The Chatham-Kent Health Alliance has issued an update regarding elective and non-urgent procedures in response to a new Provincial directive.
Meanwhile, the Province says action was needed to be taken to maximize capacity and preserve resources needed to care for patients across Ontario.
CKHA Update
In accordance with a new Ontario Health directive to Ontario hospitals, Chatham-Kent Health Alliance (CKHA) is obligated to “ramp down” some non-urgent, elective/scheduled care and procedures beginning Monday, April 12, 2021, as needed, in order to preserve critical care and human resource capacity for the province.
Hospital officials say the decision is based on increasing case counts and widespread community transmission across many parts of the province, as well as extreme pressure on the province’s critical care capacity.
At this stage, as of Monday, April 12 at 12:01 a.m., CKHA will continue to provide urgent and emergent services as well as the necessary programs/services to support these procedures, like diagnostics, post-anesthesia care unit.
Given current local demands on the hospital, CKHA will maintain its elective surgeries, inpatient and outpatient, ambulatory care and diagnostic services, hospital officials say.
“If local conditions change or if CKHA is called on to support other hospitals in the region or across the province, the hospital will take steps to immediately ramp down or cease elective services as needed,” CKHA officials said in a media release issued on Friday, April 9, 2021.
“If cancellation of surgical procedures is required, patients will be notified by their surgeon. CKHA relies on the clinical judgement of its surgeons to make informed decisions of which cases to proceed with during ramp down measures. Patients will be contacted in advance if their scheduled appointments are affected.”
Hospital officials say this is a temporary measure to create capacity within CKHA to respond to the urgent critical care needs that hospital partners across the region and province are currently experiencing.
“During this third wave of the pandemic, COVID-19 cases have risen rapidly due to variants of concern (VoC) throughout the province, and critical care beds have approached an unprecedented state,” CKHA officials say.
“Beds at CKHA are a provincial asset and the hospital must take a regional approach to help ease capacity on the wider system. This includes preparing to accept patient transfers from other regions to CKHA if needed. Occupancy across CKHA must remain at 85% or lower during this time in order to appropriately respond to provincial health care system needs. Available capacity needs to be accessible with a quick turnaround (i.e. with hours, not days).”
Currently, CKHA has capacity in its intensive care unit and has a plan to take a stepped approach to increase critical care capacity, as needed, hospital officials say.
“To ensure patients across the province receive the life-saving care they need, hospitals in harder-hit areas of Ontario are transferring patients to hospitals with critical care capacity, which could include CKHA,” hospital officials say.
“The province’s goal is to preserve critical care and human resource capacity across the system.”
CKHA will continuously monitor this ramp down measure with great care and consideration, hospital officials added.
“CKHA thanks its patients, families and care partners for their understanding during these difficult times,” hospital officials say.
“CKHA asks that patients do not call the hospital regarding their procedures; patients will hear from their surgeon if a change is required. Follow up questions can be directed to their Surgeon’s Office. The status of the pandemic continues to be assessed daily. More information will become available as the situation changes.”
Ontario supporting health system response during third wave of COVID-19
In response to the recent and rapid rise in hospitalizations, ICU admissions and the threat to the province’s critical care capacity, the Ontario government is issuing two emergency orders under the Emergency Management and Civil Protection Act (EMCPA).
These orders will maximize system capacity, ensuring that hospitals have the resources required to provide care for patients and save lives, Provincial officials say.
These temporary emergency orders will support the redeployment of health care professionals and other workers currently working in Ontario Health and Home and Community Care Support Services organizations to hospitals.
They will also provide hospitals with the flexibility to transfer patients to alternate hospital sites in situations where a hospital’s resources are at significant and immediate risk of becoming overwhelmed, Provincial officials say.
These orders, along with additional measures being taken, are expected to increase ICU capacity in the province by up to 1,000 patient beds.
“With Ontario’s hospitals facing unprecedented critical care capacity pressures during the third wave of the COVID-19 pandemic, our government is taking immediate action to ensure no capacity nor resource in Ontario’s hospitals goes untapped,” said Christine Elliott, Deputy Premier and Minister of Health, in a media release.
