KHSC receiving out of region transfers once again

As COVID-19 hospitalizations and community based infections begin to stabilize in Kingston and the surrounding area, Kingston Health Sciences Centre (KHSC) is once again pitching in to support hospitals in the Toronto area that are struggling with soaring volumes of COVID-19 patients.

Last week KHSC received transfer orders from the Ontario Critical Care COVID Command Centre and has since received several COVID ICU patients from the Greater Toronto Area (GTA).

Similar to the provincial approach employed during the third wave last spring, hospitals across the province are working together under a ‘team Ontario’ model, where hospital capacity is treated as a single-system resource and patient loads are leveled to ease the pressure on the hardest hit regions.

“We’ve seen both sides of the coin this last year, having both accepted a large number of patients from the GTA last spring and then transferring out COVID patients to other hospitals when we were particularly hard hit here in Kingston in November and December,” says KHSC President and CEO Dr. David Pichora. “This give-and-take demonstrates the strong partnership we have between hospitals in our province and is absolutely crucial so that we avoid the worst-case scenario for our health care system.”

The transfers, which are being coordinated centrally by the Ontario Critical Care COVID Command Centre, take into account multiple factors when matching patients with receiving hospitals. Primarily balancing the needs of the patient, distance of transfers, patient safety and consent.

“We’re in a bit of a different situation than last spring, as our non-COVID volume of patients and acuity remain very high while we also continue to navigate staffing shortages across the organization,” says Dr. Renate Ilse, Executive Vice President and Chief Operating Officer. “We may not be in a position to accept the same number of out-of-region patients as we did last spring, but we will do our part to the best of our abilities, to support patients who need our help, regardless of their home address.”

While all Ontario hospitals have been directed to ‘ramp-down’ non-urgent surgeries and clinical activities, in an effort to redeploy resources to support growing COVID hospitalizations in Ontario, non-COVID patient volumes have continued to grow, with more people presenting to hospital with pressing health care needs.

“As the complex, acute and specialty care provider for Southeastern Ontario, we must also continue to protect capacity for those who have suffered traumatic injuries, strokes, heart-attacks and have other urgent needs,” says Dr. Pichora. “It’s a very fine balancing act as we manage and prioritize the needs of the sickest individuals from across the province.”

Currently, activity at KHSC remains very high with our census, at times, exceeding 500 inpatients. That’s more than 50 patients higher than the week before and KHSC is now filling overflow spaces for these additional inpatients. Meanwhile, the number of very-sick patients arriving at the Emergency Department (ED) remains very high and the challenges in accommodating isolation requirements also delay transfer to inpatient beds.

“We’re seeing many factors across the province combining to create a situation that has been difficult for all hospitals to navigate. KHSC is no exception to that,” says Dr. Ilse. “We know our health-care teams are tired after two difficult years and we thank everyone at KHSC for their continued hard work and dedication. We are so very grateful to our staff and physicians for their continued efforts under very challenging circumstances. We are working with our peers to find creative solutions to these challenging circumstances.”

To date, KHSC has deployed medical residents to support nurses across the organization, hired staff to work in new ‘extender’ roles to support our specialized staff, redeployed staff to support key areas of the hospital and have received approval from Ontario Health to onboard internationally trained nurses. KHSC is also reviewing and balancing its staffing model day-to-day and shift-to-shift, redeploying staff to where they are needed the most.

“We’re exploring every opportunity available to us to ensure we can continue to provide care to those that need it most and we are in constant communication with Ontario Health and our peer hospitals to discuss patient flow and our staff situation,” says Dr. Ilse. “This includes efforts to decant patients to long-term care and our partner regional hospitals once the patient is no longer in need of the highly specialized care offered at KHSC, which at times can be challenging because the home and community care and long-term care sectors are also struggling with their own capacity and staffing challenges.”

To continue to slow the spread of COVID-19 in our community, KHSC recommends that everyone who is eligible book an appointment to receive the first, second or third booster dose of the vaccine as well as follow public health recommendations such as physical distancing, hand washing, wearing a mask in indoor public spaces and isolating at home for 5-10 days depending on your vaccination status if you have symptoms of COVID-19.