Alberta Emergency Rooms Struggle with Patient Backlog as Solutions Emerge

Emergency rooms in Alberta are facing significant challenges, with reports indicating dangerously long wait times. Doctors have highlighted the urgent need to focus on relocating patients classified as alternate level of care (ALC) out of hospitals to alleviate pressure on emergency services. According to the Canadian Institute for Health Information, ALC patients occupy hospital beds despite not requiring the full range of services that hospitals provide.

Data from Alberta Health reveals that in August, ALC patients constituted between 18 and 37 percent of the total beds across Edmonton’s four major hospitals. Specifically, 539 out of 2,325 beds at the Grey Nuns Community Hospital, Misericordia Community Hospital, Royal Alexandra Hospital, and University of Alberta Hospital were designated as ALC. Emergency physician Raj Sherman emphasized that these patients disrupt the hospital’s flow, stating, “The problem is, right now, the community works banker’s hours, nine to five, Monday to Friday, so the backlog builds over the weekends.”

Sherman advocates for improved community care, suggesting that investment in home care could allow for patient discharges around the clock. He believes that such measures would lead to safer emergency care for all. Statistics from Canada’s Drug Agency suggest that over 90 percent of ALC patients are aged 55 or older, with a median age of 80 years.

The financial implications of ALC patients are considerable. Research from the C.D. Howe Institute indicates that maintaining an ALC patient costs the healthcare system between $730 and $1,200 per day, compared to approximately $250 per day for long-term care. A memo from August projected that reducing the number of ALC patients and their duration of stay could save billions while addressing emergency care concerns.

Most hospitals in Edmonton are operating at or above capacity. In August, both the University of Alberta and Misericordia hospitals reported occupancy rates of 109 percent, even before the anticipated rise in flu cases. Sherman pointed out that Edmonton has not seen a new hospital built in 38 years, while the population has more than doubled during that time. He remarked, “We serve this massively underserviced north, and people are older and sicker.”

The executive director of the Alberta Seniors and Community Housing Association (ASCHA), Irene Martin-Lindsay, noted that support for ALC patients has not kept pace with population growth. She stated, “The systems haven’t been ready. And we are seeing many of the elderly are coming to be with their families here in Alberta.” Martin-Lindsay emphasized the need for 24/7 home care services and additional supportive living spaces to meet the complex needs of an aging population.

To address these issues, the newly established agency, Assisted Living Alberta, has been in operation since September. Minister Jason Nixon declared that the agency is “laser focused” on managing ALC patients. At a recent press conference, he announced a 22 percent reduction in ALC patients in Edmonton hospitals. Nixon’s press secretary, Amber Edgerton, indicated that prior to the establishment of Assisted Living Alberta, no dedicated team was tasked with finding appropriate care for ALC patients.

The government plans to implement the largest expansion of continuing care in Alberta’s history. This involves the creation of 383 net new spaces in Edmonton, including 71 spaces through the new Good Samaritan Society site. The province’s Assisted Living Framework commits to investing billions in tens of thousands of new continuing care spaces over the next decade, while also expanding home care services and non-medical support to help Albertans age well in their homes.

As Alberta grapples with the challenge of improving emergency room conditions, the focus on ALC patients offers a potential pathway to enhance service delivery and patient outcomes.