The story repeats itself. The emergencies are overflowing. And influenza season is not yet in full swing. The stretcher occupancy rate exceeded 200% on Tuesday at the Royal Victoria Hospital in Montreal, and practically reached 250% on Sunday. At Pierre-Le Gardeur hospital in Terrebonne, this rate was around 190% during the day, according to Index Santé. It was more than 170% in several hospital centers in the greater Montreal region.
“The biggest problem at the moment is the lack of personnel,” says the president of the Association of Emergency Medicine Specialists of Quebec (ASMUQ), Dr.r Gilbert Boucher. If we had staff like we had before the pandemic, we are really hopeful that things would really go much better. We could use all the beds in hospitals. »
Due to a lack of caregivers, beds remain closed on the floors, which contributes to the overcrowding of emergency rooms.
Emergency departments are also facing a shortage of staff. “We continue to lose people,” said Dr.r Butcher. It is very difficult to take care of patients. »
The stretcher occupancy rate almost reached 250% on Sunday at the Royal Victoria Hospital, according to the Dr Marc Béique, deputy director of professional services, hospital fluidity, adult sites at the McGill University Health Center (MUHC), which manages this hospital center.
To relieve emergency room congestion, closed beds at the Montreal Neurological Institute-Hospital were reopened. “We asked Urgences-santé to help us transfer patients [là-bas] quickly,” explains Dr.r Béique. Units on the upper floors accommodated additional patients. “There are some discharges that were given a little more prematurely than would have been wanted but obviously without risk to the patient,” he adds.
According to him, this hospital congestion is largely due to the lack of places in CHSLDs in the west of the island of Montreal. Approximately 120 patients no longer requiring hospital care remain in MUHC facilities, because they are waiting for a residential environment or a place in a rehabilitation center, for example. “This represents almost 17% of beds,” he explains. The ministerial target is 8%. »
Royal Victoria is also facing a shortage of caregivers. “There’s a shortage of emergency nurses,” says Dr.r Béique. It varies a lot from one day to the next. We also have a problem in intensive care. »
Measures have been put in place, he indicates, to improve hospital fluidity at Royal Victoria. “We started the early leave planning project this summer, with a very high recommendation from the ministry to move forward,” he said. Issues related to patient discharge are identified upon arrival.
Difficulty accessing the GAP
The waiting rooms are also overflowing, according to the Dr Butcher. Up to 14% of patients presenting to the emergency room leave before being seen, he laments. Among them, some are cases deemed semi-urgent.
“What we hear on the ground is that for 8 or 9 months, the GAP [guichet d’accès à la première ligne] did the job, said the Dr Butcher. It helped a lot with sporadic problems. » The problem is that patients with chronic illnesses (e.g. diabetes or pulmonary disorder) have difficulty obtaining an appointment at the GAP and do not benefit from longer-term follow-up by family doctors. They then find themselves in the emergency room. “There is still a lot of lack of access to the front line,” he believes.
At the Saint-Eustache hospital, around 20% of patients leave the emergency room without having seen a doctor, according to the co-head of the emergency room, Dr.D Karine Plouffe. Employees are overwhelmed. In the Laurentians, the “standard” is a stretcher occupancy rate of 150%. As of 4 p.m. Tuesday, that rate stood at 159%.
According to the CISSS des Laurentides, current emergency room traffic is linked to an increase in visits, caused, among other things, by an increase in respiratory problems. “The rapid increase in the population in the Laurentians, particularly for people over 65, is a real issue for our region,” adds the establishment in an email. “Although we have more beds open than last year, we sometimes observe that the duration of care is longer, which indicates that hospitalized users have significant health problems. » The CISSS adds that “places in accommodation settings are limited”.