Windsor Regional's emergency department to use data with hopes of reducing patients in hallways
85 per cent capacity is the hospital's "sweet spot" and where they want to be
As of Monday, Windsor Regional Hospital will begin using data to predict who's coming into the emergency department, which they hope will help reduce the number of people in hallways waiting for a bed.
Over the last 18 months, the organization said it has the lowest number of patients waiting for an in-patient bed in the entire province, after they've been admitted.
"I can tell you very unfortunately, we used to be one of the highest," said Karen McCullough, Windsor Regional's chief operating officer and chief nursing executive.
Monday's change is to better predict how many patients are coming in, for what purpose and where could they go.
"What can we do to make sure that we are reducing the amount of time patients are spending there unnecessarily," said McCullough.
"If we've had a patient in our emergency department waiting more than three hours for a bed, we literally do an investigation ..."- Karen McCullough, COO & Chief Nursing Executive, Windsor Regional Hospital
A CBC News analysis showed some of Ontario's biggest hospitals are filled beyond capacity almost every day. Richmond Hill Hospital is at the top of that list, with 179 days over 100 per cent capacity out of 181 days for the first six months of last year.
By comparison, Windsor Regional's Ouellette campus had 72 days over capacity in that same time frame. The hospital's Met campus had eight days at more than 100 per cent.
Overcapacity pressures in Sarnia 'virtually every day'
At Sarnia's two Bluewater Health campuses, the community saw 93 days where there were more people needing a bed than there were beds available.
"We have pressures virtually every day in our acute medicine units," said Mike Lapaine, president and CEO of Bluewater Health. "There's rarely a day that we don't hit 100 per cent, particularly this time of year."
When that happens, hospitals across Ontario, including those in Windsor and Sarnia, have access to "surge money" from the province. It allows health care centres to open and staff additional beds to help when an organization has exceeded its capacity.
From 7 a.m. until about noon, Lapaine said there's "a lot of frantic movement" to gain access to beds needed for people waiting in the emergency department.
When hospitals are full or nearly full, staff look at who is well enough to be discharged on their own or who might require home care.
In Windsor, officials look at which units have capacity to take emergency department patients for a day to free up space. They also utilize health care partners in the community on a regular basis, depending on which organization has capacity.
Overcapacity in Windsor was the norm
It was only about three years ago when overcapacity was the norm for Windsor Regional.
Now, because of its command centre, as well as the way it predicts and tracks patients, McCullough said they're better equipped to deal with capacity issues.
Two years ago Windsor Regional added a total of 24 beds split evenly between both campuses at their own expense. The Ministry of Health and Long-Term Care did not provide additional funding for those beds.
Windsor Regional funded more beds on their own
"We staffed them and it was basically money that we spent that, honestly, we really didn't have," said McCullough. "So [patients] weren't waiting in [the emergency room], really taking up resources and space, and we didn't have to put patients in hallways."
She said 85 per cent occupancy is the hospital's "sweet spot" and where they want to be.
If not, every day at 8 a.m. and 4 p.m., senior leadership at both campuses huddle for 15 minutes to see what can be done to improve capacity. Before this system was implemented in 2017, it was common for many people to be admitted, but still waiting for a bed.
"We now come in the morning and if we've had a patient in our emergency department waiting more than three hours for a bed, we literally do an investigation with the ED and the unit to find out how that could have happened," said McCullough.
The command centre, also referred to as "air traffic control" by hospital officials, consists of a room with eight big screen televisions mounted to the wall. It allows them to view in real-time how many beds are available, as well as overall capacity, wait times and EMS resources by each unit.
One button breaks down each unit to show total beds, when patients are scheduled to be discharged and how many beds are expected for the next day.
"Once again, it's the data, so you're predicting so you can plan," said McCullough.
Back in 2016-17 when capacity was a big problem, there was an average of 26 patients each day in the emergency department waiting for a bed. Today, that's down to about five people per day. Wait times for those beds are now an average of three hours, down from 22.
On Thursday, the Met campus had a roughly 84 per cent capacity rate, while the Ouellette campus was 96 per cent full.
This model is something many other hospitals in Ontario don't have. Other health care centres will sometimes come to Windsor Regional to observe the system and its results first-hand.