Toronto’s SickKids hospital is reporting a significant increase in the number of pediatric patients being transferred out of its beds as Ontario struggles with a wave of sick children.
As a result of the recent viral surge, an average of between two and eight children per day are being transferred out of the Toronto hospital specializing in pediatric care and into beds at local hospitals around the province.
In the midst of a surge in hospitalized children, transfers out of SickKids are now taking place daily, a far higher frequency than normal periods, when generally one or two transfers take place every week.
Julia Orkin, a pediatrician and medical officer for integrated community partnerships at SickKids, told Global News that in non-surge times an average of one to two patients are transferred out of SickKids and into local hospital beds weekly.
Since mid-November — when a triple threat of RSV, Influenza and COVID-19 combined to flood Ontario’s pediatric beds with patients — that number has exploded to between two and eight patients per day, she said.
“We’ve always partnered with our community hospitals,” Orkin explained to Global News. “What we have now is … the number of transfers to the community is higher given the surge and the volume of patients that require hospital-level care.”
The demand is so high for SickKids patient transfers to free up beds that an ambulance is on standby outside the hospital every day from noon to 8 p.m. to move children into local hospitals.
As previously revealed by Global News, the arrangement began on Dec. 4, giving the hospital access to a designated EMS vehicle between noon and 8 p.m. every day “to support timely transfers to other hospitals.”
Patients who are being moved are children who no longer require a “tertiary level of care” and can be looked after at a community hospital “that would often be closer to home.”
Orkin admitted the hospital would be “in a more challenging position” if the system were not in place.
However, she explained that transfers were a normal part of the hospital’s operation and said that no one was being moved against their will.
“Families are core to a child’s care — this is not a mandated transfer,” she said, describing the consultations that take place before anyone transferred.
“Parents are engaged in the discussion and the decision making and provide consent to transfer. Discussions (take place) around location of transfer: what’s in the family’s best interest or their preferences are always discussed.”
Orkin said the patients who leave SickKids on a transfer no longer require the hospital’s intensive or specialist care to get better.
Those with underlying conditions, who may require a particular specialist or are on the brink of needing an ICU bed, do not get transferred out. And the children that do are generally moved closer to home often to the hospital where they first sought help.
“They’re not transferring to an emergency room. They’re transferring directly to an inpatient bed where the plan of care is continued, a plan of handover is provided — it’s seen as a continuum of care,” Orkin said.
The unusually high number of transfers from SickKids comes as Ontario’s entire pediatric health-care sector reels under the strain of respiratory illnesses. Experts have previously predicted the surge, which began in earnest around mid-November, could last until the middle of January.
SickKids is working under a similar prediction.
Figures previously shared with Global News by Ornge, the province’s air ambulance and patient transfer coordinator, show November was a record for the transfer of children between hospitals.
In November, Ornge transfered nearly 140 pediatric patients with respiratory illness to other hospitals in an attempt to find an open bed suitable for care. The increased volume is 150 per cent higher than pre-pandemic levels.
“We’ve seen this with older adults, but not with the pediatrics,” said Dr. Michael Lewell, Ornge’s associate medical officer. “This is the first time we’ve seen such a significant volume with pediatrics.”
The exercise illustrates the severity of Ontario’s current respiratory illness among children, but is not compromising care, doctors are keen to stress.
“Every single patient will get the care they need in in a manner that is appropriate for their level of need,” Orkin emphasized.