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CHEO looks to redeploy staff, use online tools to tackle long waits

The Ottawa-based hospital's medical units are currently at 124 per cent occupancy after a stretch of its busiest-ever months, it said in a news release.
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The Children's Hospital of Eastern Ontario (CHEO) is redeploying staff, adding specialized positions and looking at online tools for families in response to "unprecedented" pressures and long wait times for care as similar trends are seen at children's hospitals across the province.

The Ottawa-based hospital's medical units are currently at 124 per cent occupancy after a stretch of its busiest-ever months, it said in a news release. Staff shortages and surges in patients needing mental health, respiratory and critical care have led to cancelled surgeries and delayed procedures.

On Friday, Oct. 7 CHEO detailed steps it's taking to ensure safe care for patients, including moving more medical professionals to front-line roles, adding shifts and embedding specialists with clinical care teams to ensure people are discharged sooner.

"There is no silver bullet, there is no one solution," hospital president Alex Munter said. "It's a complex problem, but really, we're throwing everything we've got at it."

Some of the changes are set to take place this weekend, Munter said, with medical professionals trained in critical care set to return to the intensive care unit, and staff from other departments set to be redeployed.

Next week, the hospital plans to place "discharge planners" in clinical teams to ensure children in inpatient beds get home sooner -- a bottleneck that Munter said has contributed to emergency department waits because there are no available beds for new patients to be admitted to. 

Another specialized job the hospital is looking to scale up is for pre-triage assessment nurse practitioners, who give immediate advice to families before admitting a child to the hospital.

CHEO is also looking to improve wait-time modelling on its website and develop an online tool to help families navigate care more easily with symptom-checker tools and present them with alternative care options.

CHEO, Toronto's Hospital for Sick Children and McMaster Children's Hospital in Hamilton have all detailed long wait times due to increased demand and pressure on their hospitals, noting a significant rise in respiratory infections and staff shortages.

Munter said children's hospitals across Canada are contending with the same issues. 

"The Canadian children's health-care system is not sized to deal with a simultaneous surge in demand and decrease in access from other providers," he said. "There's more kids and families that need care, and there's fewer places for them to go."

He said people are coming to emergency departments when they don't have family doctors or can't access other clinics. He said governments should respond with a strategy for children's health to help shore up capacity. 

"We need to bulk up and obviously we need the support of all levels of government and our philanthropic donors to help make that possible."

Dr. Jason Fischer, head of emergency medicine at the Hospital for Sick Children, also pointed to the lack of care options as one factor behind long wait times at the facility, along with staff shortages and a rise in circulating viral illnesses.

The downtown Toronto hospital, which also serves as a hub for surrounding communities, is seeing 30 to 40 per cent more patients per day, Fischer said, with wait times and length of emergency department stays both rising. 

He said SickKids is encouraging families to use hospital resources to learn about how to treat fevers at home before coming to the emergency room, and promoting its virtual urgent care platform that includes a symptom-checker and some virtual care visits -- an option that launched during the pandemic and is currently being used by around 60 families each day. 

Internally, Fischer said it's challenging to make "significant change" because staffing and physical space are fixed with demand rising so dramatically.

"We're still trying to find ways to use our resources better, to be more efficient in the (emergency department), but it's very hard to increase volumes by 30 to 40 per cent and respond to that in a timely manner, just given the resourcing constrictions we have," he said.

This report by The Canadian Press was first published Oct. 7, 2022. 


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