Horizon Health Network says hospital overcrowding is expected to worsen in the coming months, with more than four in 10 beds projected to be filled by patients who no longer need acute care.

Greg Doiron, vice-president of clinical operations, stated that the network predicts that 711 patients, approximately 41 per cent of all beds, may be occupied by medically discharged patients later this year.

Doiron explained at the public board of directors meeting on October 30 that the current situation is already impacting emergency departments.

He added that patients are waiting an average of 19 hours for a bed, and some are being placed in hallways or offices.

Four‑part plan

Doiron outlined a 60‑day plan to reduce overcrowding. It includes:

• Supported Transition Through Evaluation Program (STEP): allows medically stable patients to return home with supports while awaiting long‑term care assessment.
• Emergency diversion teams: nurses and allied health staff in ERs to connect patients with home supports and avoid unnecessary admissions. Doiron said a Fredericton pilot showed as many as 500 patients a year could be diverted.
• Faster long‑term care assessments: hospital staff conducting eligibility assessments directly, which Doiron said has already led to earlier discharges.
• Bed crisis plan: a last‑resort measure to create temporary beds by closing or shifting services if other strategies fall short.

Occupancy at 107 per cent

Board chair Susan Harley said Horizon hospitals are operating at 107 per cent occupancy, well above the 85 per cent considered safe.

She said nearly 40 per cent of patients no longer need acute care but remain in hospital awaiting long‑term care or home supports.

“We are collectively failing these patients, and that’s not acceptable,” Harley said.

Staffing and finance

Chief executive officer Margaret Melanson said Horizon has surpassed recruitment targets, with 483 nurses hired since April and a net gain of 270.

Physician recruitment is also ahead of schedule, including nine psychiatrists and 25 family doctors.

But Doiron said the network is carrying 190 unfunded beds, forcing existing staff to cover extra patients. He said nurses are often working 60 to 70 hours a week, which is leading to burnout.

Finance vice‑chair Mike Walton told the board Horizon is projecting a $47‑million deficit this year, driven by overtime and unfunded beds.

Innovation and specialty care

Horizon highlighted several advances:

• Retinal surgery program: Dr. Ken Roberts said Fredericton’s Chalmers Hospital is now performing nearly all retinal surgeries in New Brunswick, with more than 400 cases completed in six months. Surgeons Dr. Vinicius Vanzan and Dr. Wei Wei Lee joined the program in 2022.
• Liver cancer treatment: Moncton Hospital performed a cutting‑edge procedure, described by Melanson as a first for the province.
• AI scribe pilot: Maily Lockhart, executive director of primary care, said 45 providers are testing dictation software that has reduced administrative time.
• MINT clinics: Horizon is piloting a dementia‑care model at several sites.

Primary care transformation

Dr. Ravneet Comstock told the board that Horizon is moving away from solo physician practices toward team‑based family health teams.

Lockhart said the goal is to provide primary care access for 100 per cent of Horizon’s 615,000 patients.

She said 8,100 patients have been attached this fiscal year, ahead of target, and 98 physicians have signed agreements to join the model.

She said challenges include an aging physician workforce, with 63,000 patients attached to doctors over 65.

Horizon is also piloting social prescribing, which allows paramedics to connect patients with community supports.

Indigenous health and reconciliation

Aaron Hatty, regional manager of Indigenous health, and Corinne Saulnier, clinical executive director of community health, reported progress on Indigenous initiatives.

They said new patient navigators are supporting Indigenous patients in Saint John and hospital‑based care.

Horizon is also partnering with the KTMF project to improve cultural safety in cancer care.

Hatty said sacred spaces are being developed in Moncton and the Upper River Valley, including a healing garden memorial for residential school survivors.

A consultant’s report delivered 56 recommendations, including an Elder‑in‑Residence program and systemic anti‑racism measures.

Accountability and transparency

Ashley Calvert, who presented Horizon’s public dashboard, said the network is meeting its target on patient experience surveys but has fallen behind on emergency wait times.

She said Horizon had aimed to cut wait times for medium‑acuity patients by 20 per cent this year, but instead they have increased.

She said about 900 patients visit emergency departments daily, with more than 80 admitted patients waiting for beds.

Board members commended the dashboard for enhancing transparency.