Staff at the Sturgeon Community Hospital have identified a number of additional beds they can use when the emergency department activates new overcapacity protocols that went into effect on Monday.
The protocols, announced by Alberta Health Services last month, are designed to provide additional capacity when pressure on emergency departments and the health system reaches a critical threshold.
“For Sturgeon, what we’ve done is developed a more specific algorithm and identified some specific beds for use when we need to go into overcapacity,” said Wendy Tanaka-Collins, site director at the Sturgeon.
She said staff are looking at opening an additional four beds in one of the hospital’s medicine units.
“That will bring us to 10 overcapacity spaces,” she said.
Beds identified for overcapacity use are located throughout the hospital’s in-patient units.
The province has said facilities may need to adjust the protocols as they move forward in order to best meet the needs of the population in the surrounding areas.
“The overcapacity protocols build on our current practices by setting new targets that, when reached, trigger immediate action to reduce emergency department wait times by enhancing our ability to move admitted patients safely out of the emergency departments into the units where they’ll get the care required,” said Dr. Chris Eagle, acting president and CEO of AHS, during a press conference last week.
“Protocols also include an escalation plan, right up to and including myself as CEO of Alberta Health Services if the pressures cannot be resolved in a timely way. In short, everyone from front-line doctor to CEO has a clear role in accountability,” he said.
According to AHS, protocols may be activated when one or more of the following triggers have been met:
• The percentage of blocked emergency department care spaces (due to patients awaiting admission, diagnostics or consults) exceeds 35 per cent;
• When there are no additional beds in an emergency department to treat patients arriving with the most critical injuries or illnesses;
• When the hospital is full;
• When the percentage of emergency department occupancy exceeds 110 per cent;
• There are seven or fewer EMS units (in Edmonton or Calgary) available to transport patients to hospital;
• More than five patients have been waiting eight hours or longer for a hospital bed since the decision was made to admit them (number dependent on facility size).
Tanaka-Collins said the overcapacity protocols are just one aspect of the new system-wide approach that AHS is using to move patients through the system more efficiently.
“What we’re trying to do here at the Sturgeon is to try to look at what are the needs. What are the pressures and demands in the emergency department? What else is happening with our surgery units and our surgical program? What’s happening on medicine, etc.,” Tanaka-Collins said.
She said hospital managers meet twice daily to discuss the number of available beds and the movement of patients through the hospital.
“It’s about moving another patient out of the emergency department into the main hospital if they require admission.”
She said this also requires looking at different areas such as seniors’ health, and the hospital’s ability to move patients into long-term care units, when needed.
Tanaka-Collins said the new overcapacity protocols aren’t entirely different from what staff at the Sturgeon did previously.
“We’ve just really defined what our trigger points are,” she said.
Input from nurses, physicians and administration was used to develop the protocols, which were tested at some facilities earlier this month.
With 19 beds, the Sturgeon’s emergency department will reach 35 per cent capacity once there are eight emergency in-patients (EIP) — those patients in the emergency department awaiting admittance to hospital.
“Once we get the eight EIPs in the department something should happen,” said Dr. Daniel Hryciuk, an emergency room physician at the Sturgeon.
“We usually run about 50 per cent of our beds with EIPs,” he added.
“It will be very interesting to see how it happens and what processes are put together.”
