Saanich Peninsula Hospital’s emergency department will remain closed overnight until further notice after physicians warned health leaders in eleventh-hour negotiations Monday that to re-open as scheduled this week would risk patient safety because of a staffing shortage.
Overnight emergency department closings at Saanich Peninsula Hospital, which began in early July, were slated to end today but groups of ER and family physicians wrote to Island Health last week asking for an extension, saying the staffing shortage had worsened over the summer.
Negotiations with the Health Ministry went into the early evening Monday.
Island Health CEO Kathy MacNeil told the Times Colonist the health authority had hoped additional incentives offered over the last 10 days would help find physicians to fill empty shifts “so that’s why it was we’ve kind of pushed it out as far as we possibly could.” But shifts remained unfilled.
“So, unfortunately yes, we are going to have to extend the overnight temporary closure for the Saanich Peninsula emergency department,” said MacNeil.
Emergency department physician staffing shortages of about 15 shifts a month would increase to 30 to 60 per month if the hospital emergency department was forced to re-open overnight, physicians warned.
MacNeil said the health authority wants to ensure hospitals can provide consistent coverage “so it’s no good to have one night covered and then three not, so we’re really trying to make sure we have enough coverage to have consistent coverage.”
“My hope will be this won’t drag too long into the fall but it really will be how successful we are in the recruitment and how quickly we can implement some of those alternative care models,” she said. Alternate models could include care by phone call or the internet.
The Saanich Peninsula Emergency Physicians Association, which wrote to Island Health on Aug. 28, said the emergency physician staffing shortage has worsened: “Re-opening is simply not feasible and attempting to do so would pose unacceptable patient harm.”
Thirteen emergency physicians providing shift coverage are no longer able to assist this fall and winter — including one member who retired early, one who extended a maternity leave, and two locums who went off on medical leave, said the association.
Three potential new hires opted to work in Duncan and Richmond instead.
The family physician group at Saanich Peninsula Hospital wrote to the health authority in a Sept. 2 letter, saying that patient risk would increase if medical and non-medical staffing was not first stabilized.
The family doctors explained that they could not provide critical care, resuscitation for example, and urgent medical care overnight in the absence of emergency doctors.
“Again, operating a hospital without consistent and stable provision of critical care and ‘after-hours’ medical services exposes patients to significant harm, including death,” the family doctors said. “We implore you to first stabilize the lack of both medical and non-medical staffing.”
Patients requiring overnight emergency care have had to visit Royal Jubilee and Victoria General hospitals.
“Both RJH and VGH have seen increased patient volumes through the emergency department,” said MacNeil.
In July, Royal Jubilee had less than an average of one additional patient per night from Saanich Peninsula and Victoria General had less than two additional patients per night, said MacNeil. Patients are tracked through postal codes.
MacNeil acknowledged that even one extra patient, depending on the complexity, can make a difference. “We’re aware of that strain that we’re putting on the teams and so we want to be able to manage that pressure on them as well.”