapples with multiple infection outbreaks, including c. difficile, influenza and other respiratory conditions.
SMH is experiencing "the highest volumes ever of patients in Emergency needing admission without assigned beds," it says.
Fraser Health public affairs director Ken Donohue said the worst day came Jan. 11 when about 470 patients came to emergency compared to the high 300s.
Donohue rejected suggestions that staff levels at the hospital are inadequate.
"What we're seeing are high patient numbers," he said. "The acuity or the seriousness of the illness of many patients is a bit higher than normal and that means patients are requiring more care than normal."
He said there are high levels of the flu virus circulating in the community, with flu outbreaks in multiple residential care homes, and that's one trigger causing higher than normal congestion.
Donohue said extra staff have been brought on line as required.
One of the key challenges has been getting patients discharged from hospital.
"Everybody in the hospital needs to work together to ensure patient flow is working," Donohue said. "If patients no longer need hospital care we need to do everything we can to ensure they transition to home or community care or residential care."
The memo says managers and directors are helping find solutions and an operations command centre has been set up to pursue new strategies.
Donohue said residents can help by calling 811 to speak to a nurse before going to emergency in cases involving less serious illness to see if there are other options besides hospital.
It's not unusual for a hospital to be facing various infections, particularly during flu season.
Donohue said the c. difficile outbreak in one medical unit is being countered with restricted transfer protocols and enhanced cleaning and infection control procedures.
An outbreak is declared any time there are three or more cases in a unit.
C. difficile infects the intestines and can cause illnesses ranging from diarrhea, nausea, vomiting, fever and colitis and in some cases, result in death.
According to a Fraser Health's report card for Surrey Memorial, the hospital was admitted only 34 per cent of incoming ER patients within 10 hours in 2014, well off a provincial government-set target of 55 per cent.
SMH was notorious for congestion for years, leading to the construction of both the Jim Patttison Outpatient Hospital and a new $512-million ER and critical care tower.
The new larger ER opened in October 2013 but didn't immediately improve congestion as much as expected, in part because it's believed more patients who avoided the hospital in the past were now making it their first choice over other nearby hospitals.