'Exceptionally high' patient volumes push Cobequid health centre into overtime hours

"Exceptionally high" patient volumes and a lack of available beds at the Queen Elizabeth II Health Sciences Centre have required the Cobequid Community Health Centre to remain open overnight 11 times in the last month.

The Lower Sackville, N.S., site normally closes each day at midnight. Nova Scotia Health Authority officials confirmed Monday, however, that high emergency department volumes, bed occupancies and staff illnesses at the Halifax Infirmary necessitated finding alternative arrangements to ease patient flow.

The Cobequid remained open Feb. 4, 7, 8, 14, 15, 19, 25, 28 and March 1-3. Numbers for the last three nights show:

• Five patients and two staff stayed all night Sunday
• Eight patients and two staff stayed all night Saturday
• Nine patients and two staff stayed all night Friday, and a third staff member stayed until 4 a.m.

On Monday, six patients at Cobequid were awaiting transfer to the QEII.

'Best decision possible for patients'

"[Patient] volumes are exceptionally high everywhere," a health authority spokesperson said in an email.

A statement attributed to Tanya Penney, director of the NSHA's emergency program, said "while this is not an ideal scenario, it's considered the best decision possible for patients."

"We believe they are better off remaining in patient beds than on an ambulance stretcher in the hallway. This further clogs [emergency departments] and ties up ambulance crews."

Penney said health services managers are working to minimize the effect on work-life balance for staff and that "their efforts are truly appreciated."

Nagging system problems

The union representing paramedics in the province has drawn attention to offload delays at hospitals, particularly in Halifax and Dartmouth, for more than a year. Paramedics are not able to transfer a patient into a hospital's care and return to service until there is a space available for the patient.

Health authority officials recently told the legislature's standing committee on health that on average, about 20 per cent of the 1,700 medical and surgical beds are filled by people who don't need acute care.

There is direct correlation between the problems of offload delays and lack of bed availability and others, such as long waits in emergency departments.

Tory Leader Tim Houston said the situation at Cobequid makes him think about the larger sites, such as the infirmary and Dartmouth General.

"Imagine the chaos that's happening at the other areas where they're saying, 'We just can't do it anymore. We can't take any more patients.'"

A call for emergency action

Given the warning signs, Houston said more of a plan should be in place by now from the government to address things such as bed shortages and offload wait times.

NDP Leader Gary Burrill said the situation at Cobequid is entirely predictable given the calls for help from paramedics and emergency department staff for more than a year.

The offload problems for paramedics and the number of people waiting in hospital for placement elsewhere are problems that should have been addressed long ago, he said, calling on the government to start building new long-term care beds "on an emergency basis immediately."

"What we're seeing here is how this impacts every level of the health-care system."

Both Burrill and Houston said the provincial government also needs to include the Cobequid in the QEII redevelopment plan so services there can be expanded.

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