Sask. Health Authority preparing for patient transfers, triage

The Saskatchewan Health Authority (SHA) is preparing for the COVID-19 situation to get worse.

It and the provincial government have been in early talks with the Government of Ontario about the possibility of sending Saskatchewan patients to be treated there, if necessary.

“While we continue to work to maximize our critical care resources in Saskatchewan and keep our patients as close to home as possible, it is critical we have contingency plans in place should the situation change,” explained Marlo Pritchard, president of the Saskatchewan Public Safety Agency, in a teleconference with media Wednesday morning.

Pritchard added that, while he appreciates the plans with Ontario, he hopes they never have to be used. However, as the strain on Saskatchewan’s ICUs continues it appears more and more likely the option will have to be used.

Scott Livingstone, CEO of the SHA, explained that it’s been doing a lot to build more capacity into the province’s ICUs. He said other health services have been slowed down and 160 staff redeployed to ICUs. ICU capacity has also been expanded 79 beds by 150 per cent.

“We’ve also looked at other avenues for treatment as we are decanting patients out of our two larger centres into the regional centres so that we can ensure the tertiary centres are still providing the highest level of care and critical care for all patients across this province, as well as maintaining capacity to deal with any other concerns,” Livingstone said.

But, despite the capacity that’s being built into the system, Livingstone said they’re seeing an “unprecedented” rate of hospitalizations and ICU admissions.

“This is pushing the system to a place where we are not providing care to non-COVID patients across this province as we should be – hence the service slowdowns which will continue,” Livingstone explained.

The preparation is being done in case patients do need to be taken to Ontario – building capacity to transport patients with teams and air ambulance flights. No one has been sent out of the province for care yet.

Livingstone didn’t give an exact number that would trigger such a transfer, saying that it fluctuates day-to-day.

The health system continues trying to scale up capacity in the ICU, the current goal being 135 beds. Livingstone said, at this point, with 135 ICU patients they wouldn’t be able to give the right standard of care so the number to trigger out-of-province transfers would be lower than that.

“We have reserved some capacity as well to deal with things that could happen on a – for example long weekend, car accidents and traumas – but at the end of the day we are already over our capacity in ICUs so any major event … we would be triaging patients and sending out of province, we would hit our capacity,” Livingstone said.

It’s not the physical space that’s necessarily the piece creating a struggle in ICUs.

“Our single most important resource and the resource that’s the most determinant of what happens is ICU trained individuals, particularly ICU nurses, and how long we can maintain this level of ICU capacity without having folks needing to take breaks and burnt out,” Livingstone explained.

According to Livingstone, the last thing that ICU teams want is to send people away.

“But at the same time we want every Saskatchewan resident to receive the very best care they can, and that will be determined in the next few days with what’s happening with our ICU numbers.”

Pritchard confirmed the province still has not requested help from the federal government. He said that they’re in the planning phase to identify what kinds of resources are available to them.

He also repeated a point made by Premier Scott Moe last week, that they have to be realistic about what kind of help the federal government might be able to give because there are a lot of provinces looking for the same thing.