Hospitals in the greater Montreal area have been required since Monday to implement an “overcapacity protocol” so that the floors can accommodate more patients when the emergency room is overflowing. In a letter sent Friday to the chief executive officers of health establishments, assistant deputy ministers Lucie Opatrny and Daniel Desharnais indicate that “plans must be put in place first in Greater Montreal, no later than December 19 next year.” .
In a press scrum on Wednesday morning, the Minister of Health Christian Dubé had indicated that the overcapacity plans would be implemented gradually in Quebec, according to the establishments and their situation. He had not mentioned the delay imposed on establishments in the greater Montreal area. “Not everyone can go at the same speed,” he said. […] Some are already there, some are going to do it, but it will still take a few weeks. »
The duty obtained the letter sent to the CEOs as well as the accompanying ministerial directive. It is written there that the overcapacity plan must be triggered when the occupancy rate on the emergency room stretcher reaches 140%. However, measures must be put in place before that happens.
The directive, which emanates from the emergency crisis unit, indicates in particular that between 100% and 140%, medical specialists must offer consultations to emergency patients “from 8 a.m. to 6 p.m. Monday to Friday and weekends from 8:00 a.m. to 5:00 p.m., with an obligation to respond. At this stage, the imaging sector must carry out ultrasounds until 6 p.m. and CT scans (“scans”) until 10 p.m.
The floors must admit “the equivalent of two patients in temporary overcapacity per unit according to the number of signed or probable leaves, and this, according to the average leave of the installation per day”. A unit “may receive three supernumeraries and the other one, depending on the realities of each establishment”, it is specified.
The plan is triggered once the occupancy rate reaches 140% and 40% of stretcher patients are awaiting admission to an inpatient unit. The number of supernumerary patients accommodated on the floors then increases by one notch (for example, the equivalent of four overcapacity patients per unit).
When the occupancy rate exceeds 160% and 60% of stretcher patients are awaiting admission, the floors accommodate even more supernumerary patients. At this time, hospitals must also redirect “minimum 10% of patients admitted on stretcher to day medicine, to avoid hospitalization”. They must also reduce the number of surgeries “in order to achieve [un taux de] less than 140% in the next 24 hours,” the directive reads.
In the directive, the crisis unit asks health establishments to “compulsorily” designate a person responsible for “triggering overcapacity plans” in each hospital.
Asked about the implementation of the overcapacity plan in the greater Montreal area, the Ministry of Health and Social Services said it expected “that the overcapacity plans of the establishments will be ready”. “Establishments have the responsibility to trigger them and implement them when the situation requires it,” he added.