High occupancy rates roll the dice on hospital-borne infections

Hospital C-Difficule-related deaths are making the news again in Ontario.

This time hospitals in Niagara and Guelph are reporting deaths related to clostridium difficile, a bacterial infection for which symptoms include diarrhea, fever, and abdominal pain. The OHA is reported to have said that 16 hospitals are now struggling with C-Difficile.

C-Difficile spores are very difficult to clean, and can remain viable outside the body for a very long time.

It’s stating the obvious that hospitals need to maintain rigorous infection control policies – something they appear to be learning following years of ill advised cuts to cleaning staff.

Many countries believe reducing hospital crowding can also reduce chances of infection. In the UK, for example, hospitals are supposed to maintain an average occupancy rate below 85 per cent. Several years ago it was considered a national scandal when it was reported numerous hospitals were operating above that threshold.

In Ontario we continue to roll the dice on the issue of hospital occupancy, maintaining an average rate of more than 97 per cent.

Not only does the evidence suggest that such crowding leads to the spread of hospital-borne infections like C-Difficile, but it also leaves the hospital few options when seasonal surges of demand take place.

The Ontario government is trying to clear out beds occupied by so-called “alternate level of care” patients. These are people who have completed their acute care treatment, but are physically not well enough to go home. Many are waiting for long term care beds, some are waiting for home care.

This may give hospitals some additional capacity and lower occupancy rates – provided the bean counters don’t see any capacity as potential waste and close more beds.

By taking the ALC patients out it may have another unintended consequence: when seasonal surges do take place, the hospital will have less flexibility to clear beds if they are completely occupied by patients who have to be there for treatment. That means more patients in the hallways where cleaning may not be as rigorous and infections more likely.

Hospital-borne infections just make matters worse on the patients, on over crowding, and on the budgets administrators have to work with.

You can’t run a hospital like a hotel. Penny pinching only leads to higher longer term costs, sometimes tragically in the form of lives taken.

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