High patient volumes, long wait times, and ‘alternative level of care patients’ awaiting long-term care placement among challenges

Some patients waited well over six hours before being assessed by a doctor at Sault Area Hospital this summer.

While the average wait time was 2.9 hours between April and July, the 90th percentile wait time was 6.3 hours for an initial physician assessment – eclipsing the hospital’s target of 5.8 hours.

All told, it was a busy summer at the local hospital – with long wait times, increased patient volumes, and other pressures that were outlined in an operational update report presented at the board of directors meeting Monday.

Designed to hold around 290 patients, the hospital saw volumes as high as 324 patients this summer, with an average of around 300 patients between April and August.

That figure has spiked from an average of 262 in 2023/24 and 281 in 2024/25 – and may still grow worse through the fall and winter.

“That’s at a time when we aren’t facing outbreaks in our institution, which has further potential for pressure,” said Ila Watson, hospital president and CEO. 

“It’s not the typical high demand time of year, which is fall and winter, so this is something we really need to pay attention to because this is considerable pressure on our organization.”

This summer, the Ministry of Health announced plans to reduce physician services at the hospital by 15 per cent.

There are also growing numbers of ‘alternate level of care’ patients, who do not require acute hospital care – many of whom are awaiting placement in long-term care homes.

“Our main driver of growth in ALC activity is patients who are waiting for long-term care beds, and we have patients who are also in need of other community supports, but it’s largely the long-term care group,” Watson said.

“That, of course, puts some significant pressure on patient flow and our occupancy at a system level.”

Alternative level of care days at the hospital have risen from around 1,400 in mid-2023/24 to around 2,500 by mid-2025/26, with projections of up to 2,500-2,700 by 2026/27, the report states.

Despite the outlook, efforts are underway to alleviate some of the pressures the hospital is facing.

Last month, the hospital launched its virtual home waiting room to help reduce congestion in the emergency room for eligible conditions like minor injuries, infections, prescription renewals, and more.

Patients are placed in line and notified via text about when to come in for triage and care. 

Currently limited to 10 patients per day, 116 patients have used the service as of Sept. 17.

“We have some great feedback around improved patient experience, and we know it’s helping us contribute to (patient) flow,” Watson said. 

“We’ve had people even indicate that they were dubious, but tried it out, had a good experience, and have let people know.”

Watson also discussed government investments meant to bring more primary care to the community, as well as long-term care programs – in the form of both new long-term care beds and community long-term care initiatives that can help people stay at home while getting the health care they need.

“It will take a bit of time before that actually has an impact, and that will reduce pressure on our emergency department and keep people in a healthier state so that they don’t need us as much,” she said.

While the government announced expanding access to its community long-term care services earlier this month, Sault Ste. Marie was not included in the first wave – but may be included in further efforts.

“(It’s) a program that helps people access services that they would otherwise have access to if they were in a long-term care home, so that they can remain at home longer,” Watson said. “They will have further waves that hopefully we will be able to benefit from.”

As the hospital contends with high patient volumes and other pressures, Watson encouraged the public to stay up-to-date with flu and COVID-19 vaccinations, to use the virtual waiting room, and “respecting and supporting” health care workers “who are continuing to work under some significant pressure.”