Hamilton hospitals facing continued healthcare worker shortages, service delays

HAMILTON, ON – Service impacts and increasingly high wait times are likely to be an ongoing reality for Hamilton’s hospitals as record-high healthcare worker and physician shortages persist across Ontario and Canada, and as the predicted 7^th wave of COVID-19 arrives earlier than expected.

Currently, there are 675 job vacancies between Hamilton’s two hospital organizations, Hamilton Health Sciences (HHS) and St. Joseph’s Healthcare Hamilton (SJHH). Despite aggressive recruitment efforts by both hospitals, the number of qualified applicants is often not enough to fill vacancies. Staffing shortages are further exacerbated by a rise in the number of staff and physicians in self-isolation due to COVID, and a much higher number of staff off ill than usual. These pressures, along with high demand for services, are affecting all areas of hospital operations and threatening service continuity, including in community programs, inpatient and outpatient care, mental health, pediatrics, and regional programs.

Additional compounding factors include:

• An increased demand for hospital services, driven in part by an increase in the severity of illness among patients seeking care.
• Factors relating to the COVID-19 pandemic, including the impacts from surgical reductions that have resulted in patients waiting longer for surgery. Currently, there is a backlog of over 12,000 surgical cases (pediatric and adult) between HHS and SJHH, and it is not yet known when pre-pandemic surgical levels can be resumed.
  • Further, the early arrival of the 7^th wave of COVID-19 in the community is resulting in increased hospital admissions and contributing to further reductions to surgical activities. These reductions are due to hospital outbreaks impacting bed flow and a rise in the number of hospital staff and physicians off work due to COVID exposure or infection.
• Ongoing community-based challenges, including outbreaks in long-term care facilities, which inhibit hospitals’ ability to discharge ALC (alternate level of care) patients. Like hospitals, community agencies are also facing serious health human resource pressures, which create additional delays across the system.

“Our healthcare workers have shouldered an enormous load through the COVID-19 pandemic and continue to do so,” says Melissa Farrell, president of SJHH. “We are profoundly grateful and recognize a need to align service capacity to staffing levels where possible to support quality patient care and the wellness of our healthcare workers. This is a complicated process for everyone and will mean temporary service and procedure reductions as required.”

“Every day, we’re caring for more patients than our staff have the capacity to care for,” says Sharon Pierson, executive vice president, clinical operations and chief operating officer at HHS. “Hamilton’s health-care system, like all hospitals in the province, is in a very precarious position. Our ability to push onward is made possible by our people’s valiant commitment to our patients, and for their sake we’re doing all we can do to bring some relief to our highly pressured situation.”

HHS and SJHH continue to place priority on emergent and regional services, and are working closely with regional peers and the province to mitigate access and impact to hospital services. However, unfortunately, patients and families should expect long wait times. We ask for our community’s patience and understanding as we work to resolve these issues and provide our care.

As a reminder, there are many healthcare options in our community. Unless a person is experiencing a medical emergency, the following resources should be considered before visiting an emergency department:

1. A family doctor, for health concerns that can wait a day or more.
2. Health Connect Ontario, to chat with a registered nurse 24/7 via phone or web chat.
3. An urgent care centre, for health concerns that are not life-threatening but can’t wait for a doctor’s appointment. Both HHS and SJHH operate a UCC in the city.

For more information, visit needadoc.ca.

We remind our community that masking continues to be mandatory in all Hamilton hospitals and urgent care centres for all staff, patients, and visitors. This is an essential measure to keep hospital staff and physicians safe and to protect the vulnerable populations we serve. Visit hamiltonhealthsciences.ca or stjoes.ca to learn more.

 

Media Contacts

Wendy Stewart |Communications & Public Affairs |Hamilton Health Sciences |stewartwen@hhsc.ca

Maria Hayes | Sr. Public Affairs Specialist | St. Joseph’s Healthcare Hamilton |mhayes@stjoes.ca

 

Additional Data

Capacity Pressures at St. Joseph’s Healthcare Hamilton

Surgery Backlog

• 4,561 unscheduled cases as of July 18, 2022

Acute Occupancy

• Our current Acute Occupancy is 100%

 

Mental Health Capacity Pressures (Dec. 2019 to date)

• Average Monthly Referral Volume = Up 44%
  • % of Urgent Referrals = Up 33%
• Average Monthly Self-Referrals = Up 82%
  • % of Urgent Referrals = Up 16%
• Total wait for Assessment (days) = Up 55%

Emergency Department, Urgent Care and Psychiatric Emergency Service Pressures (2019 vs. 2022)

• Emergency Department
  • May – June 2019 = 4,663
  • May – June 2022 = 5,127
• Urgent Care
  • May – June 2019 = 4,707
  • May – June 2022 = 6,182

Alternative Level of Care* (ALC) Rate *Patients who occupy a bed but do not require the intensity of services provided in that care setting.

• Average Acute ALC rate including the Satellite Health Facility from Jan 1, 2022 to-date: 24.6%

Staffing Pressures

• As of July 19, 2022:
  • 106 healthcare workers positive with COVID-19
  • 27 healthcare workers isolating at home due to being symptomatic

Recruitment

• There are currently 293 job vacancies at SJHH.
• To address these needs we have implemented aggressive recruitment strategies, including:

• • • An expanded digital presence across multiple platforms, specifically those geared to online professionals
    • We have brought on additional recruitment specialists, who are being trained on new tools to better leverage online platforms
    • Holding virtual job recruitment fairs

 

Capacity Pressures at Hamilton Health Sciences

Surgical backlog

• 1,396 pediatric and 6,053 adults waiting for surgery at HHS as of June 2022

Adult occupancy

• The widely accepted sector standard for funded hospital bed capacity is 85%.
  • Occupancy rates have been as high as:
    • 125% at Juravinski Hospital and Cancer Centre
    • 112% at Hamilton General Hospital
  • HHS is currently operating approximately 82 unfunded beds. This is about the size of a medium-sized hospital.

Emergency department pressures

• HHS’ emergency departments were not built to accommodate current patient volumes.
  • The ED at Hamilton General Hospital was designed to accommodate 100 patients per day, but currently sees approximately 121 patients per day.
  • The ED at the Juravinski Hospital was designed to accommodate 85 patients per day, but currently sees approximately 108 patients per day.

• While visits to the ED at McMaster Children’s Hospital have decreased as compared to the spring, staffing shortages persist across all HHS sites and patients/families will continue to face long waits and delays to care.

Alternate level of care

• ALC rate is at an historic high – 1 in 6 (17%) adult beds.
  • There are currently 200 ALC patients at HHS.

Staffing pressures:

As of July 19:

• 159 healthcare workers positive with COVID-19
• 206 healthcare workers isolating at home due to being symptomatic

Recruitment:

• There are currently about 400 posted job vacancies at HHS.
• HHS is aggressively recruiting to fill staffing gaps. This includes:
• Implementation of a central recruitment function within human resources.
• Expanded employment marketing efforts across a number of channels, including on online recruitment platforms, through social media, and in direct advertising to more than a dozen universities and colleges targeting new graduates from a variety of programs.
• Expedited training, orientation and health interviews to speed-up the onboarding process.
• Expanded international recruitment efforts to additional areas beyond nursing, based on the internationally educated nurse recruitment program, which has successfully filled over 1,300 nursing roles across HHS since its inception in 2009.