While the health system is cracking everywhere and the shortage of personnel is suffocating the network, everything is now only targets to be reached. The list of Quebecers waiting for a family doctor, surgeries put on hold, overflows in the emergency room, lark! As The duty revealed on Thursday, we can now add to this sprint the crazy race in which we want to engage Montreal hospitals to free up beds occupied by patients waiting for accommodation.
The objective is noble, let’s say it, and corresponds to the desire of Quebecers to obtain home care. We understand very well that the Ministry of Health and Social Services (MSSS) hopes to reduce the number of beds occupied by patients who no longer require care, but are waiting for appropriate accommodation. In Montreal, 18% of beds are occupied by this type of patient. If we hope to see them leave, it is to reduce overflows in the emergency room and speed up the pace of surgery. These strategic objectives make sense.
But do we have the means to get there? The chosen formula is magical, but perilous. It is by turning to caregivers and asking them for their “collaboration”, the space of “2-3 weeks” — according to a document prepared by the Departmental Coordination Department of the MSSS and dated August 31 —, that we think of freeing up these precious places in the hospital. It is calculated that in Quebec there are 2175 of these patients who have been stationed in a bed for too long, and Montreal alone accounts for 730 (34%).
While the front line is red and struggling to find all its essential staff, the risk seems great that we will not be able to put in place the structure necessary to support such a family support system. Because it will be necessary to increase the resources intended for home care (Quebec must add more than 20 million, but that will not increase staff!), and it will be necessary to free up precious places in the accommodation units for each of the patients (Quebec wants to create 175 new places in CHSLDs, but the need is greater!).
Skepticism grows with experience. The MSSS is so voracious in the targets to be hit that it is hard to believe that this hunt for the perfect targets will not bring in its wake pitfalls caused by the lack of personnel. If by chance the resources did not follow this miracle project, it would be the patients and the caregivers who would suffer.
The day when The duty unveiled this directive, journalist Isabelle Hachey reported in The Press a disconcerting account, like a human form of this too rapid propensity of hospitals to want to free up beds. A patient with an incurable neurodegenerative disease came to no longer need “acute care” in the hospital. He cluttered a bed. While his relatives multiplied the calls in vain to find him accommodation, it was finally the hospital that found him a home. Go out ! An hour and a half after being transferred there, the man returned to the hospital by ambulance after a fall, which was fatal to him. History tells us that the family had contacted this residence, but it did not meet their needs.
Beware of the mirage of hitting targets. Because behind the numbers hide human dramas.