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Tuesday, 6 January 2015

Picard hits a home run: Hospital congestion not just an influenza problem

A national treasure, André Picard once again tells it like it really is.  Influenza is not the cause of the winter bed surges – its bad management and planning.   The increased volume of influenza hospitalizations may hit a 1% surge above background levels, whereas some hospitals are looking at over 25% excess populations  above bed numbers - and doing nothing other than blaming something over which they perceive they have no control. Jan 7 - a calculation of current admitted clients by number of beds in one are of close to 1 Million population, suggests overall impact on bed utilization is 3%  - well below the reported capacity overflow for the same area. if you have local statistics, please share them and help debunk the myth

Well done André – hit a knockout punch to ring a few bells.   Hospitals manage very well planning for holiday slowdowns, planning for reduced services on weekends, and coping outside of the 8-5 work day.  They even have demonstrated marvelous capacity to respond to labour strife with strikes and walkouts, without poorer health outcomes.

Yet, annually the surge occurs to align with the predictable wave of influenza.  And predictably the hospitals will argue for more beds, the emergency departments will complain of backed up patients, long wait times and poor quality care.  And come April, while the rhetoric reverberates, planning for a summer slowdown will be in full swing.

The cynics might reply with its just public health complaining and pushing more vaccine. If public health did a better job getting people to wash hands, cover their coughs, be immunized and even ensure that the walking ill don’t see it necessary to use the emergency room, that the hospitals would manage better.

Talk about victim blaming!!!  

That a large number of people inside and outside the hospital this year are gripping about the poor planning is a faint light that perhaps somebody might think differently.  With a dozen years at senior executive tables and nearly 30 years in the field, this writer’s skepticism is justifiably a learned response.  As one person said, “its like the movie Groundhog day.  We just keep repeating the same mistakes over and over and painfully slowly learn from our mistakes.

So good on you Picard for taking the system to task.  We deserve the criticism and we deserve chastisement for our failure to learn from the past.  

In this day and age, few senior executives last more than a couple of years – corporate history is so short that we are destined to repeat our errors, over and over and over again and sentenced to the annual winter surge to be taken in stride as a “normal”.  Besides, were it not for the winter surge, we would not have the numbers on which to argue for more beds, bigger emergency departments, more, more, more…. 

Thanks André.   We’ll be looking forward to your next home run. globeandmail ER congestion January 6 2014

1 comment:

  1. Thought provoking and scary; always budgeting for less and yet the reality is always more. Throw in an Ebola-like variable and now we have a predictable catastrophe.