Hospital waits for inpatient beds still high, but getting lower for CT scans, MRIs

Johanne Messier-Mann, Sault Area Hospital's Quality Committee chair, presented a wide range of numbers to the SAH board of directors for consideration at its meeting Monday.

For a start, Messier-Mann told the board that "ambulance offload times have shown improvement.” 

As of August, the offload time was 78.8 minutes and preliminary numbers for October show further improvement in that offload time.

Additional funding has been allocated for a dedicated offload nurse.

As far as the length of time patients can expect to be in SAH’s Emergency Department is concerned, Messier-Mann reported that low acuity patients (those in less serious condition) were in the ED for an average of 6.9 hours year to date as of August 2023, SAH’s target time being 6.2 hours.

High acuity patients stayed in the ED for an average of 15.8 hours year to date as of August 2023, SAH’s target time being 13.3 hours.

Messier-Mann reported that there have been improvements to patient care in the ED with the addition of a registered nurse, a physician assistant, the recruitment of a nurse practitioner and the adding of an extra personal support worker shift.

Messier-Mann told the board that collaboration with SAH Mental Health & Addiction services has led to enhanced care of mental health patients in the ED.

Wait times for an inpatient bed remain a challenge. 

“Despite ongoing efforts, performance is static,” Messier-Mann reported.

Year to date for August 2023 was 29.9 hours with a target of 23.5 hours, with a particular challenge being high occupancy rates hindering patient flow from the ED.”

That challenge is worsened during outbreaks, especially when dealing with multiple patients requiring respiratory isolation.

Staffing constraints have put up a big hurdle, although there has been some relief in recent months due to successful recruitment efforts, Messier-Mann reported.

Performance is meeting target in regard to finding beds for Alternate Level of Care (ALC) patients at SAH.

Year to date for August 2023 was 21.1 per cent with a target of 24 per cent.

An additional five beds have been opened in geriatric rehab. 

“There is a strong advocacy for ALC, recognizing it as a systemic problem for Algoma,” Messier-Mann said.

As of August 2023, 73 per cent of patients waiting for a CT scan at SAH were scanned within the target time, passing the provincial average of 57 per cent. For MRIs, 53 per cent of patients were scanned within the target time, outperforming the provincial average of 34 per cent. 

For both CTs and MRIs, that is an improvement for SAH over the previous year.

In April 2023, there were 1,336 patients on the surgical wait list, with 192 patients exceeding the target time. As of Oct. 12, 2023, the current wait list has 1,329 patients, with 237 patients exceeding the target, Messier-Mann reported.

17.8 per cent of SAH's current surgical wait list numbers are classified as ‘long waiters,’ with plastic surgery and oral and maxillofacial (OMF) surgery having the lengthiest wait times. Of the long waiters, 20 per cent of the volume is in urology, 15 per cent is OMF Surgery and 14 per cent is orthopaedic surgery.

SAH recruitment efforts for doctors in those specialty areas are continuing.

“The good news is that we remain leaders in long wait reduction in the northeast,” Messier-Mann told the board.

Earlier in November, the Canadian Centre for Policy Alternatives urged SAH to look at extending operating hours into evenings and weekends to address surgical wait lists.

“Our primary focus is to provide quality healthcare, and we implement policies related to healthcare at the direction of the Ministry of Health. As our role does not involve setting or evaluating public health policy, we cannot comment on the claims in the Canadian Centre for Policy Alternatives report,” wrote Brandy Sharp Young, SAH spokesperson in an email received earlier Monday.

“Sault Area Hospital has the capacity to run six operating rooms. We typically schedule four operating rooms throughout the weekdays and maintain one operating room for emergent care in the evenings and weekends. Our operating room scheduling is contingent primarily on the availability of staff and physician resources,” Sharp Young wrote.