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Sunday, March 13, 2005

Locking the Emergency Department Doors in Toronto

Yet another story about the hospital acute care capacity crunch, but with some new twists...
The Toronto Sun reports that Toronto General Hospital literally "locked the doors to the emergency department," and "posted a sign saying no ambulances or non-life threatening injuries allowed." Tom Closson, Presidnet of the University Health Network, which oversees the hospital, said "We are quite overwhelmed (since Tuesday night) and we have had a lot of sick patients." "Things were out of hand and we decided we couldn't take any more ambulances." He also indicated he wasn't aware of a law that prevented him from closing the ED. On the other hand, an official with the city's Emergency Medical Services said, "our position is Toronto General is still open until we hear differently from the ministry of health and we hope this is not an official policy." He also noted that the number of acute care beds in Toronto has dropped from 8300 in 1993 to 4700 now.
(In the spirit of an earlier post, note that Closson has a Bachelor of Applied Science degree in Industrial Engineering, and an MBA from York University in Ontario. He is a Certified Health Executive as per the Canadian College of Health Services Executives. In this bio from the Ontario Hospital Association, I cannot find any evidence that he ever directly provided health care.)
I guess I can't blame this one on managed care....
Again, the problem of episodic but worsening capacity crunches due to decreases in acute care capacity initiatied in the 1990's no longer seems confined to the US. Here, the rationale often was that efficiencies and preventive measures introduced by managed care would lessen the need for acute care beds. But things did not quite work out that way.
[Thanks to MedPundit for a tip about this.]

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