Emergency room wait times have been a concern for many years in Edmonton and now a local doctor says the city’s children’s hospital is in the midst of an unprecedented, unsustainable situation.
Dr. Shazma Mithani, an emergency room physician at both the Royal Alexandra Hospital and Stollery Children’s Hospital, said the latter is seeing patient volumes and wait times exceeding even the worst pre-pandemic situations.
“It’s been extremely busy,” Mithani said on Thursday.
“It’s just continuing to get worse and it’s almost become the new baseline in terms of patient care and what we’re seeing there.”
The Stollery operates 236 beds and is the largest children’s hospital (by bed count) west of Toronto.
Mithani said there’s several reason for the surge in patients, including COVID-19, other viruses, and mental illness.
“We definitely are seeing a lot of COVID in young kids right now. With the spike in cases that we’re seeing with Omicron again during this sixth wave, we are seeing a lot of kids coming in with respiratory symptoms and gastrointestinal symptoms with COVID,” she said. “But we’re also seeing lots of other viruses.”
The ER doc said a significant number of the children coming in have respiratory issues requiring oxygen, ongoing treatment and admission to the hospital.
“On top of that, there’s a growing mental health crisis that we’re seeing in the paediatric population.”
Staffing issues are compounding the issue. Mithani said after two years of the pandemic, health-care workers are burnt out and fed up.
“On a typical shift, we’re seeing way, way more patients than what we usually are,” Mithani said.
“To just mentally juggle all of those patients at the same time can be quite challenging and certainly can be quite exhausting.”
The situation has gotten so bad, the hospital has opened an overflow ER in clinic spaces.
“So essentially, we’re running two parallel emergency departments at the same time: one in the main area and one in a different part of the hospital, where there’s another physician over there seeing patients or just trying to get through all these people who are in the waiting room.”
Mithani said some days, she’ll look up and realize there’s 40 or more patients in the waiting room.
“It can sometimes be pretty demoralizing to just try to catch up and to try to do what you can for the patients — and just not have the resources to do that.”
Freeing up space inside the hospital is also an issue, resulting in patients sitting around in the ER waiting to be transferred: “So it’s a combination of a myriad of things.”
Long waits just for triage
Waiting to see a doctor isn’t new — Mithani said isn’t not unusual for her to see a patient that’s been sitting around for more than six hours now.
But waiting to first be assessed by a triage nurse is now taking 45 to 60 minutes usually. On bad days, it can stretch to 90 minutes.
“It can be very dangerous, because if we have a patient who’s in the waiting room, who hasn’t even been fully assessed by a nurse, who is getting sicker while waiting for that assessment, our main concern is that there is going to be a bad outcome.”
So what’s the solution?
Mithani said the hospital has exhausted a lot of the short-term solutions such as opening up extra spaces.
Nurse are also working 16-hour mandatory overtime shifts just to keep the department running, “which in and of itself is unsafe, to have that expectation for health-care workers to work such prolonged hours.”
Mithani said she’s been working on an education project called Shift pERspectives, aiming to educate the public on what is and isn’t an emergency, when it’s ok to stay home and when parents can take their kids to their family doctor or paediatrician instead of the emergency room.
Mithani said a long-term, larger solution is hiring more staff.
“Increasing staffing, relooking at the structure of the emergency departments, trying to think more innovatively about how to flow patients through the department, making sure that there’s increased bed capacity on the wards — because again, that is often a rate-limiting step for us in moving patients out of the emergency department.”
Increasing youth mental health supports in the community is also key, she said.
“Not having those community supports means that many more patients come in, in crisis from a mental health standpoint and of course, have to wait for long hours in the emergency department and put extra pressure on the department,” Mithani said.
That’s something Fort McMurray mother Kirsten Chiasson would like to see. The family came to the Edmonton children’s hospital looking for help for their son.
“It was disgustingly busy in there and they didn’t take too long to see him because of the situation. But once the doctor did see him, she saw him once and then didn’t come back,” Chiasson said from outside the hospital on Thursday.
Chiasson said staff at the Stollery didn’t offer any more help than they could get back at home and they felt the drive to Edmonton was a waste of time and money.
She said her son previously had heart surgery at the Stollery and their experience before and now couldn’t be more different.
“I just feel like this whole hospital’s went way down in the past few years,” Chiasson told Global News.
“It seems impossible for us to receive the help now that we need for our son.”
The challenges aren’t unique to the Stollery and are playing out across the province, Health Minister Jason Copping said on Thursday.
In the short term, he said Alberta Health Services is asking staff to work overtime. Efforts to hire more are ongoing, the health authority is moving resources from slower units to busier ones and patients are put anywhere there’s space.
But Copping admits, it’s a Band-Aid solution on a gaping wound.
“The answer quite frankly — and we’ve talk about this before — is building capacity and that takes time,” he said to reporters at the legislature on Thursday.
The current Stollery Children’s Hospital was built in 2001, with the majority of services and beds located inside the University of Alberta Hospital and the Walter C. Mackenzie Health Sciences Centre.
As of 2021, it was seeing more than 300,000 patient visits per year, with families coming from northern Alberta, northern B.C., all the Prairie provinces and three Territories. More than 40 per cent of children treated at the Stollery are from outside the Edmonton area.
The hospital’s foundation has been advocating for a stand-alone building for some time. Last year, the Alberta government and Stollery announced they were moving forward with a feasibility study on the idea.