CALGARY — A year after warning of a potential catastrophic collapse in the province’s emergency wards, a crusading physician is worried Alberta’s health-care system is on the cusp of another crisis.
Despite huge efforts by front-line staff and administrators to speed treatment, Dr. Paul Parks said Thursday there is now a rising number of sick patients stuck in ERs in Calgary and Edmonton because there are no hospital beds available.
“Everyone has been working hard to keep the system working above capacity, but you can only suck it up and pitch in for so long,” Parks said.
“We avoided going over the brink, but now there is concern things are moving in the wrong direction again and we could be headed back to a situation where we can’t deliver timely care.”
A controversy about lengthy waits and patient deaths in the province’s ERs erupted on the front pages of newspapers and in the legislature last October, after Parks’ repeated pleas to top politicians and health officials for a solution were leaked to the media.
While the letters from the president of the Alberta Medical Association’s emergency medicine section to Premier Ed Stelmach and his health minister, Ron Liepert, had been previously ignored, the province’s health authority moved in the wake of the bad publicity to introduce new protocols aimed at eliminating ER delays.
The number of patients stuck in emergency wards because no hospital bed was available declined steadily this year as patients were moved into beds and discharged faster.
But last month, that key indicator — frequently cited by ousted health minister Gene Zwozdesky as a positive sign — spiked upwards again by more than 60 per cent.
September figures from Alberta Health Services show that on average there were 29 patients in Calgary waiting to be admitted to hospital, up from 11 patients in August. In Edmonton, the number increased from 41 to 56 patients.
Parks said anecdotal reports this month from his physician colleagues in ER wards is that the situation is getting worse, a topic they will discuss in detail at their annual meeting today and Saturday in Kananaskis Country.
The proportion of seriously-ill patients who are admitted within eight hours — AHS’s key measure of ER overcrowding — is also of concern. The health authority has a target of 60 per cent, but last week all of the adult hospitals in Edmonton or Calgary were well below the benchmark.
At the Rockyview General Hospital, for example, only 29 per cent of patients were admitted within eight hours, a level comparable to last December, prior to the introduction of the emergency protocols.
At Edmonton’s busy Royal Alexandra Hospital, only 23 per cent of patients were admitted within the target.
“AHS has become very transparent about how the system is performing,” said Parks, “but what’s still unclear is what they’re doing to address the shortage of affordable and appropriate long term care for chronically-ill patients.”
By March 31 the health authority aimed to have just 375 patients waiting in hospital for a space in a nursing home or supported living facility. But figures for the three-month period ending June 31 show there were 511 “bed blockers” in Alberta hospitals waiting for a continuing care space, an 8.5 per cent jump from the previous quarter.
Health Minister Fred Horne said the province is on track to add 1,000 continuing-care spaces this year, which will ease the hospital and emergency room backlog.
“I’m always concerned about the situation in our emergency rooms,” Horne said.
“We have targets and we’re committed to meeting those targets.”
Liberal health critic Dr. David Swann said the government is not opening the right kind of continuing care spaces, nor is it ensuring firms under contract with AHS take the high-need patients that are clogging the acute-care system.
“They’re not full nursing beds and we’re not getting the right people into them, even if we’re creating more,” Swann said. “It’s a bit of a shell game by the province and we have to halt the cherry-picking of patients by private operators.”
The province’s health watchdog is set to release an interim report next Thursday on the situation in emergency wards.
Dr. John Cowell, president of the Health Quality Council of Alberta, said he will reveal findings from his investigation of 322 alleged cases of poor ER patient outcomes that Parks documented and sent to health officials and Conservative politicians in 2008, but he hinted he will also assess whether there has been any sustainable fix to the ER crisis.
“We want to look back at what happened,” said Cowell, “but our mandate at the council is to also look at how the situation can be improved.”
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