SHA announces Saskatoon capacity plan with hospitals bursting at the seams

The Saskatchewan Health Authority announced the Saskatoon Capacity Pressure Action Plan to target hospital capacity in the city on Tuesday.

This comes on the heels of the Saskatoon Fire Department inspecting St. Paul’s Hospital and Royal University Hospital due to complaints of overcrowding.

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“We acknowledge that current hospital capacity pressures create a difficult environment for patients who are seeking care in our emergency departments, and for staff and paramedics who have continued to provide excellent care,” said Andrew Will, CEO of the Saskatchewan Health Authority.

“With the release of this action plan, the SHA is committed to taking concrete action to address the immediate capacity pressures facing staff and patients, while also implementing long-term solutions to strengthen health services in Saskatoon.”

The release sent by the SHA said it will continue to engage with staff to hear their ideas and address their concerns, but a former nurse as well as the Saskatchewan Union of Nurses said a policy is in place preventing nurses from approaching media with their concerns.

Tami Fehr worked 35 years as an RN in the Saskatoon region and said that during her employment, head nurses and managers weren’t afraid to speak up for their wards.

“Now if they speak up, they are moved or given five wards to manage, or given wards to manage at different sites,” Fehr claimed. “‘Rock the boat’ and you are downgraded in your evaluation and your bonus is affected.”

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“I tried to give them an outlet, left contacts to the media, and guaranteed anonymity,” Fehr said. “The staff are afraid of reprimand and of losing their jobs.”

The letter she left the nurses in the hospital containing media contacts had been taken down.

“They are muzzled,” Fehr said.

The plan outlined by SHA gave a list of actions that will be taken with ranging timelines, with some things being implemented within 30 days and others within a six-month timespan.

Actions to be taken within the next 30 days include:

• Temporary deployment of staff to acute care units to coordinate the discharge of patients from acute care to appropriate care settings.
• Enhance weekend staffing in Saskatoon facilities to ensure weekend patient discharge and care transitions in alignment with standard discharge practices occurring during the week.
• Increasing adherence to existing overcapacity protocols and line of site for senior leadership to transition patients out of the emergency department to appropriate care environments and appropriate receiving facilities to reduce pressures on tertiary care.
• Enhance the Community IV Therapy Program to avoid emergency department presentations and more appropriately serve patients in community.
• Add temporary emergency department staffing, including nursing, social work, support workers and security personnel to improve patient and staff safety while longer term actions are underway.

Within the next 90 days, actions taken by SHA include:

• Procurement of additional community-based long term and convalescent care beds to enable patient discharge and care transitions from hospital to appropriate care settings.
• Increase of home care and palliative care community resources to prevent Emergency Department presentations and support decreased inpatient admissions and length of stay.
• Opening an additional three ICU beds at Royal University Hospital to ensure capacity for those patients requiring Critical Care services.

And lastly, actions listed to be taken within a three- to six-month period include:

• Implementing rapid access for unattached patients to primary care through Nurse Practitioner and Primary Care physicians in the community to avoid Emergency Department presentations and admission to hospital.
• Developing community-based programming specific to common Emergency Department presentations to better serve patients in community, keep patients healthy at home, and prevent acute care admissions.
• Implement more robust home health monitoring in Saskatoon for falls prevention and chronic disease management to prevent Emergency Department presentations.
• Complete an inpatient bed and long-term care needs assessment for Saskatoon facilities to determine the appropriate number and mix of acute care and long-term care beds required to meet the current and projected needs of the community.
• Improve access to information between acute and community services to enable seamless patient flow and care planning across care settings and better transition patients home. This means augmented WIFI capability within Saskatoon facilities to ensure staff can easily access and share patient information across care providers.

The SHA said this plan will provide Saskatoon with immediate relief as they work toward longer-term solutions.

Will said he appreciated a letter he received from staff outlining concerns about capacity and took it as a message that the health authority needs to communicate better with staff.

When asked if there was enough staff in place at this point in Saskatoon hospitals and how this plan would affect their workload, John Ash, vice president of Integrated Saskatoon Health, pointed to the province’s Health Human Resources Action Plan.

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The province announced at the beginning of November that 43 nurses were brought over from the Philippines to work in Saskatchewan out of 400 who received conditional employment offers.

Will said the health authority has implemented 29 positions in Saskatoon and has also taken steps to increase other support services.

When asked if he is confident that the SHA would be able to meet the demand, Will said it is facing capacity challenges over things like respiratory illnesses.

“I’m confident that this plan will make a significant improvement to that.”

He did say that there is hard work ahead and that it is facing a real challenge.

When asked how many patients would be better suited for home care or a long-term care home, Will said there was an excess of about 100 patients in Saskatoon at any given time.

Steven Lewis, an adjunct professor of health policy with Simon Fraser University in B.C., said that while this plan identifies the problems he has concerns about staffing.

“It’s sort of based on a lot of assumptions about moving people into areas to resolve access problems when generally in health care the biggest problem is we don’t have enough people working,” Lewis said.

He said often times people aren’t working in the right place or some are leaving the workforce because they are demoralized.

Lewis said that the ideas presented in the plan aren’t new, and that historically, the SHA and the province have not had concrete strategies to address these problems.

He gave an example of palliative care in the province, saying that funding more palliative care is sensible, but that the province will spend more on hospital palliative care rather than home palliative care, which is often left to non-profit organizations that can gather resources for people.

Lewis had several questions about the underlying details within the plan, many about staffing, if health-care workers would need to be picking up extra shifts, or if they’ll be redeployed in other avenues of the health-care system.

“There are a lot of questions involved in making this work and it’s not self-evident that it will be an easy road to success.”

He said there are a lot of moving parts here to make it a success, but that there is long-term promise, and the government needs to follow through for decades.

— with files from Brooke Kruger