The vice-president of patient services and chief nursing executive at Guelph General Hospital says they are hopeful and cautiously optimistic as COVID-19 restrictions begin to lift in the province.
But Melissa Skinner said in an interview this week that capacity issues the hospital had pre-pandemic have not gone away.
“Over the past several years, based on the size of our hospital and the size of our community, each day we have struggled with having enough beds,” she said. “COVID has just exacerbated that and really shown how much pressure there really is on a system and on our hospital.”
Even before the pandemic, one official described the situation at Guelph General in October 2019 as “bursting at the seams.”
For example, the hospital’s emergency room was seeing 15,000 more annual visits than it was originally designed to handle.
Construction to expand the department by 6,400 square feet is currently underway to address overcrowding.
As for the current COVID-19 situation, Skinner said the hospital is still seeing high volumes in the emergency department but added that it is manageable and an improvement from just a few weeks ago while Omicron COVID-19 cases were peaking in the community.
“The impact of COVID — we are seeing a decline. But what we are not seeing a decline in is just all of the non-COVID care that patients are requiring,” she said, noting that there were only six inpatient beds available on Tuesday morning.
“That’s not a lot of beds when you think about a community our size. So there is still high demand, not just necessarily always COVID but just all of those other non-COVID patient care demands.”
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As of Wednesday morning, the hospital had 16 patients with COVID-19 and 28 staff off work either due to testing positive for the coronavirus or waiting for a test result.
Meanwhile, the hospital is ramping up some of the services that were halted by the Ontario government to help preserve hospital capacity.
As of last week, diagnostic imaging at Guelph General was able to get back to 90 per cent of its volume, the sleep lab was back to 100 per cent volume, and ambulatory care was back to 90 per cent.
Skinner said the focus now moves to clearing out a significant backlog of surgeries, which amounts to about 4,100 cases, including 2,400 cataract surgeries.
“Most of the patients that we’re booking for this week are patients that can come in and have their procedure and go home. So same-day cases,” Skinner said, noting cataract surgeries as an example.
“As we start to see, and we hope to see, that decline in COVID and demand, we’re hoping to start booking in more of those complex cases that require patients to stay in the hospital, to come in and actually go to an inpatient bed and sometimes stay three or four days, depending on their surgery.”
Skinner said she didn’t know when the hospital would be able to catch up, but others in the health-care industry say it could be months before most hospitals tackle the backlog.
On Feb. 10, the Ontario government announced it would be allowing hospitals to gradually resume surgeries and procedures. This allows hospitals to increase their surgical capacity to 70 per cent and then eventually 90 per cent.
Skinner said it’s a fine balance between scheduling surgeries and not straining their resources, such as inpatient beds, as restrictions lift.
But she did say the goal is to get back to 100 per cent volume and perhaps even go beyond that.
“What does it look like to do more than we historically did? How can we invest in more equipment and more staff to eventually go up and above 100 per cent to hopefully chip away at the backlog,” she said.
“There’s going to be a real focus on that because people have been waiting for a long time.”
Moving forward, Skinner said the hospital is cautiously optimistic but there is also some worry as restrictions lift because they have not seen the decline in COVID-19 cases that they were originally hoping for.
She said this is likely due to restrictions being eased on Jan. 31.
“So as we open up more and more, we’re likely we’re going to see more cases of COVID, which means more hospitalizations,” she said.
“We’re hopeful that we will be able to move through these phases so that everyone can get back to a little closer to the way things were before the pandemic. Whenever there is a change, the health-care system braces for the impact.”
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