ER protocols working, AHS says

New protocols announced last month to handle backlogs in province's emergency rooms are showing good initial results, Alberta health officials say.

New protocols announced last month to handle backlogs in the province's emergency rooms are showing some initial results, Alberta health officials announced Friday.

"Our emergency departments are always busy and busier at this time than any other," said the acting CEO of Alberta Health Services, Dr. Chris Eagle.

"We're still seeing progress with respect to the number of patients waiting for treatment in a hospital bed and that's encouraging."

The protocols are enacted whenever wait times in Calgary and Edmonton emergency rooms reach certain benchmarks. Between Dec. 20 and Jan. 10, they were enacted 20 times in Edmonton, and 11 times in Calgary.

Edmonton hospitals encountered an additional 50 situations where the protocols were enacted to head off escalating situations, AHS said.

Protocols include moving some patients out of hospital beds over to long-term or community care spaces. People who travel from smaller communities to Edmonton or Calgary for specialized medical treatment could be discharged back to facilities back home.

While the actions are starting to take effect, Eagle acknowledged more has to be done.

"There are many longer-term things that we need to do as Alberta Health Services to improve access to emergency departments including creating more spaces in the community for seniors patients," Eagle said.

He said there is still concern about what impact flu will have on the system.

Staff meeting to review protocols

The province offered numbers to compare the number of patients waiting in ERs for admission to hospital beds over the past four months.  In Edmonton, the average daily number of patients was 80 in September, 84 in October, 71 in November and 48 in December.

There were 44 people waiting on Friday.

In Calgary, the average daily number of patients was 68 in September, 53 in October, 42 in November and 19 in December. Seventeen people were waiting on Friday morning.

However, AHS has some way to go to meet a self-imposed benchmark it wants to reach by March of having 70 per cent of ER patients treated and discharged within four hours.

In Edmonton last week, the Royal Alexandra Hospital only met that benchmark 39 per cent of the time. The benchmarks were reached only in 40 per cent of visits to the University of Alberta Hospital, 50 per cent at Grey Nuns, and 61 per cent at Misericordia.

The Stollery Children's Hospital came the closest to meeting the benchmark by reaching the four-hour discharge goal in 66 per cent of all visits.

The numbers were only slightly better in Calgary last week. Foothills Medical Centre met the benchmark in 47 per cent of visits. The numbers were 48 per cent at the Peter Lougheed Centre, 51 per cent at Rockyview and 75 per cent at Alberta Children's Hospital.

The benchmark for getting ER patients who require hospital admission into a bed is to have 45 per cent of patients admitted within eight hours of registration.

The Grey Nuns Hospital in Edmonton met the goal 19 per cent of the time. It was 24 per cent for the Royal Alexandria, 29 per cent for the University of Alberta Hospital, 28 per cent for Misericordia and 52 per cent for the Stollery.

In Calgary, Rockyview General Hospital met the benchmark in 26 per cent of visits last week, it was 36 per cent for the Peter Lougheed Centre, 41 per cent for Foothills Medical Centre and 70 per cent for Alberta Children's Hospital.

Health care staff, physicians and administrators are meeting in Edmonton Friday to discuss the impact of the protocols.

The protocols can be enacted whenever ER crowding reaches a number of criteria, including when the number of emergency room beds filled by patients needing admission, diagnostic tests or physician consultations exceeds 35 per cent.

Action will also be taken if there is no ER space to handle people with life-threatening conditions, ER capacity is at 110 per cent, or more than five patients have waited more than eight hours to be admitted to a hospital bed.