Minister promises to reduce ER wait times
Alberta Health Minister Gene Zwozdesky committed Wednesday to setting wait-time benchmarks to get patients in and out of the province's hospital emergency departments faster.
"The maximum time in an emergency room for a patient who does not require an overnight bed or an overnight stay should not exceed four hours," he announced at a news conference with the Alberta Medical Association.
"The maximum time in an emergency room for an admitted patient from triage, through diagnosis, through treatment and into an actual overnight bed placement should not exceed eight hours."
Zwozdesky made the announcement after meeting Tuesday with Dr. Paul Parks, the emergency medicine section president for the Alberta Medical Association. The minister hopes to have the policy in place by Christmas.
Parks wrote a letter to the health minister earlier this month, warning about a "potential catastrophic collapse" of emergency care in the province without immediate intervention. The letter, that was obtained by the media, contained numerous examples submitted by doctors where patient care was compromised by extreme wait times.
Parks said the benchmarks will help, but he wants to know who is in charge at every single hospital. Currently, doctors find no one at Alberta Health Services is taking responsibility for the situation because accountability is diffused by the layers of bureaucracy.
"When we're crying for help, who do we go to?" Parks asked. "Who owns this big system problem that can help us in the [ER] when we want to see these new patients coming in the door?"
Alberta Health Services set the same time limits a year ago but has rarely met them.
"I think the average is about 20 to 30 per cent of the time we're meeting those targets, and that's been like that for quite a while now, for a couple of years," said Dr. Felix Soibelman, president of the Edmonton Emergency Physicians Association.
"So we really need to get going on this and that's what we're begging and pleading Alberta Health Services and our health minister to help us with."
Zwozdesky said managers in Alberta Health Services will be held accountable this time.
"They have it in their performance measures, their personal contracts, to make some of these improvements already. We're just putting the benchmarks in there," he said. "If it becomes a staffing issue, then clearly the CEO will have to look at that."
Nobody should feel threatened: Zwozdesky
On CBC Radio's The Eyeopener on Wednesday morning, Zwozdesky said he had a "very productive meeting" with Parks.
He said the main problem is the acute-care beds to which patients are normally assigned after being admitted to hospital by emergency room doctors.
"Unfortunately, those acute-care beds are full.… And the reason they're full is because there are a lot of people in acute-care beds today that need to be transitioned to some form of continuing-care space," said Zwozdesky.
"The fact is there's a bottleneck there and that's why we're working aggressively, and have been for months, to alleviate that pressure."
Zwozdesky said there are already many steps being taken to free up beds and ease ER wait times. These include opening more beds, increasing home-care funding, looking at changing hospital discharge protocols and encouraging people to use Health Link Alberta where possible, instead of heading to the hospital.
ER wait-time targets have been set many times in the province and then exceeded. Parks suggested bureaucrats should lose their jobs if those targets aren't met.
Zwozdesky said that while "everything should be considered" in addressing ER wait times, nobody should feel under threat.
"We're trying to work this through together," he said. "Accountability is something we did talk about, [and] we'll be talking about it more."