Edmonton doctors warn of NICU crisis that could lead to baby deaths

Doctors in Edmonton are warning that babies could die because of packed neonatal intensive care units in the city.

Physicians with the Edmonton Zone Medical Staff Association have sent a letter to Health Minister Adrianna LaGrange and Athana Mentzelopoulos, president and CEO of Alberta Health Services, pleading for help with what they say is a horrifying situation.

Doctors say neonatal intensive care units in Edmonton hospitals have reached a critical juncture.

“We’re starting to get to the point where there is potential serious harm that is going to be afflicting the most fragile, vulnerable patients that we have in this province,” said Dr. Mona Gill, who co-authored the letter and is the president of the Edmonton Zone Medical Staff Association.

“We would like to tackle the problem before we’re making headlines for dead babies in the province.”

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Gill is a new mother herself and that triggered her to write the letter.

“I can’t even stomach the fact that my baby could potentially be transferred to another province during such a critical time to provide care, because of lack of foresight by this government to address capacity issues that they have known has existed for years now,” she said.

The doctors say there has been a bed shortage for years and that is now having consequences.

EZMSA said 30 per cent of this year, Edmonton NICUs have been working at 95 to 102 per cent capacity.

“The nurses are caring for too many babies at one time and this results in frail, underweight infants not being able to even eat on time,” the letter said.

It also noted the environment is not conducive for families, saying the semiprivate layout of most NICUs does not allow parents to stay with their babies.

For example, the association said only two out of 69 beds in the Royal Alexandra Hospital NICU are a single-patient room. There are nine care-by-parent rooms, but the bulk of these are semiprivate.

“One can imagine how difficult it would be for parents to be forced to be away from their baby during this precarious time,” the letter reads.

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The Edmonton Zone Medical Staff Association said in 2022 and again in 2023, briefing notes were submitted to Alberta Health sounding the alarm for urgently needed beds, staffing, transport teams, and pediatrics/neonatology teams.

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“These have largely been ignored,” the organization said.

EZMSA said the intent to add six new beds in the zone has resulted in net zero new beds. It gave the example of how the NICU at the Sturgeon Hospital in St. Albert had six beds open to address the critical need – but because ongoing funding could not be secured, beds were closed at other sites where they were already facing their own capacity issues.

Alberta’s population continues to increase and Edmonton doctors fear there will be grave consequences for not keeping up with demand for spaces.

“These babies have nowhere else to be cared for and we believe the situation has become so critical that deaths of infants may soon follow.”

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“We are asking that meaningful attention be paid to the province’s littlest patients,” the letter concluded.

The health minister said Alberta babies might have to be taken out of province for health care.

“If we need to transport those babies or their families to other cities or other provinces, I’m willing to do whatever it takes to make sure that our babies are well looked after,” LaGrange said.

Opposition NDP leader Rachel Notley slammed the suggestion as a failure of government.

“We are moving our most vulnerable little patients to other parts of the country. That says to me the UCP is failing, fundamentally, on the most important job they have,” Notley said.

Notley called on the government to reverse the decision to cancel the planned hospital in south Edmonton that would have added new NICU beds, in addition to a new Stollery, “just to bring us to the minimum capacity that we need for a young and expanding population.”

“Danielle Smith needs to understand this situation as the emergency that it is.”

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The doctors agreed that instead of moving patients – more beds, more staff and more funding are all desperately needed.

“Not even the emotional factor, the sheer cost of trying to transport an infant across provincial lines is astronomical,” Gill said of the specialized transportation systems needed to move ill children.

“It’s in the tens of thousands of dollars alone just to transport that baby.”

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There are currently 133 NICU beds in the Edmonton Zone and 126 NICU beds in the Calgary Zone. In addition, there are 17 NICU beds in Red Deer, 10 NICU beds in Grande Prairie, 16 in Lethbridge, and seven in Medicine Hat, Alberta Health Services said in a statement.

AHS acknowledged there is “significant patient demand” but that there is capacity in the province.

“Occupancy fluctuates between 90 and slightly above 100 per cent, but again, we have capacity,” AHS spokesperson Kerry Williamson said in a statement Tuesday afternoon. “As of noon today, there were nine NICU beds available in Edmonton Zone, 14 in Calgary Zone, seven in Red Deer, seven in South Zone, and three in Grande Prairie.”

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He added during times of high volume, teams across the province work together to ensure kids get the care they need – transferring them if required.

In its letter, the staff association also claimed pay and working conditions offered for clinical assistants are not competitive in comparison with other provinces, work restrictions have been imposed on these providers without consultation, and mechanisms to attract and recruit have been a failure.

It said a lack of funding for nurse practitioners is also of concern.

The health minister has asked her team for a full review to see what the situation is and how to fix it. There is no timeline for when that will be completed.