Alberta hospitals overcapacity heading into cold, flu season: ‘Packed to the gills’
Karen Bartko
2024-10-10 00:29:53
Typically at Alberta hospitals, summers and falls are — relatively speaking — slower before the winter respiratory virus season brings an influx of patients.
However this year, doctors in Edmonton say there has been no reprieve.
“We’re really packed to the gills already,” said Edmonton critical care specialist Dr. Shelley Duggan, who is also the new president of the Alberta Medical Association.
“We’re starting, unfortunately, what will be our respiratory viruses and flu season with being in substantial overcapacity.
“It’s going to be quite a crisis to manage over the coming months.”
The AMA said in recent days in Edmonton, wards for family medicine — filled with patients who are usually older, more frail and need medical issues addressed in a hospital setting that they would not be able to manage in the community — have been operating at about 155 per cent of capacity.
Meanwhile, Duggan said hospital units for general internal medicine has been at 135 per cent capacity.
“This is obviously problematic because we just don’t have the spaces, as well as the people, to look after all of these patients. And so this leads, of course, to a backup into our emergency departments.”
Duggan said in the Edmonton Zone, there are a large number of EIPs — that is, patients who have been admitted to a hospital but remain in the emergency department because there’s no physical space for them in a unit upstairs.
Because of that, hospitals in the city can’t accept any patients from elsewhere in the province, such as rural facilities, unless it’s an urgent or critical case.
“There are always patients that need to come regardless of no space, who need a speciality surgery or transplant patients,” Duggan said.
“But otherwise, we are having to keep those patients in the facilities that they’re in at the time and supporting with phone advice because there’s just no room to bring anybody into the zone.”
AHS said it’s taking proactive steps to manage capacity at Edmonton hospitals, which are currently experiencing high occupancy levels, as expected, as respiratory illness season gets underway.
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“In response, AHS implemented a new process called the GIM Escalation Pathway at the beginning of October: when patient volumes hit certain triggers, the Edmonton Zone’s General Internal Medicine (GIM) units will temporarily pause accepting patients with non-urgent needs from other zones,” AHS said in a statement to global News.
“Instead, those patients will continue to receive care at their local hospitals, with Edmonton GIM physicians providing consultative advice and support to colleagues outside the zone. This ensures that patients receive care close to home while reducing pressure on Edmonton’s busy hospitals.”
Even when patients are able to be moved from the ER to a unit in Edmonton, the AMA said being overcapacity means there are often three patients in a room designed for two, or patients are being put in spaces not intended for care and don’t have a bathroom.
“We’re finding every nook and cranny there is to be able to put patients, which is often not great care and not a great situation.”
Health Minister Adriana LaGrange confirmed Wednesday Alberta Health Services is looking at opening surge capacity beds.
“They’re looking at reinforcing the workforce as well to make sure that we have the right complement of doctors, nurses, etcetera as we open those beds,” LaGrange said, adding surgeries may also be moved as needed.
“This is something that is done on an ongoing basis between the hospitals, etc. That is all part of the planning when there is pressure on the system.
“But we are monitoring it very, very closely.”
LaGrange said in some cases, out-of-town patients in Edmonton may be moved close to home.
“If we have patients in hospitals in our urban areas that are overcapacity, is there a possibility of reallocating them back to their home communities, if in fact they’re able to go back to their home communities? We look at all those options.”
LaGrange added the province anticipates having a flu season very similar to last year and preparations are ongoing.
The AMA said typically, there is a lower patient volume over the summer months but this year, that was not the case.
“We were into overcapacity protocol and had still a significant number of EIPs even in August of this year, which would typically be a slower time for hospitals,” Duggan said.
The AMA president said in the past two years, Alberta has welcomed hundreds of thousands of new residents but critical education and health-care infrastructure has not kept pace.
“Edmonton has not had a new hospital, essentially, built since the 1980s,” she said in reference to the Grey Nuns Community Hospital in the southeast. “There hasn’t been a significant increase in infrastructure in the province, so we just don’t have the availability of places to put these patients.”
“You can’t bring up 400,000 new people into a province and not expect them to need health care. It’s a similar situation that we’re seeing in schools. We’re running out of space because we just haven’t planned for the population that we now have.”
The health minister said Alberta Health Services is adding capacity. AHS said it’s opening 200 temporary acute care beds and recruiting staff.
Duggan said a surge happens every year during cold and flu season — but this year, the system is starting out already at a breaking point.
“We know it’s coming. The problem is we’re already fairly maxed out in capacity. And so you know, the solution is really going to be to ask people to to work harder and more.
“I don’t know, in terms of space, how much more there is to use — in terms of where to put patients.”
But beds are only one piece of the puzzle; staff is also needed. The surge comes at a time when countless Albertans are without a family doctor, and feel forced to go to hospital for care.
The Alberta Medical Association has also been working for a year to get in place a new payment model for family doctors and rural generalists, but that has yet to be locked in.
A memorandum of understanding was signed in 2023 and LaGrange has said a new model would be in place this fall.
Many Alberta physicians now say they can’t wait any longer for the province’s promised Physician Comprehensive Care Model, which would help ease current financial pressures.
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Duggan said the AMA held a forum in recent weeks where it heard from several physicians contemplating closing their family practices.
“One person stood up and said they had a date in November that their group was meeting to decide and that would another 5,000 Albertans without a family physician — and we’re hearing that from our colleagues across the province,” Duggan said.
“Without a new any hope on the horizon for a new compensation model, I think we are going to reduce more physicians.”
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