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Health-care worker shortage presenting serious challenge to Niagara hospital system

Posted Sep 22nd, 2022

This is an opinion column by Niagara Health President and Chief Executive Officer, Lynn Guerriero published in the St. Catharines StandardNiagara Falls ReviewWelland Tribune and NiagaraThisWeek

There is no bigger issue facing Ontario hospitals today than the serious shortage of health-care workers.

These challenges are unprecedented and something we will be dealing with for years to come.

Niagara Health staff and physicians take extraordinary measures every day to minimize impact on services. No area of the hospital is untouched, forcing us to align our services with available staffing levels to deliver safe, quality care and take care of our workforce.

These workforce shortages are also being felt across the broader healthcare system — from hospitals to home and community care, long-term care and primary care — resulting in longer wait times.

The provincial government recently announced its strategy to create health system capacity and add health human resources. We are also refreshing our organizational priorities through our current strategic planning process that will drive our focus locally over the next five years and support our efforts to address what has become an unsustainable situation.

The pressures at Niagara Health have become most apparent in our emergency departments, which is a similar experience for other Ontario hospitals. We are all struggling with significant patient volumes and staffing pressures in our emergency and other factors within our hospitals and respective communities that are contributing to emergency department pressures.

A number of hospitals temporarily closed their emergencies for short periods over the summer, and I am grateful that we have succeeded in keeping our three departments and two urgent care centres staffed and open.

Our emergencies are the busiest areas of the hospital and see an average of 400 patients each day. During the month of July, 2,000 patient emergency department visits were for non-emergencies, and I ask our community to use our health system wisely by considering the many other health-care options available when not in need of serious medical attention.

Contacting your family doctor or other primary care provider, visiting a walk-in clinic or accessing our new virtual urgent care in situations that are not emergencies will help ease the pressures at the hospital and support you in getting timely access to the right level of care. A comprehensive resource can be found on our Niagara Health website to help you make the right decision.

Another pressure point is with our anesthesiologists.

Several times this summer, a shortage of anesthesiologists led us to redirect patients needing after-hours emergency surgeries from the Welland site to our Niagara Falls and St. Catharines sites. Demand for the services of anesthesiologists is increasing at the same time we are experiencing a nationwide shortage of these health-care professionals.

Patients will likely see more redirects in urgent situations to minimize the impact on service continuity.

We have made significant progress to clear backlogs in surgical and diagnostic procedures, which were paused several times during the pandemic based on provincial direction. In both cases, we are performing at 95 per cent of our pre-pandemic volumes.

Patients who require emergency surgical and diagnostic procedures are immediately receiving this care, however, almost 5,000 patients are awaiting non-emergent surgeries that were postponed, mostly cataract and orthopedic procedures. And patients are waiting 140 days for non-urgent CT scans and 220 days for non-urgent MRI scans.

Timely access to non-urgent surgery and diagnostics is a priority, and we are working with the provincial government and our partners to add capacity.

Other work underway to alleviate staffing pressures and mitigate service impacts include: aggressively recruiting and retaining health-care workers; working with family physicians and other primary care partners to enhance resources in the community; enhancing our academic partnerships to train Niagara’s future healthcare workers; and providing additional training to our healthcare professionals to advance their skills.

We are exploring care delivery models beyond the traditional physician-and-nurse-centric model.

You’ll hear new terms such as physician and nurse extenders, roles which are part of a broader team approach to assist with shortages. This includes adding physician assistants to our current model to extend the care provided by physicians. These highly trained health-care professionals will diversify the care team and provide additional support to physicians.

The south Niagara site will be transformational for our region and for the delivery of health care as we know it. Our planning for this state-of-the-art hospital began before the arrival of COVID-19 and did not account for the impact the pandemic would have on staffing.

However, these plans to shift from five sites to three and modernize our hospital care model will help strengthen our team’s expertise, assist with retention and recruitment, and contribute to solving the staffing shortages that are expected to last into the next decade.

Our staff and physicians are doing their best in challenging circumstances and continue to demonstrate the utmost dedication to patients and their families.

Yes, there are significant challenges to overcome.

By working together with our community and partners, and thinking in new ways, we will overcome them. I am excited for the future as Niagara Health continues to evolve, transform and grow to deliver the safe, quality care Niagara residents deserve.

Niagara Health System