Population growth and health care shortages could lead to more Code Orange warnings on PEI

In just over three months, hospitals on PEI have seen three Code Orange reports, compared to the same number in all of 2023.

As the province’s population continues to grow and health care in the island’s hospitals becomes scarce, some health officials say this will happen even more often in the coming years.

Code Orange is issued when multiple potential patients require emergency care due to an accident or other type of incident with many victims. In that case, more people may need to be called.

“We typically think of these as traumatic events that could involve a car accident or a fire, as was the case in the recent cases,” said Dr. Ken Farion, medical director of hospital services and patient flow at Health PEI.

“You could also imagine some kind of poisoning or environmental disaster that could lead to a large number of patients coming out – or even an outbreak of an infectious disease [where] suddenly a large number of patients, for example in a nursing home, suddenly became ill. That could trigger the reaction.”

Whether a hospital declares Code Orange depends on how busy the emergency department is and how many staff are present at that moment. The criteria therefore differ per hospital on the island.

Two of the three Code Oranges this year, at Prince County Hospital in Summerside, involved fewer than five potential incoming patients.

Farion said other factors include the time of day, how busy the various departments in the hospital are and how many staff are present at the time so that action can be taken in the event of an emergency.

“What can be quite overwhelming for Western Hospital, [in Alberton]if two or three patients came to their facility that really only had one doctor and a couple of nurses, it would look very different if it came here to the Queen Elizabeth Clinic [Hospital in Charlottetown],” he said.

Code Oranges on PEI in the past five years:

• 2024: QEH: 1 (June 11 apartment fire at Elena Court); PCH: 2 (July 7 house fire near Kensington; June 28 four-vehicle collision on Route 2 near Springfield)
• 2023: QEH: 3, PCH: 0
• 2022: QEH: 3, PCH: 1
• 2021: QEH: 1, PCH: 0
• 2020: QEH: 1, PCH: 0

Whether or not Code Oranges become more common, the president of the PEI Nurses’ Union said the response of health care professionals to the outbreaks is working.

“When we declare Code Orange, a fan is sent to the telephone systems and… [nurses] “We basically get a phone call and say, ‘Can you come, yes or no?’ and usually it’s a quick yes and… we always get plenty of people showing up,” said Barbara Brookins.

The union leader worked for decades as an intensive care nurse and saw her share of reports.

“When it happened, you knew your colleagues would come and the resources would come, in terms of doctors, the ward staff, just people to control the crowd. It all worked out and it was the best feeling, because you knew you were facing the unexpected and you had people supporting you.”

Farion said Health PEI is working to standardize codes and responses across all hospitals on the island.

He pointed to the province’s population explosion and health care shortages as possible reasons for the more frequent Code Orange declarations and the willingness of hospital staff to declare one.

“As we know, resources in healthcare and hospitals have come under pressure after the pandemic. As a result, the threshold for needing additional support may be slightly lower than in the past,” Farion said.

“And those two things have led to us maybe announcing the event a little bit more often than we have in the past.

“And that’s okay. It just means we’re prepared and we know how to respond.”