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November 12, 2022

MCH Capacity and Surgical Activity Update and Changes

McMaster Children’s Hospital (MCH), like all pediatric hospitals in Ontario, is under immense and increasing strain not unlike the pressures that have impacted Hamilton Health Sciences (HHS) adult sites since the pandemic began.

Inpatient occupancy for pediatric beds at MCH is extremely high and significant surge capacity has been required to meet volume pressures. There is very limited physical space available to add areas where care can be provided.

In addition to measures implemented in recent weeks, additional action is being taken to address capacity issues at MCH, especially on inpatient units. This includes the direction to transfer 16- and 17-year old surgical pediatric patients who need to be admitted to an inpatient bed, from the MCH to two HHS adult acute sites. Patients requiring clinically urgent care (priority 1) will not be transferred and outpatient surgeries will continue at MCH.

Starting on Saturday, November 12, 16- and 17-year old surgical patients at the MCH emergency department who need emergent surgeries, will be transferred to:

  • The Juravinski Hospital (JH) site: general, plastic and urology surgical cases.
  • The Hamilton General Hospital (HGH) site: orthopedic, trauma, plastic and ENT cases. (NOTE: trauma patients who are 16 year-old and older have already been receiving care at the HGH.)

Teams at the JH and HGH caring for these pediatric surgical patients will be supported remotely by their colleagues from the MCH. In addition, there is a breadth of experience already available at the HGH site, in particular in relation to caring for pediatric burn and trauma patients. Both sites also respond regularly to pediatric patients who present to the ED.

In accordance to provincial direction, there are already protocols in place for the transfer of critically ill patients who are 14 years-old and older to critical care units at our adult sites. These actions are only being taken because of the extraordinary pressure at MCH.

HHS continues to work with regional partners to minimize disruptions across our hospitals and ensure all available community and regional resources are being applied to help reduce demand on the MCH. This includes:

  • First sending patients to regional hospitals with pediatric wards/beds.
  • Temporarily modifying the MCH “catchment area” so that patients at hospitals, and those being transported by ambulance, in the Kitchener-Waterloo, Wellington County, Cambridge and Guelph areas are sent to the London Health Sciences Centre, instead of the MCH.
  • This includes the following hospitals:
    o Grand River
    o Saint Mary’s General (Kitchener)
    o Cambridge Memorial
    o Groves Community Memorial (Fergus)
    o Guelph General
  • Note: this does not include NICU patients who will continue to come to MCH and critically ill children who will continue to be transferred via Criticall to the most appropriate and available site.

We recognize the impact that such difficult decisions may have on the patients and families we serve. We are grateful for their patience as we make these changes to ensure continuity of care for everyone.

We sincerely appreciate the work of all our staff and physicians to support patients and their families at this very trying time.