KHSC asks residents to ‘know where to go’ as patient surge and staff shortages strain resources

Kingston Health Sciences Centre (KHSC) is requesting community support and action as the hospitals it oversees here in Kingston weather a storm brought about by multiple factors.

KHSC, the health care organization that oversees the operations of Kingston General Hospital (KGH), Hotel Dieu Hospital (HDH), and the Cancer Centre of Southeastern Ontario issued an “urgent” request via social media on Monday, Jun. 27, 2022. In the four-part post on Twitter, the organization explained it is “currently experiencing a surge in patients across the hospital which, combined with ongoing staff and physician shortages and lack of post-acute beds in the community, has led to longer wait-times” in KHSC emergency departments.

“We are asking for your help,” KHSC stated.

According to Dr. David Pichora, President and CEO of KHSC, the issues leading to this situation are “not new,” but rather exacerbated as the effects of the COVID-19 pandemic continue – both with COVID-19 cases, and with the backlog the pandemic has created for those seeking medical treatment.

“I guess it goes back years,” Pichora said of the staff and surgeon shortages and the lack of post-acute care beds in Kingston; but he noted that those issues are “amplified by two and a half years of pandemic.”

“We were relatively spared in waves one and two, but we really got a significant uptick in activity in wave three, with patients being transferred in from elsewhere…  then, the choke point, if you will, was ICUs, right around the province.”

Through waves four and five, acute care, capacity medicine, and internal medicine became the more prominent issues, Pichora said. “But… what we’re seeing now is a waning impact of COVID in the hospital, and a rising impact of just general [patient] surge with lots of really sick people.”

The local hospitals are seeing many more people coming in because “they don’t seem to have an alternative: they can’t get a primary care appointment, or they can’t get one in a timely fashion,” or they may require access to community agencies focused on mental health or addictions.

“And then, at the other end of the system, we’re not getting patients flowing out of hospital to create the beds that we need for the people in emerg, because of gridlock in home community care and long-term care, for all the same reasons around staffing, largely,” Pichora explained.

“So it’s not a new problem; it’s just a growing problem. And it’s accelerated by… the fact that staff are really tired, and they just want to forget about this and have a summer vacation. And that’s what we want them to do. They need it.”

Pichora went on to explain how the compounded issues and exhaustion are impacting the very people whose services and expertise are in such high demand.

“Some of our senior nurses are starting five days of vacation by coming in and doing a double [shift]. That’s just not good for anybody. But it’s a sign of the way things are right now. I’m thankful that folks are continuing to step up,” Pichora said, “but we really worry about their health, and what it’s going to be like tomorrow and the next day, because… I don’t anticipate these surge pressures are going to go away. We have to just keep finding ways to manage it.”

One of the ways to address the situation is to ask that area residents put in extra effort to find an alternative to attending an emergency department at a local hospital, Pichora said. This could mean trying to get an appointment with a family physician, going to walk-in clinics as opposed to emergency departments, and a variety of other options, which can be found in KHSC’s ‘Right Place, Right Care’ guide. This resource helps Kingstonians ‘know where to go’ to address their health concerns through the appropriate avenues, acting as a sort of ‘pre-age’ to hospital triage.

KHSC is also exploring many new and different concepts to reduce the strain on the system and on those who work within it.

“We’ve hired an awful lot of people; we’re still hiring people and training them. We’re creating new so-called ‘extender positions’ to try to support, for example, an RN on a ward, so that there’s someone who can do some of the running work for them, so that they can do the stuff that an RN really needs to do and extend their capacity. We’ve been doing a lot of that, and we continue to do it,” said Pichora.

“We’re redeploying staff as we have to, but nobody likes that,” he continued, noting that staff redeployment is only done when it’s absolutely necessary.

“We have continued to find new and different ways to do things… in the last two and a half years, and we’re continuing to do that. Who knows, we may be morphing our [COVID-19] assessment centre one more time! We’ve already done that more than half a dozen times in terms of where it’s located and what it does, but we’re thinking about what we can do to create some primary care type capacity in the community, specifically focused at offloading the pressures on our ER. That’s the subject of some meetings this week that we’re working on.”

And with Canada Day just days away, Pichora encouraged residents to celebrate safely to ensure another patient surge doesn’t overwhelm the hospital system locally. At the same time, he cautioned that COVID-19 has not gone away. Pointing to the recent peaks in COVID-19 activity found in wastewater locally, he emphasized the need for everyone to be up to date on all COVID-19 vaccinations they are eligible for, since those who are fully vaccinated are far less likely to require medical care in hospital if they contract the virus.

Still, large gatherings pose a risk, as do excessive alcohol consumption and drug use, so proactivity on the part of the community is just one of the methods KHSC is asking residents to employ, as the current patient surge isn’t expected to end soon.

“Everybody wants to say that we’re done with this, and we’re past it. But unfortunately, that’s not really the case. I don’t think we can say that with any level of confidence,” Pichora said.

“We would like to see patients get care in the community when they can. And I’m pretty sure that’s what they want, too. Nobody wants to go to the ER and sit there for hours and hours, which is [likely] if you’re a relatively low priority case and there are really sick people ahead of you… It doesn’t take too much imagination to imagine how it’s going to go.”

To read the entire message from KHSC, visit their Twitter account.