Health officials are trying something new to ease overcrowding at Nanaimo Regional General Hospital.
The hospital has more patients than it does approved acute care beds, which means patients are housed in hallways, alcoves and wherever else appropriate space is available.
Doctors on the pediatric unit at NRGH spoke out recently about the hospital’s practice of putting adult patients in a room on the children’s ward initially intended to be a treatment room for children.
They say the room has housed adult overflow patients for more than a year. Shortly after the doctors went public with their concerns, one adult on the ward was diagnosed with Clostridium difficile.
Elin Bjarnason, executive director of patient flow and care transitions, said the health authority established an Extraordinary Discharge Operations Committee at NRGH several weeks ago.
She said formation of the committee was motivated by an increase, starting in the early summer, of what health officials call alternate level care patients – patients who no longer require hospitalization, but the hospital is unable to discharge them for various reasons, such as because they are awaiting a spot in a long-term care facility, the patient requires extra supports to go home or there are complicated social factors.
“They may not have a home to go to,” said Bjarnason. “Some have complex situations. It requires some conversation and some thought.”
The committee consists of managers of different departments in the hospital and team leaders in areas such as home and community care, mental health and patient flow.
The group meets daily to discuss the patients and determine the best solution to each individual situation, said Bjarnason. In the past, regular meetings involving such a large network of people did not occur.
“We’re really supporting our front-line staff in a much more direct, day-to-day way,” she said. “It’s great to get the leaders together at one table. People have different ideas on how we can problem solve.”
Bjarnason said the committee is already seeing results – there is about a 30 per cent turnover in alternate level care patients at NRGH so far.
But patient turnover remains a challenge in many complex situations, she added.
For example, it could take longer to place a young person with dementia in a long-term care facility, or to find a solution to concerns a care facility has with a patient’s behavioural issues.
“Health care isn’t smooth sailing,” said Bjarnason.
A Nanaimo woman who spent a few nights in the pediatric ward recently is speaking out about the hospital’s practice of putting adults in the children’s unit.
Kathy Lennstrom, 46, was placed on the pediatric ward after she received internal and external injuries after jumping out of a second-floor window to escape a fire in October.
“It wasn’t a very comfortable feeling at all,” she said. “There’s more adults up there than kids.”
When Lennstrom walked down the hall, she could see parents look at her and then shut the door to their child’s room. Some parents kept the door shut all the time.
Lennstrom doesn’t blame parents for shutting their children away – these parents don’t know what diseases the adults on the ward have and what kind of people they are – but added that children deserve a place where they feel comfortable to run around.
“[Kids] should be able to run down the hall,” she said. “My daughter spent lots of time in the peds ward. I would have hated to see adults in there.”
The adults on the ward are disruptive, Lennstrom added.
When she was in there, adults were being moved in at 1 a.m. or 2 a.m. and she could hear children who had been woken up by the activity crying.
“It was too much shuffling around late at night, early in the morning,” said Lennstrom.
Dr. Jane Pegg, a doctor in the pediatric unit, said since one patient was diagnosed with C. diff, the ward was cleared of adults, but doctors have received no guarantee from the health authority that adults will not be put back on the unit.
She said doctors have started a petition to help bring awareness and support to the issue, which is available at http://www.change.org/petitions/vancouver-island-health-authority-stop-admitting-adult-patients-to-the-paediatric-ward-at-nrgh.