St. Anthony patients kept on stretchers while beds remained in storage

Weeks after cutting eight acute care beds at the hospital in St. Anthony, health officials were discussing how to handle an overflow of patients there a situation that saw people kept on stretchers instead of beds being taken out of storage.

That's according tointernal Labrador-Grenfell Health documents obtained by CBC News through access to information.

Charles S. Curtis Memorial Hospital in St. Anthony closed eightbedsin mid-February, those documents show. There are now 42 acute care beds there.

Emails among top brass and managerial staff show the hospital was operating with too few bedssoon after,by March 16.

The four-bed emergency department was full of admitted patients and there was someone on a stretcher in the corridor, waiting to get in.

The patients should have been able to move to beds in their respective units, freeing up space in emergency, but there were no available acute care beds.

In an email, the hospital's site manager suggested re-opening some of the closed beds and the idea was green lit by then interim CEOBarbara Molgaard Blake, before the acting regional director of acute and long-term care, Wanda Slade, weighed in.

It is not good, perception wise, to put beds back that were just removed.- WandaSlade

"Just thinking it is not good, perception wise, to put beds back that were just removed," Slade said.

Blake then reversed her decision.

"I'm all for whatever message is deemed the best!" the interim CEO wrote back, adding in parentheses "which I agree is not taking out beds unless we have to."

Problems with ER overflow

The first move was to look for patientsto discharge. Staff went from floor to floor, but couldn't find any.They reached a solution an hour and a half after the initial email was sent out.

"Done with no beds coming out of storage using a stretchers [sic] for less than24hrson [medicine/surgery](should have discharge tomorrow) and keeping 2 clients in ER overnight," Blake wrote.

Two days after that, on March 18, a site supervisor sent another emailexplaining the overcrowding issueshadcontinued over the weekend.

She had opened a space that "technically [she] wasn't supposed to use," because there was already an admitted patientinthe emergency room and she felt it"wasn't an appropriate place to keep [the new patient]."

She also noted that the Meditech system software for patient records wasn't yet set up in the emergency department.

Labrador-Grenfell Health responds

Labrador-Grenfell Health said the reduction of eight beds came as a result of "right-sizing."

In a statement, the health authority said, "neither the level of care nor how care is provided has been affected by these changes."

It explained that the reduction of beds meant some four-bed wards had turned into two-bed, or semi-private, rooms, saying the reduction has"facilitated a number of benefits to service including enhancements in privacy, confidentiality and patient access to care as well as improvements to workspace areas."

Letter sent about cost-cutting

The bed reductions came six months after the deputy health ministersent a letter to the board chair ofLabrador-GrenfellHealth about cost-cutting measures.

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"Thedepartment is working on implementation plans forexpenditure reduction initiatives that are 'provincial in scope,'" the letter said, and outlines various cost-saving areas, including bed reductions.

It includes atable outliningexpected savings forLabrador-GrenfellHealth at $1,994,200 for 2017-2018.The biggest chunk of thatsavings $1,487,400is expected to come from a "reduction in travel, overtime, relief and operating costs."

In an internal email,Labrador-GrenfellHealth CEO BarbaraMolgaardBlake referenced thatletter in a discussion about "additional efficiency expectations."

The Department of Health initially declined CBC's request for an interview, instead supplyinga statement.

"Over the last three years, the budget has remained steady at approximately$3 billion,"the statement said, referring to the overall amount spent on health care by the province.

"There is no direction from the department to reduce the number of beds in the health-care system."

The department said it's focusing its cost-saving initiatives onother areas, instead of frontline services.

Minister answers questions at legislature

Health Minister John Haggie did address the issue at the House of Assembly Thursday afternoon, after the Opposition Tories cited CBCstories about hospital overcrowding during question period.

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Haggietold reporters there have been no other acute-care bed closures in the health-care system, and none are planned.

He said the challenge is addressing the needs of patients waiting for care that is better provided in other facilities, instead of through acute care.

Haggieindicated that the solution lies in community changes everything from commitments tobuild more long-term care beds to something as simple as putting a rail in a bathroom at home.

"What's happened in St. Anthony is they had two challenges," Haggietold reporters.

"One was their average bed utilization runs around 54 to 75 per cent. So those beds are never staffed, because there's no demand for them. What then happened was there was a quality issue, the patients were complaining about privacy."

He said the four-bed rooms there are not built to modern code, and date back to the 1960s.

Labrador-Grenfell Health suggested converting them into two-bed rooms, to deal with privacy issues and help nurses provide better care.

Haggie said that doesn'tinterfere with patient care, because they are not staffed anyway.

As for the overflow issues affecting the emergency room in St. Anthony, Haggie called it "another unfortunate coincidence."

He said there were nine patients over that period who were placed in isolation under instructions from the medical officer of health. They couldn't share rooms, because ofinfection control procedures in place.

"That then cut down access to space, and to beds," Haggienoted.

The minister said that only happened once, and ended up affecting two patients.