Changes in health care: The complexity

Despite the hope that life would return to normal in the wake of the pandemic, reality proved quite different.

Queensway Carleton Hospital’s Critical Care team is just one of the many witnesses to the lingering effects. Not only is the ICU seeing more patients, but they’re seeing sicker patients who require more advanced, specialized care.

“Whether their care has been delayed due to the pandemic or lack of resources, patients are now coming to us with more advanced co-morbidities and malignancies than ever before,” says Dr. Akshai Iyengar, Chief and Medical Director of Critical Care at QCH.

In the 2023/24 fiscal year, the ICU had 4,749 patient days – roughly 37 per cent more than five years ago. They made 1,113 consults – a 25 per cent increase from one year prior.

Ventilator use also increased, with an occupancy rate of 25 per cent. The number of patients receiving Sustained Low-Efficient Dialysis (SLED) – renal replacement therapy for end stage kidney disease – increased by 82 per cent.

We’ve also seen an increase in Alternative Level of Care (ALC) patients who require more complex and resource intensive interventions; some of which include Vascular Access Devices, paracentesis, feeding tubes, and resuscitation.

Through it all, the pandemic accelerated access to new equipment like advanced ventilators, and monitoring tools like Geo-echo and shock which help take care of sicker patients. The ICU has also adopted an organ and tissue donation program in collaboration with the Trillium Gift of Life Network; a program that didn’t exist at QCH 10 years ago.

We’re using more advanced interventions and collaborating with regional partners to deliver cutting edge treatment to patients.

With each passing year, the hospital’s workload intensifies, reflecting not just an increase in patient numbers, but a shift in patient acuity and needs. Yet, amidst these challenges, our teams remain committed in their dedication to providing unparalleled care. Through the acquisition of new tools, adoption of advanced interventions, and collaborative efforts with regional partners, they stand ready to confront the evolving landscape of healthcare head-on.