Acute care

Flu season hasn't officially arrived in Windsor, yet the city's emergency rooms are already bursting at the seams.

Last week Windsor Regional was at 105 per cent capacity. Hotel-Dieu Grace was at 107 per cent. That exceeds the crisis in October, when backlogs meant long waits in the ER and threatened elective surgeries.

The same thing is happening now, and for the same reason. Between the three sites, there are at least 150 patients in acute care beds who shouldn't be there. Frail or elderly, they should be living in long-term care facilities.

One of the reasons they're languishing in our hospitals is a shortage of alternate-care spaces in Windsor, and that problem won't be solved any time soon.

The 256-bed long-term-care facility announced by Schlegel Villages last Friday will take at least 20 months to open. That seems speedy after waiting all those years to get a shovel in the ground at the Hotel-Dieu Grace site, but it's still creating an accommodation crunch.

The other reason is an unfortunate change in provincial policy. Earlier this year Health Minister Deb Matthews struck down the "first bed available" provision that allowed hospitals to transfer ALC patients to any long-term care facility with a vacant room, freeing up emergency rooms for those needing immediate treatment.

While ALC patients could pick and rank their top five choices for long-term care, they were still obliged to take the first available opening under the old rules. It didn't mean they would be forced to stay there indefinitely; they could still move to their desired location when space became available.

In October, frustrated Windsor Regional CEO David Musyj called on the government to reinstate the first bed available policy. "We're turning into a quasi long-term care facility," he said, noting that 91 ALC patients were actually using desperately needed acute-care beds at the time. Because the Liberals had taken away a hospital's ability to charge those patients up to $600 a day, there was no incentive to leave.

It's a touchy subject, because elderly patients claim they're being discriminated against. Nothing could be further from the truth. These are patients who, by virtue of their age and health, meet the criteria for long-term care. With 28 long-term beds empty last week - 18 in Windsor and 10 in Tilbury - hospitals should have been given the right to transfer their ACL patients to them. They would still have had the option of moving into their preferred facility at a later date.

That didn't happen because, as Musyj said, the new policy means "they can stay until they get the one they want."

On Monday, hospital officials were warning of long ER wait times and begging people to stay away unless their conditions were serious. But how do you define that? If you're suffering chest pains or doubled over with kidney stones, the emergency room is exactly where you're supposed to be. If you've got an elective surgery that's been booked for months, you should be able to have it done as scheduled.

The health minister made a serious error in judgment when she put the needs of a small group ahead of the needs of the general population. She has rewritten the criteria in such a way that acute-care patients are being denied life-saving medical attention.

Sadly, this will only get worse unless the Liberals revisit their flawed approach. Our aging population means there will be more and more people needing ALC facilities. Until they're built, those patients must be treated in facilities designed for their needs, wherever they might be located.

Notes: Matt Harrison plans to start Tues

Despite still not passing a kidney stone, Rangers pitcher Matt Harrison said he's planning on starting Tuesday's game against the Tigers.

Harrison, 25, went to a Cleveland hospital on Friday night because of the pain and then stayed at the team hotel on Saturday. He was back at the ballpark on Sunday and threw a bullpen session.

“It was fine," Harrison said about the bullpen session. "I didn’t feel any pain throwing. I ran to see if it would hurt bouncing up and down and that was fine. I guess tomorrow I’ll just go out there and throw.”

Harrison said Monday that he experiences pain in the mornings when he wakes up and sometimes late at night, but doesn't believe it will impact his ability to pitch on Tuesday.

The Rangers, though, will have a backup plan. Dave Bush is slated to spot start (again) if he isn't needed in Monday's game.

Other notes:

* Josh Hamilton said he tried to back off a little bit in Tampa Bay to guard against injuries, but "felt off" and isn't worrying about it any more. He said he'll try to play as smart as he can but can't alter his game much. "I'm telling myself to just relax and play," Hamilton said.

He said he didn't fight manager Ron Washington when he told him he was getting a day off, saying he knows he needs the time and has to utilize it wisely.

"I need my rest and can take time to work on things, but also give my body a break," Hamilton said. "I feel good."

Hamilton noted that usually in rehab assignments he gets a chance to play the field for five innings, then six, seven, etc. This time, he was only the DH, so he didn't get that easing in period. That makes the off days important. And he added that despite hitting two homers in two days, he doesn't believe getting a day off will hurt his rhythm.

* Brandon Webb said he could throw a bullpen session Tuesday or Wednesday and then hopefully pitch in a game after that. His rehab was stalled last week with rotator cuff inflammation, but he says medication appears to be working and he feels better. But he's yet to throw hard since feeling the discomfort, so the club will see how he feels after his next session and decide the next step from there.

* Washington said his team will have to grind through a tough stretch of road games this month. They are only in Arlington for three days before heading back out for a 10-game, 11-day trip through Minnesota, New York and Atlanta. "How do you stay fresh in 101-degree heat out there?" Washington said. "That's what the schedule is and we have to keep getting after it."

* Washington said he put Craig Gentry in as a defensive replacement for Endy Chavez on Sunday in Cleveland because he feels like Gentry can run down balls in the gap better and he wanted to be sure anything hit deep could be snagged.

* Scott Feldman (right knee) is scheduled to throw a bullpen session today. He says he's curious to see how he feels following it.