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Dear Honorable Health Minister Zwozdesky,
On behalf of the Section of Emergency Medicine (SEM) of the Alberta Medical
Association, I feel compelled to bring to your attention our member’s serious concerns
regarding the state of emergency medical services in our province. Severe systemic
overcrowding continues to adversely impact access to acute care emergency services within the
province. Unfortunately, this is not a new problem, and despite repeated pleas and
communications with your Ministry and Alberta Health Services, access block and emergency
department/system overcrowding continue to worsen. Readily available objective data clearly
delineate that overcrowding in our province today is worse than it has ever been, and front line
emergency physicians continue to express grave concerns regarding their inability to provide
safe or timely care to patients presenting to our Emergency Departments (EDs). Due to severe
access block, we are routinely failing to meet even the basic recommended times to assess and
treat acutely ill patients arriving to our hospitals, and suspect that the problem will only worsen
as the winter illness season approaches. While the long term commitment by AHS to create
long term care (LTC) beds in our province is very much appreciated and necessary, we would
like to encourage you to implement an immediate plan to urgently decant our EDs of admitted
Emergency In‐Patients (EIPs). The severity of the ongoing emergency department/system
overcrowding cannot be understated: currently our provincial urban EDs have more than 50%
of their acute care beds occupied and blocked, on a 24/7 basis, by EIP's.
As you are likely aware, the housing of EIPs in our EDs is not a new problem within our
province. In fact, SEM executive, along with other leaders in our Emergency Medicine
community, have provided extensive written documentation of the real impact of systemic
overcrowding on a number of occasions over the last two years (attached). There have been a
large number of communications and meetings with senior health leaders (Health Ministers
Hancock and Liepert included), as well as top AHS administrators (including Dr. Duckett and his
predecessors), and despite acknowledgment and agreement regarding the severity of the crisis
the situation continues to degrade. In fact, in February 2008 Premier Stelmach acknowledged
the issue personally, and pledged to address the crisis immediately (letter attached). His
response was triggered by a letter to the Health Minister that included a long list of real and
significant sub‐optimal outcomes as a direct result of severe systemic overcrowding.
Unfortunately these examples were only selected cases from an extensive daily occurrence of
sub‐optimal outcomes in our province's EDs, and even worse, they continue to represent the
sub‐optimal occurrences in our ED waiting rooms to this very day.
We feel compelled to continue to advocate on behalf of our patients, and recently
members of our section have met with yourself, Deputy Minister Ramotar, as well as Dr.
Duckett, in order to inform our healthcare leaders that Albertans continue to suffer and receive
substandard emergency care as a direct result of a lack of capacity within the system. Again,
our data and feedback from Emergency Physicians throughout the province indicate that our
overcrowding problem continues to worsen and we anticipate the potential catastrophic
collapse of timely emergency care delivery in the upcoming months. There must be an
intervention immediately.
We very much support and advocate for AHS's principle of the "right patient in the right
place", in addition to the government's campaign to improve "access". Please help us urgently
decant our EDs of EIPs. We recognize that this is a complex system issue, and that a large
number of both long and short‐term implementations and solutions will need to be instituted.
In order to provide safe and timely emergency care, and while the long term pieces are being
addressed, we need immediate removal of the EIPs from our EDs. Health care system
overcrowding must be shared by the entire system. LTC patients need to be moved into
hallways and empty wards. EIPs must be moved to acute care beds on hospital wards, and only
then can undiagnosed and untreated patients be moved from dangerously overcrowded
waiting rooms, or transferred from rural and regional centers, into EDs where life saving
measures can be implemented in a timely fashion.
Thank you very much for your time and attention to this extremely important issue. The
Section of Emergency Medicine looks forward to working with yourself and your Ministry to
immediately address this ongoing crisis.
Dr. Paul Parks
President ‐ Section of Emergency Medicine
Alberta Medical Association
cc
Premier Ed Stelmach
Deputy Health Minister Jay Ramotar
Mr. Fred Horne MLA
Dr. Raj Sherman MLA
Dr. Stephen Duckett CEO AHS
Dr. Dave Megran, EVP & Chief Medical Officer AHS
Dr. Chris Eagle, EVP Quality Service and Improvement AHS
Mr. Ken Hughes, AHS Board Chair
Dr. John Cowell, CEO HQCA