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COVID wasn’t responsible, Dr. Robert Barnes said, though some patients tested positive while being admitted for other conditions.
The decision on Sunday to preemptively turn away low-priority patients from the Children’s emergency department was for them to avoid wait times of up to 18 hours, Dr. Robert Barnes said. Photo by Allen McInnis /Montreal Gazette Article content
A perfect storm led to the overcrowding of the Montreal Childrens Hospitals emergency department over the weekend, the hospitals associate director of professional services says.
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Non-urgent cases were asked to stay away in an advisory that was lifted Monday after extra staff was brought in to respond to the increased demand. In contrast to the issue of overcrowding in adult emergency rooms across Quebec, which was anticipated for the summer because of staff shortages and COVID-19, Dr. Robert Barnes did not associate the situation at the Childrens with either.
Capacity to treat patients was the same when the advisory was issued as it is during a typical summer, Barnes said, though it might have been increased more substantially in response to the issue if some staff werent unavailable because of the virus. So far, the hospital has been able to secure two to three more days of added capacity, he said.
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Its a perfect storm right now, and if summers are going to look like this on a more regular basis, we are going to need to adjust our usual resources and staffing allocations, Barnes said.
He added there were various reasons hospital beds were full on Sunday, but that COVID wasnt responsible, though some patients test positive while being admitted for other conditions, resulting in added precautions.
Its a variety of issues, he said. Newborn babies who are stable enough to leave the neonatal intensive care unit but not well enough to go home just yet we have a number of children with chronic conditions that can flare up at any time, but we have a good number of them right now who are sick enough to need an in-patient bed or an intensive-care unit bed. And we have a wide variety of infections, both viruses and bacteria.
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Some of the viruses currently in circulation typically present during winter, when pediatric hospitals are busiest are playing a role, Barnes said, but not to the same extent as last summer when the city had just come out of isolation.
Its part of it, but not the whole story.
The decision to preemptively turn away low-priority patients from the Childrens emergency department, Barnes said, was for them to avoid wait times of up to 18 hours.
We basically told families upfront that if the category is (low priority), we dont want you stuck here for so long that its basically the same thing as not being able to serve you, he said. And you deserve to know that in advance.
For Dr. Katharine Smart, the president of the Canadian Medical Association, the advisory issued by the hospital speaks to the ongoing challenges in the health-care system.
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Theres so many aspects of it that are under strain, and were just constantly working on the very edge of being able to keep going, she said. Theres no give in the system, and I think what happened there yesterday is just an example of that, they went as far as they could with it, and then all of a sudden they just hit a point where theyre like we can safely no longer continue working at this capacity and we have to actually ask people not come here.’
In its announcement on Sunday, the hospital had asked that patients with non-urgent conditions turn to family doctors, walk-in clinics or Info-Sant (811). Barnes reiterated that advice Monday, stressing that emergency rooms are for emergencies, but said parents should use their intuition when deciding whether to head to the ER immediately or wait to speak to someone at Info-Sant.
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Dr. Judy Morris, president of the Quebec Association of Emergency Physicians, said on Monday emergency department visits are increasing across the province, which could be partially linked to the reduced capacity of other services over the summer.
If (patients) dont have access to a nurse or their usual clinic, they might have to show up to the (emergency department) to seek care, she said. All my colleagues are seeing kind of record numbers of patients showing up through their doors certainly the highest numbers that weve seen since the beginning of the pandemic.
But in adult hospitals, staff shortages from both COVID-19 and holidays are also contributing to ER overcrowding, Morris said, where occupation rates are high and theres a marked increase in wait times and patients leaving without being seen.
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Theres not official delestage like there was in winter, but we know that some other activities in hospitals have to be cut as a result, like surgeries, Morris said.
Asked if she feels like the situation is approaching the point of being out of control, she said most health-care workers already feel it is.
Theres a tiredness that has been setting in for quite a while, she said.
At the beginning of July, the Canadian Association of Emergency Physicians released a statement supported by its Quebec counterpart calling for governments, hospitals, unions and other relevant parties to address the critical conditions in ERs.
We need to keep talking about it, because we need to recognize that the problem is there and that we need to actively work to try to find solutions, Morris said.
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Overcrowded Montreal Children’s ER tells non-urgent cases to stay away Montreal ERs overcrowded as health-care staff shortages continue Share this article in your social network Advertisement 1
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