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Alberta patients experience ‘very long’ wait times for care in emergency departments: AMA survey

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Alberta patients experience lengthy wait times for care in emergency departments: AMA survey
A new survey gives an intimate look inside emergency departments in Alberta. From long waits to people avoiding the hospital entirely, it paints a picture of the stress being felt by both patients and health-care providers. Morgan Black reports – Jul 22, 2022

A survey released Friday by the Alberta Medical Association takes a closer look at how patients feel about the state of emergency care in the province.

The patient survey was conducted in June and shows 84 per cent of respondents believe wait times in Alberta emergency departments are “fairly” or “very” long. Most people reported waiting up to five hours for care, roughly 40 per cent said they waited two hours or less, and 15 per cent reported waiting over six hours.

Of those who took the survey, 71 per cent said they believe timeliness of care in Alberta emergency departments has declined in the past four years.

Nearly half — 49 per cent — believe the quality of care in emergency departments has declined over the past four years.

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Dr. Paul Parks, the president of the section of emergency medicine for the AMA, said the conditions are “extremely demoralizing.”

“None of us that go into health care want to see people suffer and not be able to help them or have them have very, very long waits,” he said.

“It’s very, very difficult and it just seems to be getting worse and worse. And there’s no question that that is a factor that is driving away a lot of our nurses and allied health-care workers and making staffing even harder.”

The survey showed 46 per cent of patients went to an emergency department for care because they had no other options available to them. For example, it was after hours or a family doctor/walk-in clinic was not available.

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“Every Albertan should have access to a medical home, should have a primary care physician and should be able to get timely access to primary care. So that’s a critical issue we have to improve across the province,” Parks said.

Click to play video: 'Alberta patients waiting ‘very long’ for care in emergency departments: AMA survey'
Alberta patients waiting ‘very long’ for care in emergency departments: AMA survey

The physician added that he doesn’t believe emergency departments are overcrowded because of misuse.

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“Sometimes the quick and easy patients are the ones we can see and the really sick ones we can’t get in,” he said.

“That is more really sick patients that need to be admitted into hospital. And because the hospitals are full and long-term care is full and all the downstream effects are full, we can’t get those patients admitted into hospital and see the new sick patients.”

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He said emergency room workers are seeing a large number of patients who show up with serious conditions and leave without being seen because they have to wait too long.

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The survey also showed that 78 per cent of patients are self-triaging at home, asking themselves whether their situation is serious enough for a trip to the emergency department. Of those, 49 per cent said they decided at least once not to go to the emergency department.

“It’s scary. That’s the thing that every time we advocate — myself, my colleagues when we get out there — we want to inform the public that the system is really stressed and really, we need help,” Parks said.

“We always balance that with, we don’t want to scare people away. There’s a lot of conditions out there that may seem minor that are not.

“We’re seeing very, very delayed presentations of very complicated, complex disease that maybe would have been a lot easier to manage and would have been a lot better for the patients if we’d seen them sooner.

“We don’t want people to be minimizing their symptoms or not coming in when they need care. We want to be there to deliver safe and timely care.”

In a statement, Alberta Health said it continues to experience significant pressure on the health-care system, particularly in emergency departments. The province said that can be attributed to higher-than-usual volumes of seriously ill patients, the continued impact of COVID-19 and increased staff vacancies and absences due to illness.

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“This is not unique to Alberta and is being experienced across the country,” Alberta Health said Friday.

The province said it has seen a “very sharp increase” in patients requiring emergency department and EMS care. In the second quarter of 2021/22, there were 490,383 emergency department visits across Alberta, which is a 12 per cent increase over the same quarter in 2021.

Provincially, daily visits to emergency departments and urgent care centres have increased by 62 per cent since April 2020, according to Alberta Health.

Additionally, the province said it is seeing patients who need more specialized care, which puts pressure on staff and resources.

The province said it is working with Alberta Health Services to find long-term sustainable solutions, but added wait times are going down in Alberta.

The survey also found that rural sites (outside Calgary and Edmonton) saw the highest level of single visits to emergency departments (45 per cent) and multiple visits (13 per cent visited four times or more).

Parks said this shows the importance of keeping those rural centres open. In recent months, many rural urgent care centres have had to close for periods of time due to staffing issues.

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Alberta Health Services said Thursday the urgent care centre at Airdrie Community Health Centre will temporarily close on Friday, Saturday and Sunday evenings from 10 p.m. to 7 a.m. for about eight weeks due to “gaps in physician coverage.”

“That’s a massive negative impact. That urgent care centre exists because there’s a large patient population,” Parks said.

“It serves the need of that population. Those needs and that demand do not go away just because they’ve closed on the weekends.”

“This should never be accepted as normal or that this is a minor inconvenience,” Parks said. He described the situation as akin to acting in a “disaster mode” where the demand is outweighing the available resources.

“We don’t have enough human beings, nurses, allied health-care workers, physicians to keep open an urgent care centre that we absolutely need that serves a critical function.

“People should realize how desperate times are when an urgent care centre as big as Airdrie is being closed.”

So what’s the solution? Parks said the first step is for everyone to realize there’s a problem. He said short-term disaster management steps need to be implemented, including moving people around and doing whatever can be done for areas that are really struggling.

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Another piece is valuing health-care workers, Parks said.

“We are struggling with human resources. You can build eight more hospitals in this province if you want and they’re meaningless if there’s no doctors and nurses to work in them. They’re just buildings.”

Alberta Health said its 2022 budget laid out funding to help build health-care capacity. This includes $100 million for up to 50 new, permanent, fully staffed ICU beds this year. The province said 19 of those are already operational.

The investment, which includes another $100 million in each of the next two years, will create over 600 jobs, according to Alberta Health.

The survey of 4,398 albertapatients.ca panellists was conducted between June 14 and 24, 2022. A probability sample of this size would yield a margin of error of +/-1.5 percentage points 19 times out of 20 at a 95 per cent confidence interval, according to the AMA.

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