Some Hamilton hospitals cancelling surgeries as capacity levels surge above 100 per cent

With respiratory virus season kicking off, some hospitals in Hamilton are cancelling or postponing surgeries to deal with increased demand on strained services.

This week, representatives from Hamilton Health Sciences (HHS), St. Joseph’s Healthcare Hamilton, Hamilton Public Services and the Hamilton Family Health Team held a press conference to update residents on the impact of the viral season on the city’s health care facilities.

According to HHS, capacity at all hospitals exceeds 100 per cent, with Hamilton General Hospital at 105 per cent, Juravinski Hospital and Cancer Centre at 118 per cent, McMaster Children’s Hospital at 112 per cent and West Lincoln Memorial Hospital at 114 per cent.

A news release says 93 patients in hospital have tested positive for COVID, but less than five patients with the virus are in the ICU.

HHS says the pressures on the system, which is struggling to cope with an influx of patients suffering from acute illnesses, traumatic injuries, opioid-related health emergencies and mental health crises, are compounded by staff shortages.

“[HHS]is facing persistent staff and physician shortages, and capacity challenges related to the onset of the respiratory illness season, and increased patient acuity and volumes,” the health service said in a news release.

“Our emergency departments and intensive care units are particularly pressured, including at McMaster Children’s Hospital. HHS leaders and physicians are monitoring the situation closely and working to ensure the stability of staffing and access to our regional programs.”

Sharon Pierson, COO and chief nursing executive at HHS, told reporters that the organization has had to cancel elective and scheduled procedures over the last two weeks to create capacity in the system.

The impacted patients are waiting for cardiac and oncological surgeries and procedures.

“We ensure time-sensitive care proceeds,” Pierson told reporters.

Pierson said HHS is dealing with not only a significant amount of very sick patients but also with gridlock generated by a lack of capacity within the community to care for people who no longer need to be in the hospital but cannot go home. She also said the ongoing shortage of health care workers is creating additional strain.

“The accepted standard for hospital bed occupancy is 85 per cent, yet there are many days where occupancy at our hospitals exceeds 110 per cent,” Pierson said in a statement.

“We know that waiting for care can be stressful and are grateful for everyone’s patience during this very trying time.”

Cheryl Williams, executive vice president of clinical operations at St. Joseph’s Healthcare Hamilton, said that while St. Joe’s has not had to cancel or postpone procedures, it’s experiencing strain.

“This is a time where it’s so much easier to pick up a virus like a cold or flu and even COVID and at St. Joe’s, we are already seeing an increase in the number of people coming to the emergency department,” Williams told reporters, adding that the impacts aren’t solely related to the uptick in respiratory viruses such as COVID and influenza.

“St. Joe’s is already feeling the pressures of being stretched to capacity much of the time and it’s not just from the various respiratory illnesses that are beginning to surface. Our hospital was hovering at around 100 per cent capacity most of the time and regularly running over 100 per cent in some service areas, such as acute medicine and mental health.”

Williams told reporters that when people need to be admitted, it can take a while to find a bed for them. She also said St. Joe’s is seeing patients with more complex mental health needs, some requiring inpatient treatment.

“The opioid crisis in Hamilton is also having a significant impact on our emergency services and across our clinics,” she said.

Pierson also told reporters that the HHS has had to move patients to different facilities but has not yet had to move anyone out of the region. She also said that the increase in demand is further compounded by the fact that the hospital is still running at about 90 per cent of its pre-COVID surgical capacity.

“A lot is being done to try to alleviate pressures on the health care system right now. We have inordinately deep relationships with our community partners and we’re looking at every opportunity to maximize our post-acute capacity,” she said, adding that 250 to 275 patients at HHS are looking for beds.

“We do have patients in hallways across all of our sites as well.”

Bruce Squires, president of McMaster Children’s Hospital, said that while the situation in the hospital is not as critical as it was this time last year, the pediatric system–which is quite small to begin with–is stressed.

“McMaster Children’s Hospital is also experiencing significant capacity pressures and staffing challenges. Inpatient capacity at the hospital is consistently at or over 100 per cent. We were at 112 per cent in terms of pediatric bed occupancy,” he told reporters.

Offering some reassuring news, Squires told reporters the level of children visiting the hospital is stable compared to most respiratory viral seasons.

“The number of admitted patients with respiratory viral illnesses has been relatively stable over the last two weeks, so that’s actually good news,” he said, adding that spikes in RSV (respiratory syncytial virus) have been reported across Ontario.

Squires also said that staffing issues are compounding the strain brought on by high demand and that the hospital is still working through a surgical backlog brought on by COVID-related measures.

He also said the province’s $40 million investment in health care has helped alleviate some of the strain, allowing the hospital to open more ICU and other beds.

“Measures over the course of the pandemic did impact children and the delays caused an overall backlog where patients waited too long for care. We are making progress with the recent support from the provincial government and we’re grateful for that investment that’s enhancing our ability…to deliver health care to children and youth.”

In a news release, HHS said that residents can alleviate some of the strain by utilizing other health care resources when they’re not seriously ill.

“Individuals with mild illness or mild symptoms usually don’t require a trip to the [emergency department],” said Dr. Brian McKenna, a lead physician with the Hamilton Family Health Team, in a statement.

McKenna told reporters that people who believe they’re at increased or high risk of serious illness should speak to their doctor about what they can do to protect themselves from viruses.

McKenna said residents should seek medical attention if they have a lingering fever that won’t respond to over-the-counter medication such as Tylenol or Advil, cannot complete normal tasks or if their condition worsens after appearing to improve.

“We are seeing an uptick in terms of the respiratory virus season. We are seeing more coughs, colds and flu-like illnesses over the last four to six weeks. If we are in store for what we saw last November to February, we are in for significant strain well beyond where we’re at right now,” he told reporters.

McKenna said residents without a family doctor can visit a walk-in or use a provincial portal that can connect them with doctors accepting new patients.

As for how to avoid getting sick, Dr. Elizabeth Richardson, Hamilton’s Medical Officer of Health, said residents should ensure they are up to date on their COVID and flu vaccines, stay home when they are sick, practice respiratory hygiene (coughing and sneezing into their sleeves, avoiding handshakes and regularly washing their hands) and consider masking in crowded indoor spaces and around those who might be vulnerable to infection.

In a news release, the HHS said people who are sick but who do not require emergency assistance can see their family doctor or go to an after-hours clinic, call Health811 to speak to a nurse via phone or web chat, or visit an urgent care centre.

“Hamilton’s emergency departments are busier than ever, and those without serious health concerns will face very long wait times,” the organization said in a statement.

HHS said anyone experiencing a medical emergency should call 9-1-1.

As for what health care facilities are doing to cope with the overwhelming demand and limited capacity, the HHS said it’s maximizing care in post-acute care settings such as the Satellite Health Facility, St. Peter’s Hospital and Regional Rehabilitation, expediting patient discharges when possible, offering virtual and remote care options to patients who can recover at home and enhancing the existing workforce.

“We acknowledge that many staff and physicians have been asked to work additional hours and we are grateful for their commitment to our patients and families.”