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Hospital congestion rates improve in Fraser region

Health authority reports less hallway medicine, C. difficile
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The rate of hallway medicine where patients are treated in hospital overflow areas has fallen by nearly 60 per cent in Fraser Health.

A six-month drive to cut hospital congestion in Fraser Health has led to a significant drop in patients being treated in hospital hallways or other overflow areas.

The previous average of 100 admitted patients at any time getting hallway medicine in overflow areas has been cut to 43, and they've been eliminated entirely at some hospitals, according to a health authority report on the improvements.

Former health minister Mike de Jong directed Fraser Health last June to pursue improvements on five fronts after the report of the Fraser Health Congestion Review Panel flagged ongoing high levels of congestion that many staff considered intractable.

One of the biggest gains reported was a cut by nearly half in the rate of C. difficile infections in area hospitals, attributed to enhanced cleaning and hand-washing strategies.

Alarmingly high rates of the bacteria-spread illness had prompted the health region to send roving "super clean" teams through six hospitals in early 2012.

The congestion-control exercise didn't reach all of its targets.

It succeeded in increasing the percentage of admitted ER patients getting a hospital bed within 10 hours to 58 per cent – up from 51 per cent last year but not yet consistently at a target of at least 61 per cent.

All hospitals are now beating a target of having more than 90 per cent of hip surgeries performed within 48 hours of the patient being admitted.

"We cannot take our foot off the gas," the report says, cautioning that "there will continue to be pressure on access to services and from time to time there will likely be congestion-related events."

Fraser Health previously estimated the region will be short 1,100 beds by 2020 but that study is being updated to recalculate expected demand for acute care beds.

The 2,200 acute care beds across 12 hospitals are routinely full.

But the 2014 opening of the new $512-million expansion at Surrey Memorial will add 150 more beds.

The province has also committed to a huge redevelopment of Royal Columbian Hospital and other expansions or redesigns are under consideration.

"It is clearly understood that expanding hospitals is not the sole solution to meeting increasing demand,"  the report said, adding there's a critical need to increase community-based services.

The report shows the average length of stay of a patient is down from 8.4 to 8.1 days but not yet at a target of 7.9.

Some of the gains were made through methods like having home care staff at emergency departments intercept incoming elderly patients and redirect them back home, provided it's appropriate and sufficient home support can be dispatched.

"When we stopped caring for patients in the south hallway [at Surrey Memorial] and I saw that the number of admitted patients in Emergency had been reduced in half, I knew we were doing something right," said Martha Cloutier, Fraser Health's emergency clinical operations director for Surrey Memorial, Delta and Peace Arch hospitals.