The population of frail, elderly patients occupying acute care beds at Health Sciences North has been gradually climbing throughout 2012, according to one of the hospital's administrators.

These patients, who occupy acute care beds while they wait for placement in a nursing home or other community facility, are known as alternate level of care or ALC patients.

As of Aug. 16, there were 93 ALC patients at the hospital's acute care site, officially known as the Ramsey Lake Health Centre.

That almost matches the highest ALC level the hospital has seen this year, according to Dave McNeil, Health Sciences North's vice-president of clinical programs and chief nursing officer.

ALC numbers at the acute care site peaked at 97 earlier this year, but anything in the 90s is at the higher end of the spectrum, he said. The lowest number of ALC patients at the Ramsey Lake Health Centre this year was in January, when there were 43.

That doesn't include the 30 patients in the ALC unit at the hospital's former Memorial site, now known as the Sudbury Outpatient Centre.

“As anybody can see, the numbers of patients that have been designated ALC within the institution have been growing over the calendar year,” McNeil said.

The growing ALC population is part of the reason Hamilton Health Sciences CEO Murray Martin has been brought in by the North East Local Health Integration Network (LHIN) to look at how Health Sciences North is being run, McNeil said.

Murray has been mandated to make recommendations on how this and other problems at the hospital can be mitigated.

When there are high levels of ALC patients, it puts pressure on the emergency department. There's a long wait for patients processed by the emergency department to receive an inpatient bed because so many beds are already being occupied by ALC patients.

As of Aug. 16, there were 16 patients in the emergency department waiting for an inpatient bed.

“It's been averaging somewhere in and around 20 to 22,” McNeil said. “This summer has been somewhat difficult, with higher numbers occurring. We've had days when we've had 27 or 28 inpatients (in the emergency department), and through the day it might peak up to 30.”

This, in turn, affects wait times in the emergency department, he said.

During the month of June, for which the most current data is available from the Ministry of Health, patients at Health Sciences North's emergency department waited an average of 7.8 hours for complex conditions and 3.3 hours for uncomplicated conditions.

“If you're trying to flow patients through the emergency department where you do have much of your capacity blocked, it becomes much more difficult for you to actually achieve the wait time targets,” McNeil said.

“There's just a lot more inpatients waiting within the emergency department, which diverts staff resources toward the care for those patients that reside in the emergency department, waiting for a bed. Also, it impacts access to the availability of treatment spaces.”

All of these issues are as a result of an aging population which just needs more access to health care, McNeil said.

“People are sick, people require care, and right now the system is still aligned to the hospital as that vehicle of last resort.”

The province's solution is a shift toward using more community-based services instead of institutional care, he said. This transformation is going to take some time, though, McNeil said.

The hospital itself has put in many programs over the last few years in an attempt to reduce overcrowding at the hospital.

They range from outpatient programs which attempt to keep patients out of the hospital in the first place to an elder life program, where volunteers spend time with seniors in the hospital to prevent them from becoming confused. More such programs are on the way, McNeil said.

“I'm going to preface it in this way — the programs we've put in place over the past two years, I do see as having had a benefit in the community already.”

There are concerns, though, that the scheduled closure of the final 30 beds at the ALC unit at the Sudbury Outpatient Centre as of March 31, 2013 will result in a spike in ALC patients at the Ramsey Lake Health Centre.

McNeil said the hospital is working with partners such as the North East Community Care Access Centre and the North East LHIN to come up with a plan for where these patients will go once the beds close, and to mitigate any impact the bed closures might have on the hospital.