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The Saint John Regional Hospital. Image: Brad Perry

Horizon Health aims to move more people out of hospitals

By Brad Perry Feb 26, 2024 | 4:42 AM

The Horizon Health Network says it is working to reduce the number of alternate level of care (ALC) patients in its hospitals.

Around 34 per cent of beds are currently occupied by ALC patients, including seniors waiting for long-term care.

Greg Doiron, vice-president of clinical operations, said they would like that number to reach 20 per cent within two years.

“We, through the work we’ve been doing, have seen some changes to the ALC number, but it’s not good enough, and we have a lot more work to do,” Doiron said during a presentation to the health authority’s board on Friday.

Around 373 beds, or 23 per cent, were occupied by ALC patients around the start of the pandemic in April 2020.

That figure ballooned to a peak of 607 beds, or 37 per cent, last October, according to the vice-president, but since come down slightly.

Doiron said that was at the height of their dialogue with government about strategies needed to make fundamental change.

Tara Stewart, regional director of patient flow, said there are many reasons why patients could be waiting in a hospital bed.

As of Jan. 31, 52 per cent were waiting for placement in long-term care while 29 per cent were going through the Social Development process.

“This can include people that are going through the financial piece or who are waiting for an assessment,” said Stewart.

Six per cent are going through social or legal processes, which she said contributes to an approximately one-year length of stay.

Horizon Health vice-president Greg Doiron, third from right, speaks during the health authority's board meeting on Feb. 23, 2024. Image: Brad Perry

Meanwhile, Doiron said there is direct correlation between ALC numbers and how admitted emergency department patients will need to wait for a bed in a nursing unit.

The vice-president said the average length of stay in an ER is expected to increase by just under an hour for every 10 ALC patients in a hospital.

With the number of seniors expected to increase by more than 26,000 over the next five years, the health authority said “immediate and aggressive action” is needed to prevent the hospital system from being overwhelmed.

Doiron said a total of 41 projects have been identified to help improve system-wide challenges related to ALC patients.

“They’re focused on systemic change. We’re looking at items that will allow more rapid access to long-term care, creating new kinds of vetted areas like transitional care units using nursing homes and also other environments,” he said.

Margaret Melanson, interim president and CEO of Horizon Health, said they would ideally like to see no ALC patients waiting in hospitals, but they know that is not realistic.

“We have a growing population, we know we’re going to have continued pressures on our system, but it’s a start,” she said of the health authority’s target.

“There is a need for investment in care for seniors, both for them to remain in their home as well as whatever care setting they need outside of hospitals. That is something that the government will need to undertake.”