ER doctors express 'confusion and alarm' over Alberta Health Services' position on bed closures

Emergency medicine doctors have written a letter to the CEO of Alberta Health Services calling for immediate action to address overwhelmed and understaffed emergency rooms.

The letter, sent Friday and signed by a dozen ER doctors includingthe president of theAlberta Medical Association's section of emergency medicine, expresses "confusion and alarm" in response to how AHS has characterized the state of Alberta's emergency rooms.

AMA's section of emergency medicine represents 450 ER doctors across Alberta.

ER access 'continues to worsen,' doctors say

Last month, AHS CEO Dr. Verna Yiu wrote in an op-ed for Postmedia that "there is no bed shortage in Alberta."

Yiu wrote that if a patient needs a bed, one will always be available. She attributed bed reductions to staff absences, due to vacations or other reasons, and routine summer closures.

The ER doctors accusedYiu of downplaying the significance of bed closures and staffing issues.

"Many of us are very concerned that AHS has misinterpreted its own data to avoid any further confusion or disconnect between AHS leadership and those providing clinical care in our overflowing [emergency departments], allow meto state very clearly that [emergency department access block] is currently severe and continues to worsen with each passing day," the letter reads.

The doctors listed a variety of reasons contributing to the issues with access:

• Deferred care throughout the pandemic, meaning patients are now showing up with later-stages of illness.
• Increased mental health issues.
• Increased EMS volumes and staffing shortages.
• Lowered access to primary care, pushing patients to ERs.
• Increased isolation demands, needs for PPE and other issues related to the pandemic.

Dr. Shazma Mithani,the section of emergency medicine representative for Edmonton, said emergency rooms across Alberta are seeing volumes 10 to 20 per cent higher than before the pandemic.

On top of that, COVID-19 hospitalization numbers are beginning to increase as cases surge in the province.

"Having a big influx of COVID-19patients into hospitals, I'm quite worried about how the health-care system is going to manage it. How are front-line health-care workers going to come out on the other side of this?" she said.

AHS has said 98 per cent of its acute care and emergency beds are available.

Some towns currently have no ER beds

But the provincial tracking site shows bed reductionsin more than two dozencommunities.

One of those is the town of Hardisty, which currently has no emergency care spaces the health centre usually sees an average of around 150 ER visits each month.

Dozens of surgerieswere cancelled last week at Edmonton's Royal Alexandra Hospital after four operating rooms were closed,and Mithani said she expects to see further surgery cancellations as hospitals make space for COVID-19 patients requiring intensive care.

"Human resources are certainly limited, both with doctors and nurses and other front-line health-care workers. Everybody is really burnedoutbecause of the pandemic over the last 18 months. It's a very stressful time and here we are entering a fourth wave," Mithani said.

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AHS said in an emailed statement that it understands the pressure emergency departments have been under and that it acknowledges doctors' concerns.

"The op-ed was intended to share information with the public and provide reassurance that the healthcare system remains safe and accessible to all Albertans, recognizing that we have temporary hospital bed reductions occurring at some sites," the statement read.

"There are pressures in our sites as we see an increase in COVID-19 cases, increased visits to our emergency departments, as well as increased competition for health-care staff."

AHS said it will reach out to physicians directly to discuss the issues raised in the letter.

AHShas also invoked its emergency work rules, which could force nurses to work mandatory overtime and cancel holidays.

The Opposition has called on the government to take action to increase hospital capacity,calling the current bed closure situation a crisis.

"The UCP are essentially telling Albertans not to get hurt or sick if you live in these communities. If you're working at the tank farm in Hardisty and have an accident, or have a complicated pregnancy and live in Wetaskiwin, you could be forced to drive half an hour away to get help," said NDP Leader Rachel Notley in an emailed release.