Icu Bed Capacity In New Brunswick

New Brunswick has 142 ICU beds province-wide, with 44 of those in the Vitalite Health Network. In 2021, the Horizon Health Network's five largest hospitals had 98 ICU beds in place, 53 of which were occupied. During the COVID-19 pandemic, the province's ICU capacity has been strained, with hospitals reaching over 100% capacity.

ICU capacity in New Brunswick hospitals

The COVID-19 pandemic has put a strain on healthcare systems worldwide, and New Brunswick in Canada is no exception. The province's hospitals, particularly those in the Horizon Health Network and Vitalité Health Network, have been operating at or above capacity, impacting their ability to provide critical care to patients.

ICU Capacity in Horizon Health Network Hospitals

The Horizon Health Network, which includes the Moncton Hospital, Saint John Regional Hospital, Dr Everett Chalmers Regional Hospital, Upper River Valley Hospital, and Miramichi Regional Hospital, has been particularly strained during the pandemic. In September 2021, the Moncton Hospital had 22 out of 23 intensive care beds occupied, and across the network, 66 out of 98 ICU beds were occupied, with seven by COVID patients and 59 by non-COVID patients. This high occupancy rate of over 90% in the five largest hospitals in the network has been a cause for concern, as it limits their ability to handle a surge in COVID-19 cases.

ICU Capacity in Vitalité Health Network Hospitals

The Vitalité Health Network, which serves the francophone population of New Brunswick, has also faced challenges during the pandemic. In April 2021, the Edmundston Regional Hospital, part of the Vitalité network, was bearing the brunt of a COVID-19 surge, with seven patients in intensive care and five on respirators, exceeding its capacity of nine ICU beds. In January 2021, five of the 15 hospitals in the network were already running at over 100% capacity, and the overall hospital occupancy rate was 82.5%, above the target of 80%. This has had a significant impact on their ability to provide care, with more than 100 surgeries cancelled in a 10-day period in January 2021.

Overall ICU Capacity in New Brunswick

In total, there are 142 ICU beds across New Brunswick, with 44 of those in the Vitalité Health Network. In October 2021, as the fourth wave of the pandemic hit the province, ICU departments were reported to be "close to the brink," with only 16 to 18 beds available out of the 98 within the Horizon Health Network. This situation led to the network moving to the red level, indicating that all non-essential services would be reduced or cancelled to focus on critical care.

The strain on ICU capacity in New Brunswick hospitals has highlighted the need for careful management of resources and staffing, as well as the importance of public health measures to control the spread of COVID-19 and prevent overwhelming the healthcare system.

ICU bed occupancy rates

The COVID-19 pandemic has put a strain on healthcare systems worldwide, and New Brunswick, Canada, is no exception. The province's ICU bed occupancy rates have fluctuated during the pandemic, with hospitals often operating at or above their target occupancy rates.

In April 2020, at the beginning of the pandemic, New Brunswick's healthcare system was described as being under "great stress and strain." At that time, the Horizon Health Network, the province's largest health authority, had 98 intensive care unit beds in place, 53 of which were occupied. This equates to an ICU bed occupancy rate of approximately 54%.

However, as the pandemic progressed, ICU bed occupancy rates in New Brunswick often exceeded capacity. In January 2021, five of the province's 15 hospitals were already running at over 100% capacity, even though there was only one hospitalized COVID-19 patient in the entire province. This highlights the impact of the pandemic on the healthcare system, as hospitals struggled to manage non-COVID-related cases while also preparing for a potential surge in COVID-19 patients.

The situation became even more critical during the fourth wave of the pandemic in October 2021. The Horizon Health Network interim chief executive officer, Dr. John Dornan, warned that ICU capacity was "close to the brink," with only 16 to 18 beds available out of 98 within the health authority. This left them with difficult decisions, considering the use of post-operative recovery areas and redeploying staff to increase ICU capacity.

The Vitalité Health Network, another major health provider in New Brunswick, also experienced high ICU occupancy rates. In September 2021, their hospitals reached 96.4% capacity, with 70% of all intensive care beds across the province occupied. This strain on ICU capacity prompted Vitalité to announce an "alert level increase" and implement new COVID-19 preventive measures to "preserve the offer of care and reduce pressure on the health system."

The challenges faced by New Brunswick's healthcare system during the COVID-19 pandemic highlight the delicate balance between inpatient occupancy rates and the need to preserve ICU and other beds for potential COVID-19 surges. The province's experience underscores the importance of proactive measures, such as social distancing, masking, and vaccination, in managing the impact of the pandemic on healthcare resources.

COVID-19 impact on ICU bed availability

The COVID-19 pandemic has had a significant impact on ICU bed availability in New Brunswick. In April 2020, the province's largest health authority, Horizon Health Network, reported having 98 ICU beds, 53 of which were occupied. The Vitalité Health Network, serving the province's francophone population, had 33 ICU beds prepared for COVID-19 patients, with the capacity to surge to 116 beds in two stages.

