A nurse employed in Alberta reached out to The Alberta Worker last week to raise awareness regarding recent changes Alberta Health has made to overcapacity space.
An overcapacity bed is one that is outside a regular examination or recovery room, typically in a hallway. They have no privacy, no in-suite washroom, and often no call bell.
Also called OC spaces, these are unfunded bed spaces that are used when inpatient demand exceeds funded capacity, or the capacity that AHS has allocated funds to.
They are typically split into two categories: headwall OC spaces have continuous access to oxygen and suction, while non-headwall OC spaces require portable oxygen and suction.
According to a South Health Campus Resource Document, published in September 2020 and which I’ve included at the end of this article, the overcapacity patient criteria used to exclude several patients if they had the following symptoms or behaviours:
- Abnormal or unstable blood pressure
- Palliative or imminent death
- Needs assistance from more than 1 person
- Precautionary isolation
- Airway impairments
- Disruptive (aggressive, delirious, confused, etc)
- Hip fracture
- Needing chest tubes
- Vacuum-assisted closure dressings
- Bariatric
- Requires constant care
According to a Powerpoint presentation given in March of this year, which I’ve included at the end of this article, AHS has changed the exclusionary criteria for OC spaces in the Calgary Zone.
The presentation says that “headwall OC spaces will have no additional exclusion criteria and treated therefore in the same way as funded bed spaces.”
In addition, AHS has reduced the exclusionary criteria for non-headwall OC spaces to just three:
- Airway impairment
- Continuous suction
- Airborne or contact isolation
So patients facing imminent death? I guess you’re dying in the hallway instead of a private room. Patients being aggressive? I guess you can be aggressive in the hallway with everyone passing by. Patients needing help from 3 nurses? I guess you’re getting help in the hall with everyone watching.
AHS referred to this reduction in exclusionary criteria as “streamlining” in the presentation.
Furthermore, the presentation said that healthcare workers will be expected to use these beds if they’re all that’s available.
An inpatient unit will be expected to admit patients into these beds following a request from the Bed Planning team if these spaces are the only available capacity and if a patient meets none of the exclusion criteria. As usual, if a patient is not best suited for this bed on arrival, internal shuffles will occur to ensure each patient is in the best available bed to meet their care needs.
By reducing the exclusionary criteria for these beds, AHS can increase the number of patients using the beds. And because these are unfunded beds, it allows AHS to reduce ER wait times without spending more money.
And that means that the Alberta government can make it seem as though they are increasing healthcare access while still balancing the budget.
However, because these beds are unfunded, they don’t come with an increase in healthcare workers. So, we’ll get more patients admitted but the same number of nurses and doctors to care for them.
And considering that AHS is trying to reduce overtime and agency staffing levels, these healthcare workers will be expected to care for more patients in the same amount of time.
That’s going to lead to worker burnout, which itself will result in higher turnover and further exacerbate the current staffing crisis in Alberta’s healthcare system.
And let’s not forget that over the previous decade, Alberta saw 5 years of wage freezes and an average annual increase of barely over 1%, which is far under inflation.
2 replies on “AHS to increase use of unfunded hospital beds”
As a Nurse on an acute care unit, I appreciate your concern with over capacity, as the patients we care for are very sick and we are often short staffed. However I do want to give some insite to those who do not work in hospital and are not faced with these challenges.
AHS may have a criteria for OC beds, however where a patient is placed is still at the discretion of the Carge Nurse and Bed Placement. An patient immently dying would be given a private room for them and thier family. A patients requiring a lift (3 person assist) would be allocated to a room with a ceiling lift or a room where one can be accessed. Patients who are allocated to “Hallway beds” are independent, do not need isolation, havr no oxygen/suction requirements and are days from discharge. There are curtains for some privacy and a bathroom in a room close by is allocated.
I hope this helps clear up some of the unknown! AHS has thier minimum requirements, but please know your nursing staff has you and your loved ones specific care needs in mind.
Thanks for the additional information, Stephanie. And thank you so much for all your labour. I hope you and your fellow nurses finally get a contract you deserve.