Alberta’s ERs hampered by ‘lack of beds,” MDs say
Published in The Calgary Herald June 8, 2009
CALGARY - Representatives of the Canadian Association of Emergency
Physicians say the No. 1 problem facing emergency care in Alberta is the
inability to treat patients quickly and efficiently because of a lack of beds to send
them to.
"We've had one Band-Aid solution after another in the last few years, and while
we have a health-care system in Alberta that is operational, it's entirely covered
in duct tape," said Dr. Joe Vipond, a Calgary physician and chairman of a
national medical conference meeting in Calgary.
"Emergency rooms are really good at one thing--diagnosing and treating acute
illness. Once it's diagnosed and the initial treatment has started, there is no need
for them to be in an emergency room; they need to be in a hospital bed.
"The feeling that we have is that we have a crisis in our hospitals due to the lack
of the acute care beds that exist. When things back up, they pile up in our
emergency room and make it dysfunctional."
More than 700 physicians and nurses are attending this conference, which runs
until Wednesday at the Telus Convention Centre.
The event is a forum for emergency medicine colleagues to network, exchange
ideas and discuss potential solutions to problems faced in emergency rooms
across the country, and thus plays a vital role in the development of national
standards and clinical guidelines.
For the Calgary physicians on hand, it was an opportunity to share their
grievances and listen to solutions from doctors elsewhere in the country and the
world.
The province of Alberta spends more than any other on health care, yet average
wait times here are higher than the national average.
"We end up, a lot of times, with 50 per cent of the beds in the emergency room
being used up by patients we've already seen," said Dr. James Huffman, an ER
physician at three Calgary hospitals and resident co-ordinator of the event.
"But there's no bed anywhere else in the hospital, and we can't bring anyone else
in from the waiting room because those beds are taken. That's the biggest
issue."
To deal with this crunch, some Calgary hospitals have found a novel solution. Media coverage CAEP09 4
They've taken to examining patients in newly designed examination rooms, built
adjacent to the waiting rooms, stocked with basic medical equipment. There is
one at the Foothills Hospital, and another one set to open shortly at the Peter
Lougheed Hospital.
"The theory behind those rooms is, if the next person I'm scheduled to see is in
the waiting room, I'll take their chart and take them from the waiting room to the
examination room, do my exam, and send them back to the waiting
room,"Huffman said.
"That way we can conduct our examinations privately, and they don't have to
share private information around strangers. And that's a temporary fix, it's not a
long-term solution to our problem."
Dr. Tom Rich, an emergency physician who works at Foothills, says it's not
perfect, but it allows patients to be seen quicker.
"It's really not an efficient use of the doctor's time to find a patient and take them
to where they're supposed to be," he said. "But it's better than leaving them
unassessed for eight hours. Is it ideal care? No. But it's better than the
alternative."
None of the doctors pointed a finger at the provincial government for its lack of
support, but rather on the health care system itself for being managing
inefficiently.
"There's times we come to work and there's 40 admitted patients in our
department, and if you've got 40 patients and you've only got 60 treatment
spaces, well you don't have a 60-bed emergency department, you have 20-bed
emergency department," Rich said. "You're functioning at 60 per cent capacity."
Dr. Raj Sherman, a former ER physician and now an MLA for Edmonton-
Meadowlark, said the problem is our health care system is being bombarded with
the perfect storm of population growth, homelessness, drug abuse, increased
cancer rates, childhood obesity and overly specialized medical staffing.
"All these things compound," he said.
"The emergency issue is a complex issue that's not an emergency problem, but a
system problem. The key will be prevention, we need community based
programs where we can stop illness, to stop people from getting sick in the first
place. Because we can't keep going the way we are."
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