As the pandemic progressed, the availability of ICU beds in New Brunswick continued to be a concern. In April 2021, the Edmundston Regional Hospital in northwestern New Brunswick experienced ICU strain during a COVID-19 outbreak, with seven out of nine ICU beds occupied. The hospital had to transfer two patients to a hospital in Fredericton.

By September 2021, the situation had become more critical. The Moncton Hospital, part of the Horizon Health Network, had 22 out of 23 ICU beds occupied. Across the province, 70% of all intensive care beds were occupied, and the number of COVID-19 cases was breaking daily and overall pandemic records. The Horizon Health Network's five largest hospitals were nearing or over capacity, with some operating at 100% or more.

The pandemic has exacerbated existing challenges in the hospital system, and medical professionals have raised concerns about the lack of resources for pediatric patients and the strain on emergency departments in major cities. As COVID-19 cases continue to surge, the impact on ICU bed availability in New Brunswick remains a pressing issue, with the potential for further strain on the healthcare system.

Overall, the COVID-19 pandemic has had a significant impact on ICU bed availability in New Brunswick, with hospitals struggling to manage the influx of patients and the province facing challenges in terms of bed capacity and staffing.

Challenges faced by hospitals

The COVID-19 pandemic has brought to light the challenges faced by hospitals, particularly regarding their intensive care unit (ICU) capacity. The demand for ICU beds during the pandemic has highlighted the lack of surge capacity in rural healthcare systems and the reliance of rural hospitals on their urban counterparts. This has resulted in a disproportionate impact on rural communities, as they have limited access to ICU services.

One of the main tactics employed by hospitals to address this challenge is to increase the number of beds. This strategy relies on epidemiological data and infection case predictions. For example, New York City required 40,000 beds at the peak of the pandemic in March, but the demand decreased subsequently. However, the challenge of limited ICU beds is not unique to rural areas, as even urban hospitals have struggled to adapt and develop strategies to expand their ICU capacity.

The shortage of ICU beds during the pandemic has had severe consequences. It has led to a surge in COVID-19 cases, overwhelming available resources and compromising the quality of care. Physicians have been forced to triage treatment among critically ill patients. The rapid increase in cases has also exposed the lack of adequate hospital staffing and personal protective equipment (PPE).

The relative shortage of hospital resources, including ICU beds, has been a growing issue that can influence the practices of physicians and the care provided to patients. This has been particularly evident in low-income countries, where patients may not seek care due to an inability to pay for services, resulting in an underreporting of cases and deaths.

To address these challenges, mandatory reporting of ICU, acute care, and hospital bed capacity, as well as accurate coronavirus case numbers and mortality rates, should be implemented. Additionally, a tiered critical care approach that focuses on expanding space, staff, and supplies may help maximize the quality of care during surges and future disasters. Implementing strategies to encourage sufficient hospital bed capacity and resources is crucial, especially as many countries are experiencing a second wave of COVID-19 cases.

Measures to manage ICU bed shortage

Increase the number of ICU beds

One way to manage ICU bed shortage is to increase the number of beds available. This can be done by repurposing existing spaces, such as step-down units, medical/surgical units, or other clinical care spaces, as ICUs. Additionally, creating new medical units in areas not typically dedicated to clinical care is also an option. During the COVID-19 pandemic, many hospitals worldwide had to expand their ICU capacity to accommodate the surge in patients requiring critical care.

Optimize staffing

Another measure to manage ICU bed shortage is to optimize staffing. This can be achieved by deploying non-ICU staff, such as non-ICU nurses and physicians, to support ICU teams. Implementing tiered staffing models, where non-ICU skilled physicians and advanced practice providers work under the supervision of intensivists, can also help manage the workload. Additionally, cross-training ICU-trained nurses with other nurses to assist in non-ICU aspects of care can expand the nursing workforce.

Implement triage guidelines

In the event of a pandemic or other public health emergency, triage guidelines can be implemented to alleviate system burden and ensure equal treatment when resources become scarce. These guidelines can help determine which patients receive priority access to ICU beds based on factors such as vulnerability, age, and likelihood of recovery.

Expand the physical space

To manage ICU bed shortage, it is important to expand the physical space available for critical care. This can be done by setting up centralized 'command centers' to optimize patient distribution across hospitals and ICUs based on bed and resource availability. Additionally, high-risk patients can be monitored in areas outside the ICU using wireless systems, further expanding the capacity to provide critical care.

Utilize technology

Technology can play a crucial role in managing ICU bed shortage. Telemedicine and remote monitoring technologies can help conserve resources, especially personal protective equipment, and free up ICU beds. Additionally, the use of technology enables the development of large registries and facilitates data collection and platform trials.

Frequently asked questions