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Directive 3, for nursing homes, applies a universal solution to Toronto/Ottawa problem. That solution is causing harm to residents and impeding outbreak preparedness in smaller rural communities.
We need to allow limited staff sharing and reduce restrictions on readmissions.
We need to allow limited staff sharing and reduce restrictions on readmissions.
Over the last decade, I have never seen an outbreak chain between two facilities. Workplaces were already restricted once an outbreak was called.
There is a shortage of HCWs, especially specialized staff. It is ether share staff, use agency staffing, or neglect residents.
There is a shortage of HCWs, especially specialized staff. It is ether share staff, use agency staffing, or neglect residents.
This is not a matter of “hire more staff and make the positions full time.” We do not have enough HCWs to do that. If you make them choose a facility, the other ones go without.
Maybe this works in the cities, but not in rural areas.
Maybe this works in the cities, but not in rural areas.
The province is trying to get rid of 3/4 bed wards through attrition. You cannot admit, or re-admit, unless:
1) negative swab less than 24 hours old
2) LTCH has a private room to isolate them for 14 days (+ second swab TAT so ~18 days)
3) You eventually put them in a 1/2 bed room
1) negative swab less than 24 hours old
2) LTCH has a private room to isolate them for 14 days (+ second swab TAT so ~18 days)
3) You eventually put them in a 1/2 bed room
This has created disincentives for hospitals to admit LTCH residents. One of the strategies I had worked out to isolate COVID residents in ward rooms was to ask the support hospital to admit them. This is no longer possible.
I think the intent was to stop hospitals from overfilling nursing homes but what they ended up doing was turning hospitals into the Hotel California.
If a hospital admits a LTCH resident from a class C home, they have now gained an ALC patient. There are legally prohibited from going home.
Even residents from A/B homes have huge barriers to re-admission. That 24 hour window opens randomly and homes need a spare private room.
Even residents from A/B homes have huge barriers to re-admission. That 24 hour window opens randomly and homes need a spare private room.
The result? Acute care hospitals don’t admit LTCH residents unless they absolutely have to.
The mental health health of residents is harmed by evicting them from their homes and prolonged isolation.
The mental health health of residents is harmed by evicting them from their homes and prolonged isolation.
What needs to happen? Allow staffing bubbles with public health or MLTC approval. Expand the 24 hour transfer window. Remove the isolation requirement for transfers between COVID free facilities. Allow residents to go home, even if their home is a 3/4 bed room.
Tweeting is cheaper and faster than therapy. That felt good.
