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If you have been to the Health Sciences Centre lately you
may have heard the overhead announcement “Gridlock is
in effect. Please activate your departmental protocols.”
Many people then ask: “What is Gridlock?” Gridlock
is a condition at the Thunder Bay Regional Health Sciences
Centre when there are more patients waiting for admission
than there are beds available. However, not all patients in
a bed still require Thunder Bay Regional Health Sciences Centre
services. Delays in discharges can occur for a variety of
reasons including waiting for:
- Formal discharge
- Physician consultation
- Tests and/or results
- Interprofessional team assessment
- A bed in another acute care facility, long-term care facility, rehabilitation facility, or supportive housing
- Transportation home or to another facility
- Conference with family to plan discharge
- Assessment for community services
As a result, some patients admitted through the Emergency
Department have to wait until a bed becomes available. When
the number of patients waiting for beds is over 10, the space
in the Emergency Department is utilized for these patients
and impacts the ability of the department to bring patients
to rooms as they are filled with patients waiting for beds.
What We Do During Gridlock to Accommodate Our Patients
By definition, Gridlock means we are operating at overcapacity.
Once the Health Sciences Centre is in Gridlock, we have to
implement special, temporary measures to accommodate all of
our patients. Our goal is simple: to ensure that our patients
receive the best care possible in these difficult times.
However reaching that goal can be anything but simple. It
is difficult to accommodate everyone and meet everyone’s
expectations. The entire facility responds to increased volumes
of patients and acknowledges that patients will be in unusual
accommodations. We have to review each unit and move patients
who are stable from their beds to alcoves so that we can treat
patients who require a higher level of care that is not safe
to deliver in a hallway.
To communicate that the Health Sciences Centre is in Gridlock,
we have implemented an overhead paging system so both patients
and staff understand that these extraordinary measures are
in place. Extra staff is sometimes needed to service the increased
demands.
These temporary procedures help us manage overcapacity periods,
but they are only short-term solutions. The Health Sciences
Centre is working with our community partners to find solutions
to the system issues that contribute to Gridlock. We strive
to provide excellent care and would like any suggestions on
how we can improve during these difficult times.
We encourage you to fill out your Patient Satisfaction Survey
or email suggestions to: tbrhsc@tbh.net
TBRHSC Gridlock - FAQs
- Q. What is Gridlock?
A. Gridlock is a situation at the Health Sciences
Centre where there are more patients than beds available.
As a result, new patients often have to wait in
the Emergency Department for a bed to open up.
- Q. Does Gridlock mean that the Health Sciences
Centre is closed? Will I or my family be refused
care?
A. No – never. Anyone who requires emergency
services will be treated – you will NEVER
be turned away. Patients will be treated based on
their need so wait times for non-urgent care may
be longer during Gridlock.
- Q. Why aren’t there any beds?
A. The Health Sciences Centre is an acute care hospital,
which means we provide specialized medical care
that is not available anywhere else. However, many
patients still require some form of healthcare after
their hospital visit, be it in a long-term facility,
through community services, or through home care.
In most cases, these services need to be in place
before they can leave the Health Sciences Centre,
so even though they are medically safe to leave,
they simply have nowhere else to go until other
services are available.
- Q. Is the Health Sciences Centre too small?
A. No. We have 375 acute care beds. At the height
of Gridlock, we had over 425 patients, with a peak
of over 80 patients waiting for alternate level
of care services. If all those patients had been
transferred, we would have been operating under
capacity.
- Q. Will I be sent home early to make room
for other patients?
A. No. Nobody will ever be “discharged early”
or be otherwise refused services. Those who require
acute care will always have access to acute care.
- Q. What are you doing to help long-term care
patients get the services they need?
A. We are currently working with our partners to
put a program in place that will allow patients
to receive the care they need at home. From there,
patients may decide to stay at home or move to a
longterm care facility. They receive the alternate
level of care they need, and a bed is made available
for someone else who needs it.
- Q. Is this only a “Thunder Bay”
problem?
A. No. Hospitals across Ontario are experiencing
this problem. It is due to many, many factors, including
an aging population. However, our Emergency Department
was one of the busiest last year with projected
visits of 106,000 this year. This can make the problem
extra challenging. We are working with our community
partners to streamline services so all people of
Thunder Bay and Northwestern Ontario have the right
care, at the right place, and the right time.
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