Don’t bank on quick ER cure

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Anyone unfortunate enough to visit a hospital emergency room in the last few years probably is not surprised to hear dire warnings about the pending collapse of the system or to learn median wait times are approaching 20 hours at many urban hospitals in the Edmonton and Calgary regions, including our own Sturgeon hospital. Despite recent media attention and political finger pointing, the system did not break overnight, which makes it all the more unlikely that a cure is on the immediate horizon.

Median wait times of 19.7 hours at the Sturgeon is a familiar story across the province where a lack of long-term care beds means patients, many of them seniors, are being shown acute care beds in the ER. These are local seniors who are forced to endure lying for hours, days and even weeks in emergency wards. Premier Ed Stelmach acknowledged the problem dating back to 2008, while local doctors broached the issues with top administrators several years ago yet little has changed. It’s an unacceptable, shameful example of a collective failure in long-term and strategic planning on behalf of Alberta Health and Wellness and its health superboard.

The ER problems are symptomatic of a government with an untreated disconnect between political and administrative channels. This was most acutely felt when Ron Liepert held the health portfolio and appeared to butt heads with his handpicked health czar Stephen Duckett. The situation hasn’t improved with the more diplomatic Gene Zwozdesky, as we saw with proposed bed closures at Alberta hospital that were later scrapped, and recent statements by Duckett that the problem isn’t as bad as politicians and doctors suggest shows the government’s vision does not necessarily fall in line with those at Alberta Health Services (AHS).

The ER situation had been largely ignored until the public release of a letter from Paul Parks of the Alberta Medical Association to Zwozdesky that described a “potential catastrophic collapse” of emergency care in the province. That letter, coming from such a high-profile physician, has publicly confirmed what many of us who’ve suffered through ER waits always suspected and in the process have backed the Stelmach government into a defensive posture.

Zwozdesky’s recent commitment to ensuring four-hour targets from triage to discharge for non-admitted patients and eight hours from triage to a bed hit all the right chords but in reality only raise eyebrows that change will actually come. This is, after all, a benchmark that was first proposed almost 20 months ago but can’t and won’t be met until at least December. The minister has promised to accelerate the opening of new beds, yet can’t provide any specifics on staffing at many empty wards in busy Capital region and Calgary hospitals. AHS officials, meanwhile, suggest taking on the new beds will not be problematic.

Doctors at the Sturgeon do not expect the local problems to correct themselves anytime soon despite an expansion to the ER that’s currently in progress. As we’ve seen in Edmonton and Calgary, construction does not lead to decreased wait times if the beds and people to staff them aren’t a priority. AHS has apparently told doctors that no more nurses will be hired at the Sturgeon, meaning status quo for patients who must continue waiting endlessly in crowded, albeit newer, conditions. Until Health and Wellness and AHS start to show some consistency that they’re on the same page, Albertans have every right to be skeptical about a forthcoming cure.

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St. Albert Gazette

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