Capacity pressures = safety concerns

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Four people sharing a single bed beside a curtained window.
No free beds? That’s alright, we’re all friends here, yeah?  Clker-Free-Vector-Images via Pixabay, manipulated by lee lim

Hallway healthcare is on the rise, as are resulting safety violations

Reaching capacity is a recurring issue for many hospitals due to a lack of staff and beds, making “hallway healthcare” a common practice, if a dangerous one.  

Hallway healthcare refers to the provision of care in “beds, in hallways, [and] in waiting rooms because there simply isn’t enough space in the emergency room and in the rest of the hospital,” said Vicki Mowat, the Saskatchewan NDP MLA for Saskatoon Fairview. Overcrowding in hospitals is a serious concern that can lead to ineffective healthcare treatment and even safety hazards in an emergency.  

The Saskatchewan Health Authority (SHA) released the Regina Capacity Pressure Action Plan (RCPAP) to address capacity pressures in Regina’s hospitals. This plan was developed and implemented in response to warnings from a Regina fire inspector about fire code violations in the Regina General Hospital and The Pasqua Hospital.  

According to the Regina Fire Inspector, the practice of hallway healthcare contravenes the National Fire Code of Canada. This is found under section 2.7.1.6., which states “Means of egress shall be maintained in good repair and free of obstructions.”  

As defined in section 1.4.1.2, “Means of egress means a continuous path of travel provided for the escape of persons from any point in a building or contained open space to a separate building, an open public thoroughfare, or an exterior open space protected from fire exposure from the building and having access to an open public thoroughfare. Means of egress includes exits and access to exits.”  

By providing healthcare in hallways, which count as access points to fire exits, the means of egress is potentially obstructed and in violation of the Fire Code.  

Sheila Anderson, the SHA Vice-President of Integrated Regina Health, explained the factors that have been contributing to capacity pressures and the resulting hallway healthcare. “Regina’s tertiary hospitals are facing capacity pressures that are being exacerbated by seasonal respiratory viruses and a rise in patients presenting with increasingly complex needs,” Anderson said. Anderson also said that pressures are expected to rise through the “holiday season,” making the implementation plan a high priority. 

In response to the warning from the Regina Fire Inspector, the SHA released the RCPAP to address the issue. According to a news release from the SHA on December 21, 2023, this plan “outlines several concrete actions to alleviate and address the immediate pressures facing Regina hospital capacity while introducing long-term measures.” 

So far, the SHA reports that several actions have been made to increase hospital capacity in Regina, including “the addition of 28 medicine beds at the Pasqua Hospital; the addition of Emergency Room Staff including Registered Nurses, physicians, security personnel, and porters; the addition of four General Internal Medicine Admitting physician FTEs; addition of six high acuity beds at Regina General Hospital (RGH) acting as a step-down unit to ensure capacity for those patients requiring Critical Care services; addition of two 24/7 staffed ambulances in the community; the addition of six hospice beds at Wascana Rehab Centre; and an announced additional community Policy and Crisis Team (PACT) in Regina.”  

The SHA will implement plans to build on the above actions in the next three months. These plans include working towards adding staff to acute care centres to “support timely and appropriate discharges from acute care to free up inpatient beds more quickly,” adding more palliative home care resources to lessen the time inpatients must stay in the hospital, adding four high-acuity beds at the RGH, increasing hospitals adherence to Overcapacity Protocols, and increasing chronic disease supports in Regina.  

Going forward, these plans should serve the purpose to decrease the capacity pressure on hospitals, and help minimize the practice of hallway healthcare that infringes on the safety of those in hospitals.  

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