President and CEO of Quinte Health Care (QHC) Stacey Daub and Dr. Colin MacPherson, Chief of Staff of QHC gave a community update Monday on what is destined to be very challenging fall/winter season for Ontario’s health care system.

QHC officials explained the system is experiencing a dramatic increase in demand for services stemming from the combined impact of ongoing COVID infections, the early return of high rates of seasonal respiratory illnesses, staff absences due to COVID and health human resource shortages. This fall has seen a significant increase in Respiratory Syncytial Virus (RSV) in kids, creating substantially higher pediatric related emergency department (ED) visits and hospital admissions at community and children’s hospitals.

“We’ve continually rallied at each wave of the pandemic, and quite honestly right now we are kind of at the end of the eighth wave, and still feeling the impact of COVID,” Daub stated. “But adding to that, we are seeing the early and assertive return of seasonal viruses, including influenza but also something called RSV, which I think house holds didn’t know what that was but are coming more and more knowledgeable. RSV has really tipped the scales in terms of demand from a population that really hasn’t been accessing the hospitals as much during the pandemic because COVID didn’t have a big impact on children but RSV really does. ”

QHC President and CEO Stacey Daub. (Submitted Photo)

While QHC teams have worked exceptionally hard to maintain access to hospitals services and address pandemic related surgical backlogs, QHC’s four sites are not immune to trends and their impact on the hospital operations, their teams and the community. QHC is currently operating at 135 per cent of their funded adult medicine capacity and 135 per cent of their pediatric in patient medicine capacity, translating into immense pressures at each of their community hospitals. Pediatric visits to the ED in October are up by 20 per cent compared to 2021, with a 40 per cent increase in the number of children between 4 and 10 years of age.

These extreme pressures have resulted in extended ED wait times, delays in transfers between hospitals and from the emergency departments to an in patient bed.

“There is a lot of work provincially to coordinate care for children and their families across the province, with supports to some highly specialized centres, like Sick Kids and CHEO,” said Daub. “Which means our hospitals have to become better equipped at being able to support kids locally so that they can care for those children who need that highly specialized care. And a good example for us is, recently we’ve been working with all four of our hospitals to make sure our emergency departments are equipped with pediatric equipment that they will have available and readily available, we’ve been working with community pharmacists and other partners to make sure alternates to the emergency department and finding new and different ways to access some of the medications that perhaps had been challenging for some families to access.”

QHC Infographic

Delayed care from earlier waves of the pandemic, ongoing outbreaks in local long term care and retirement homes and a severe shortage of home care and primary care in communities are resulting in a steady increase in ED visits, increased admissions and persistent challenges in transitioning patients back to community for care. The local hospital remains the fail safe for people from across communities, requiring Quinte Health to rapidly adapt to the changing environment and to partner broadly to support the community.

“With the increase in visits that were seeing particularly with our paediatric patients and sitting so consistently at an occupancy of 135 per cent in both paediatrics and in our adult medicine wards, its really critical for us to get a message out to the public to continue to take care of yourselves,” Dr. MacPherson said. “The fact is, its difficult to give this message and I know its become difficult for people to hear it. We’ve been giving the same message, it seems for a very long time, but fortunately, or unfortunately the same message applies, and its extremely important.”

In anticipation of these challenges, Quinte Health initiated a series of actions this summer to proactively prepare, plan and implement measures to mitigate the impact to our community.

The following highlights some actions underway:

• QHC are working hard to preserve hospital capacity so there is access to care when our community needs it the most. QHC are working with Ontario Health and local health partners on programs so people have another option for care instead of the hospital, and are working to support timely hospital discharges.
• QHC are working with local and regional partners, including partner hospitals, to collectively manage the enormous demand for hospital services.
• QHC are working with local and provincial government on strengthening the local health system and addressing equity issues associated with access to primary care, community care and hospital services.

QHC acknowledge the community partners for the collaborative spirit they have exhibited and for sharing in the efforts to find solutions to a health care crisis that spans well beyond the hospital corridors.

Supporting and stabilizing the Quinte Health teams.

• QHC have implemented assertive recruitment and retention strategies in the most competitive recruitment environment they’ve ever faced. Year to date, Quinte Health has added an additional 85 clinical staff members to our local health care teams, including 25 nurses. Despite this success, there is still a considerable gap in Quinte Health’s health human resources given the considerable growth in patients and beds in operations (56 per cent increase).
• Support programs for front line and leadership teams that recognize and help mitigate the successive impact of the pandemic and current working conditions on the people and teams at Quinte Health.
• Engaging their physician leaders and teams to develop innovative ways to serve the community, given the ongoing resource issues.
• Recognition and retention strategies focused on retaining existing staff and physicians.

Improving access to care. Targeted actions to improve patient access to care delayed by the pandemic, with a focus on diagnostic imaging and surgery.

• Despite human resource shortages, the surgical program has been diligently working to reduce the surgical backlog. As of October, the percentage of patients exceeding wait time targets is down to 15.5 per cent. This compares to the provincial rate of 52 per cent
• 87 per cent decrease in the significant mammography backlog created during the pandemic shutdown – from a backlog of 3171 patient requisitions for mammograms to 390.

QHC needs your support. The Fall/Winter is expected to create a historic level of demand on Quinte Health hospitals.

QHC are requesting the following from their communities:

• Let’s create healthier communities together. We all play a role in prevention and we can all make a difference. If you feel sick, even with mild symptoms, please stay home. If you have symptoms, including when you are recovering from illness, wear a mask to protect others. Wear a mask indoors, especially in social settings with the most vulnerable – older individuals, children under 4 years of age and those with underlying medical conditions. Wash your hands frequently and clean high‐touch surfaces often. Get your flu shot and stay up to date with the COVID vaccine. Save the Emergency Department for emergencies – for non‐urgent conditions try your primary care provider, a walk‐in clinic or virtual care for non‐emergency medical assistance.
• Support your local health care teams in terms of acknowledgment at every opportunity. The individual hospital staff member or physician is not responsible for what ails the current system. We understand how frustrating it can be to wait. Please be kind and let them know how important the work they are doing is to all of us.

“Wearing a mask to me is not a big deal, somehow its become a political statement or issue,” Dr. MacPherson stated. “In the hospital were wearing masks all the time and ill often have it on and come back and close the door by myself in the office and an hour goes by and I realize my mask is still on, I’ve come not to notice it, its really a simple thing to do.”

“The people who work at Quinte Health they have been by these communities sides every step of the way,” expressed Daub. “Through covid, through eight waves, they’ve been by the communities side throughout this RSV and paediatric, they’re here for you, they are remarkable people, they care for their community, they care for one another and if there is something small you can do in your day-to-day routine like stay home when your sick and wear a mask when your interacting with people, its a small gesture that makes a huge impact on the people who work here and our community at large. Colin and I are both extremely proud of our teams, we worry about our teams all the time in terms of what they have endured and how they continue to rally behind new populations that have come through. They are a source of inspiration for us and for the community.”