The Ontario Hospital Association (OHA) has developed this resource page to offer broader reporting of hospital capacity in the context of COVID-related hospitalizations and COVID-related critical illness (CRCI) admissions to hospital intensive care units (ICUs). Below is a link to download the Hospital Capacity Slide Deck that is updated regularly.
Background and Context
The global pandemic continues to highlight and exacerbate the capacity pressures facing Ontario's hospitals which existed prior to COVID-19, including crowded emergency departments (EDs), high occupancy and difficulties discharging patients designated as Alternate Level of Care (ALC) who await more appropriate services provided in a different setting. Despite these intense pressures which have been amplified during the past two years, hospitals have been able to quickly pivot to respond to the pandemic's ever-evolving and complex demands.
Hospital Occupancy Pressures
Understanding ICU Capacity
Considerations around ICU capacity need to take into account the increased resource intensity required to care for patients with COVID-related critical illness, and more importantly, availability of health care providers to care for these patients, beyond just physical bed space. Patients admitted to the ICU with COVID-related critical illness are extremely sick, can have longer lengths of stay in ICU and have higher health human resource (HHR) demands. This is especially important context because hospitals are contending with HHR shortages, an exhausted workforce, and disruptions due to potential illness and isolation requirements.
The deck also contains a slide on hospital occupancy (slide 9) which indicates that bed occupancy across the province is approaching 90 per cent, even with the additional hospital beds announced by the government as part of the province's COVID-19 response. Rates vary by hospital, with some that are over 100 per cent occupancy. This is partly due to the over 5,000 patients designated as ALC waiting in hospital beds for a more appropriate level of care (e.g., long-term care, home care, etc.). High bed occupancy limits hospitals' ability to respond to a sharp increase in patients requiring hospitalization; stand-by capacity is also needed for individuals who require emergency care (e.g., motor-vehicle accidents, emergency surgery, etc.). This is why a sudden surge in patients with COVID-19 who require hospital care often leads to delayed care (postponement of scheduled surgeries and procedures) and patient transfers, as a way to manage these capacity pressures.
Help Hospitals and Health Care Providers by Doing Your Part
Over the past two years, we have also learned a great deal about what works in the fight against COVID-19. Our strongest defence is vaccination. In addition to getting vaccinated as soon as possible, Ontarians must continue to take other steps to protect themselves and their communities. This includes following the advice of Ontario's Chief Medical Officer of Health to follow appropriate masking practices, work from home when possible, and keep gatherings small. Hospital teams continue to do everything they can to care for and protect Ontarians. As the risk increases, they need all Ontarians – especially those who are not yet vaccinated – to do their part in return.