Superbug comes to a crowded Ontario hospital

The Sault Area Hospital has yet another outbreak of hospital acquired infections (HAIs), the Sault Star reports . In fact the MRSA outbreak was declared September 7, and 22 patients have now tested positive.

Hospital president Ron Gagnon pointed to overcrowding as a contributing factor. "It's showing over-capacity is an issue," he added.

As per government policy, the hospital is trying to reduce bed occupancy by developing new programs to move patients back to home.  And the hospital has achieved some modest success.  As of last week, 99 "ALC patients" (typically patients in medical or surgical beds who no longer require a medical or surgical bed), down from an average 103 in September.

However, the majority of these patients  -- 73 -- are awaiting placement in long-term care and cannot benefit from these programs.

As elsewhere, long-term care spaces are scarce in the community.

And as elsewhere, the problem of high bed occupancy and the high number of ALC patients has been an ongoing problem for some time.

In 2007, SAH president Gagnon noted: "We average 40 patients in acute care beds who no longer require acute care. We've had upwards of 60 on some days." About one-third of SAH's acute care beds housed non-acute patients at the time.

The superbug problem is not new either.  After a deadly C. difficile outbreak of 2006-07, SAH implemented 29 recommendations to control infections, including enhanced housekeeping. SAH also dealt with a superbug outbreak last November.

Gagnon said that with the latest outbreak they've also stepped up housekeeping in affected areas to twice daily and introduced "terminal" cleans after discharges from certain parts of the hospital.

Gagnon could not say how much the enhanced measures would cost, but said the budget has room for contingency costs and "we will be obviously dipping into that."

The costs associated with past outbreaks were significant, helping to push the SAH into deficit in 2007.

In March 2007, when the hospital faced a deficit of $8 to $9 million, the hospital had spent about $5 million on extra expenses for the C. Difficile outbreak that began the previous spring. 

At the time, hospital CEO Gagnon also blamed the deficit on the inability of the SAH to move ALC patients to the community due to a persistent shortage of resources in the community.

The more things change, the more things stay the same....


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