The Globe and Mail recently published a story about overcrowded Emergency Departments in downtown hospitals due to condo developments and population growth. St. Joe’s President and CEO Elizabeth Buller responds with an op-ed piece detailing how population growth also affects community hospitals.
Sadly, the issue of ED overcrowding is not limited to the large tertiary care hospitals in the downtown core, there is also a significant impact on the community hospitals. As the sole acute care hospital in southwest Toronto, St. Joseph’s Health Centre provides access to emergency care for a catchment area of 500,000 people – the same population as the city of Hamilton (which has three adult and one pediatric ED). Our Emergency Department, built for 60,000 patient visits, last year cared for over 100,000 people from our community. Like the downtown core, the population in the west end has grown dramatically, especially in areas of new condo development like Liberty Village and Humber Bay. And like the downtown core, St. Joe’s provides care for a substantial number of people in our community with complex medical and mental health needs.
Built in the era before SARS, the aging and strained physical plant of our ED lacks the number of enclosed isolation-type rooms that would be common-place in newly-built EDs today. Our ED team has used innovation to compensate for the strain, by implementing novel approaches that allow us to start treating the majority of patients in less than one hour. While our Health Centre is engaged in a $70 million capital fundraising campaign, a large portion of which will be used to create a revitalized ED, the need exists now.
Compounding the challenge of ever-increasing patient volumes is a virtual shrinking of available space in the ED due to admitted patients who have no bed to go to within the Health Centre. While the Health Centre has opened additional beds in the past year to try to alleviate the pressures in the ED, more of our acute inpatient beds are occupied by patients who no longer require acute care, but, through no fault of their own, cannot access long-term care or specialized rehabilitation beds in a timely fashion, because they too are filled beyond capacity. Commonly, one out of every five of our acute beds is occupied by patients who no longer require a hospital bed; recently, this number has swelled to one in four. The impact on patients seeking care in our ED is inevitable. Admitted patients can spend hours or even days in the ED; and finding a place to treat the next sick person to arrive becomes more and more challenging.
Emergency department crowding is not an emergency department problem; or even a hospital problem. It is a system problem, and it requires a system solution. The current crisis affects not only hospitals, but entire communities. For community Health Centres like St. Joe’s, it impacts all those we serve in the west end of Toronto.
Emergencies, by definition, are situations that cannot wait. The State of Emergency described so eloquently in your article is no exception.
President and CEO
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