Board Chair Message - April 2005

Acute healthcare is a complex business. The more I am exposed to acute care issues, the more respect I have for the people who look after us in our time of need.

I am increasingly concerned though, that the lack of alternate level of care beds is complicating our delivery of acute care services. For example, on Wednesday, March 30th, 35 of our in-patients were finished with their acute care phase, but had nowhere to go. Apparently, 29 of these patients needed rehabilitative care in an alternate level of care setting and an additional six patients were waiting for placement to a long-term care facility.

To compound the problem, our Emergency Department was holding patients waiting for an in-patient bed. Overflow units had patients, surgical units had medical patients, and some surgeries were delayed or cancelled. In addition, staff members were anxious about those patients who needed an acute care bed but might have to be sent out of the city to another hospital because our site was overwhelmed with demand for service. As I listened to the evidence, it was a bit unnerving, to say the least.

People who do not need acute care should be moved to alternate levels of care settings to continue with their proper plan of care. If they need rehabilitation, they should receive that care in a setting that is more appropriate to their need. They are often left with us to recover in an acute care environment that is not equipped to focus as fully on their recovery.

I sit on various committees that examine utilization reports. The reports speak to on-going treatment of patients, appropriate levels of staff, as well as the capacity and the flexibility to manage unpredictable peaks in requests for care. Discussion always centers on discharge planning and how many people are ready to be moved from TBRHSC to an Alternate Level of Care site. When times are busy, I can appreciate why care providers send patients to other hospitals in Ontario, out of province, and in some cases, out of the county.

We are encouraged that studies are underway and recommendations are coming forward that may help relieve the “bed” tension in the system. It is paramount that we provide the right care in the right environment at the right time in the right place. Ideally, the healthcare continuum should plot a plan of care that seamlessly moves a patient through the system.

We are waiting for the implementation of the Local Health Integrated Network Strategy (LHINS) hoping that it will help with the movement of patients through the continuum of care. We are hoping for the best. As well, with budget constraints, we are hoping that we do not have to reduce services, especially at a time when activity has us often bulging at the seams.

Let us start somewhere. Let us work together to enable appropriate patients to be moved to an alternate level of care environment which would, in turn, permit us to deliver acute care to those who need it. The business case is strong. Appropriate care benefits everyone.

Sincerely,

Ron Nelson, Chair
Board of Governors

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