“Together with the provincewide Stay-At-Home Order, these measures will help to ensure that hospitals continue to have the staffing and resources they need to care for patients. We continue to work with our hospital and health care partners to fight this deadly virus, and I want to thank all of Ontario’s frontline health care workers for their tireless work each day to protect the health and safety of Ontarians.”
Over the last year, the government has made significant investments and efforts to build capacity and maintain the integrity of Ontario’s health care system, including investing $5.1-billion to support hospitals, creating over 3,100 more hospital beds, Provincial officials say.
However, as Ontario, like other provinces and jurisdictions around the world, combats the third wave of the COVID-19 pandemic and deadly variants, further action is needed to allow hospitals to maximize capacity and ensure patients are receiving the most appropriate care.
Effective immediately, similar to orders previously introduced, home and community care support services organizations (formerly LHINs) and Ontario Health will be provided the authority and flexibility to voluntarily deploy staff, such as care coordinators, nurses, and others, to work in team-based models in hospitals that are experiencing significant capacity pressures due to COVID-19, Provincial officials say.
In addition, home and community care support services organizations will now be authorized to deploy staff to backfill redeployed staff within and to another home and community care support service organization.
In addition, the government is taking action to better leverage Ontario’s hospital system as one connected resource, improving the ability of hospitals to respond to the most emergent and acute needs so that all patients can receive the most appropriate care in the right setting, Provincial officials say.
During major surge events where the demand for critical care threatens to overwhelm a hospital, the province will allow hospitals the flexibility to transfer patients to alternate hospital sites without obtaining the consent of the patient or, where the patient is incapable, their substitute decision maker, Provincial officials say.
Hospitals may rely upon this order to facilitate the transfer of a patient to an alternate hospital site only when necessary to respond to a major surge event, when the attending physician is satisfied that the patient will receive the care they require at that other site and that the transfer can be effected without compromising the patient’s medical condition, and where all of the other conditions specified within the order have been met, Provincial officials say.
As soon as possible following the conclusion of the major surge event, the alternate hospital site would be required to make reasonable efforts to transfer the patient back to the original hospital site or to another suitable care location which is consented to by the patient or substitute decision maker.
Effective Monday, April 12, 2021, Ontario Health has also instructed hospitals to ramp down all elective surgeries and non-urgent activities in order to preserve critical care and human resource capacity.
At this time, the ramp down instruction does not apply to the Northern Ontario Health Region.
Pediatric specialty hospitals can also continue their plans to care for children and youth and may help if required to support other regional hospitals, Provincial officials say.
“Since the beginning of the COVID-19 pandemic, hospitals and health care providers have worked tirelessly and thanks to their efforts, have allowed our province to protect Ontarians and provide care for patients,” said Matt Anderson, CEO of Ontario Health, in a media release.
“These are challenging times for all Ontarians, and we understand that deferring scheduled surgeries and other procedures will have an impact on patients, their families and on caregivers. We are monitoring the situation and will work to resume as soon and as safely as possible these deferred services and procedures.”
These time-limited orders remain valid for 14 days unless revoked or extended in accordance with the Emergency Management and Civil Protection Actand will come into effect on Friday, April 9, 2021.
Provincial officials say COVID-19 related ICU admissions are already over the peak of wave two and as of April 9, 2021, there are 552 patients in ICU due to COVID-related critical illness, and ICU occupancy provincewide has already surpassed 81 per cent.
Modelling data predicts that this number will pass 600 within the next week.
On April 7, the Ontario government, in consultation with the Chief Medical Officer of Health and other health experts, declared a third provincial emergency under s 7.0.1 of the Emergency Management and Civil Protection Act (EMPCA).
Effective Thursday, April 8, 2021 at 12:01 a.m., the government issued a province-wide Stay-at-Home order requiring everyone to remain at home except for specified purposes, such as going to the grocery store or pharmacy, accessing health care services (including getting vaccinated), for outdoor exercise, or for work that cannot be done remotely, Provincial officials say.
