Thread by @PfParks

Anybody who reads about this tragic case and thinks this has to do with a HCW not recognizing the severity at triage has simply NOT been paying attention.


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Our triage system completely fails when we have DOZENS of triage level 2 and 3 pts in our WRs, with added severe overcrowding and unsafe levels of EIPs (EIP = SICK admitted pts that should be on specialized wards in the Hosp).
2/14

Covenant Health sites not only have EIPs, they also have TWAs = transfer waiting to be admitted = can spend DAYS in the ED simply waiting for a team to admit the sick pt, but they can’t be admitted because the admitting services are “FULL”. This does NOT happen at AHS sites.
3/14

CH CEO and admin know about this EIP/TWA issue (FOR YEARS) but no plan to address. This puts the pts at risk, the ED teams at risk, and of course ALL of the new WR pts at risk too…

Tons of worldwide evidence that EIP/TWA = increased morbidity and death for pts!
4/14

So why can’t the Emerg teams see new sick pts?
Think of it like our ED teams are running an ENTIRE WARD of complex pts admitted in their ED beds. The ED has become a hospital ward with all care being delivered to admitted diagnosed pts, and no room to care for the new pts.
5/14

EMS has mandatory offload times, the EDs do NOT (no auto move to ward), the wards do not (no auto move to LTC)... the bottleneck is the ED, it cannot close its doors, it cannot say no...

CH CEO allows TWA, when no other hospitals have this unsafe policy!
6/14

In 2010 Emerg Leaders raised the alarm, and provided examples of sub-optimal cases, and the HQA did a report and found it was all related to too many EIPs and Hospital Capacity.


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AB made some massive improvements from 2010-16, added surge spaces and protocols… but guess what… we have 500,000 more pts in EDMZ and NO ADDED BEDS… EIPs and capacity issues are even worse now.

Surge capacity is ALL GONE.
8/14

The sub-optimal cases that we are seeing everyday in our major EDs are as bad or worse than the cases that triggered the HQA review in 2010… and the Premier and govt are fully aware of the bad outcomes regularly occurring … they have been repeatedly warned.
9/14

Despite this situation: the Premier cancelled the only new Adult hospital build that was planned in EDM, and govt has since made a bunch of announcements, but there will be NO NEW CAPACITY for 10yrs at best (maybe a new Peds hospital in 2035???)
10/14

This is a tragic outcome for this pt and their family, but the sad reality is that the only reason people are talking about it is because the family released a video.
11/14

Emerg HCWs see similar tragic outcomes regularly, due to worsening overcrowding, and have repeatedly been working within channels to request system wide solutions, but sadly it just does not seem to be a priority for our govt.
12/14

When’s the last time Albertan’s heard the Premier talk about this crisis in our EDs? What are the govt’s proposed solutions? More fragmentation? More fast care for rich people for non-life threatening conditions?
13/14

Until we declare the crisis for what it is, and create system wide solutions along with permanent hospital/LTC capacity ASAP, this will be the future for many ABs for years to come…
14/14

@threadreaderapp Please roll up