Out-of-province patient transfers to Ontario being initiated

October 18, 2021, 11:13 am

On Monday, October 18, the Saskatchewan Health Authority (SHA) will be transporting one patient to Ontario to receive intensive care services because capacity challenges that SHA says "are compromising the quality and availability of critical care for all Saskatchewan residents."

“We recognize the stress this will cause the families affected,” said Scott Livingstone, CEO of the SHA. “We continue to work every day to maximize capacity to provide care as close to home as possible, but this decision is necessary to maintain the quality of critical care services our patients need. We are extremely thankful to our partners in Ontario for stepping up and providing this support.”

Up to six transfers total are expected by end of day Wednesday, with a longer term assessment of out-of-province support beyond Wednesday currently being finalized.

Saskatchewan’s Provincial Emergency Operations Centre continues to assess available resources from other provinces and the federal government to support Saskatchewan’s ICU needs.

As national supports are scarce, it is much more effective to transfer a small number of patients out of province to relieve pressure on the health care system, than it is to secure and relocate highly skilled ICU staff.

However the province has also asked the federal government and the military for help.

Earlier this year Saskatchewan received patients from Manitoba, after that province experienced a rise in COVID related ICU admissions. We intend to learn from that experience as we manage our own surge in critical care demand.


Safety
Planning for these transfers has been done jointly with the Ontario Critical Care Command Team as well as key medical leaders in Saskatchewan, including physicians and other leaders with expertise in critical care and patient transport. This has involved incorporating best practices from other jurisdictions and lessons learned to date on interprovincial co-operation on critical care transport during the pandemic. The top priority in these joint planning processes has been to ensure safe and seamless processes are in place to support out-of-province transfers.

A clinical team will preform daily assessment of all patients, and will carefully match each patient to an appropriate available bed. The team will also consider the local and overall system capacity at the time the assessments are being made. Patients selected for transfer will be those that are medically stable and appropriate for transfer. A highly skilled care team will accompany them throughout the duration of the transfer.

“Our local physician leaders, staff and our partners in Ontario have worked diligently to prioritize safety and continuity of life saving care in the planning for these transfers,” said Dr. John Froh, SHA Deputy Chief Medical Officer and pandemic physician lead in the SHA Emergency Operations Centre. “We are immensely grateful for their commitment to our patients and families.”

Family support
Although family members will not be able to travel directly with their loved one, travel and accommodation costs for two essential family/support people will be covered by the province. Additional details on supports available will be provided directly to affected family members. Social work and mental health supports will also be made available to family members as required.


Federal support
The Provincial Emergency Operations Centre is submitting a request Monday for additional federal resources to address Saskatchewan’s hospital capacity challenges including specialized staffing and military support.


Reporting
Starting Tuesday, October 19, daily public reporting will be available on the number of patient transfers to date. Additional details on where to access this information will be provided at that time.


Key facts
The Saskatchewan Health Authority normally has 79 ICU beds in the province. The overall number of patients admitted to an ICU bed in Saskatchewan (COVID plus non-COVID) has been ranging from approximately 139 per cent to 153 per cent normal planned capacity over the last 10 days (patient numbers ranging from 110 to 118). As of October 17, 2021, 118 patients are receiving ICU care in the province. This has been made possible by surging beyond capacity with beds and staff utilized from other areas of patient care.

In addition to pressure in ICUs, patients requiring high flow oxygen are also being cared for on hospital wards outside of the ICU. This has ranged from 30 to 40 each day over the last two weeks. These patients would normally be served in an ICU and are at high risk of requiring more advanced care in an ICU setting.