“Capped services”
We will be hearing more of this AB.
With capacity and workforce challenges, many in-pt consulting services are indicating it is unsafe to continue taking MORE overcapacity pts into the hospital.
Services are “capping” = no more consultations/advice/admissions This means:
Not only will sick pts remain in overflowing EDs - with a constant stream of new sick pts to be seen…
But specialty consult services will no longer provide care, advice, consultation to the pts in the ED

This article is so important and it highlights 2 critical issues growing in Alberta:

1 - Moral Injury for all of our HCWs
2 - HCW intimidation and a growing culture punishing/discouraging advocacy
🧵to highlight:

cbc.ca/news/canada/ca… Moral injury - working ever day in an untenable environment and watching pts (including the littlest of children) suffer is taking its permanent toll. /2

Thinking on what is AHS… it dawned on me I AM AHS. 

Myself and all the amazing HCW colleagues that make up this massive health org

Sure it’s not perfect. Sure “it” frustrates me at times. 
But when you boil it down it is an org of amazing people working hard in hard times AHS and it’s team has done some really amazing work over the last couple of years while faced with unprecedented (cringe word, but it really is apt) challenges…

“AHS” has admitted it is struggling.
The Access Block and human resource challenges are real.

If you entered an ED WR and saw this wait time:
Would you wait to find out if that chest pain was your heart or “just heartburn”?
Would you sit with your elderly loved one in a plastic chair for 17hrs to see if their confusion was from something serious?
Would you write you MLA? I want to be very clear: I want all Albertans to seek care and to still go to their EDs if they are ill/worried.
But to me a posted 17hr wait makes me extremely concerned that THOUSANDS of Albertans may not have safe and timely access to emergency care
We need to raise the alarm

Quick health governance primer:
AH=Alberta Health = govt and bureaucrats who set health policy and budget
AHS=Alberta Health Services = medical admin and clinicians that operationalize the health policy

The 2 should be distinct and arms length for many very good reasons

/1 AH - this is the healthcare outcomes we expect (EMS response times, ED wait times, surgical wait times… so on)
AHS - runs the acute care system and creates longer term plans to achieve these set health goals

The two bodies should be distinct and arms-length

/2

Let’s talk about “Emerg Depts are under strain”:
“Strain” is a euphemism for unmitigated disaster zones.
UAH this AM: 55 admitted in-pts in 50 emerg care spaces.
Means: 55 pts that should be elsewhere in the hospital stuck for DAYS in the ED, out of 50 care spaces total! This means NO CARE SPACES to see the new undifferentiated emergency pts. Over 60 in the waiting room receiving NO care…
Means senior nurses demoralized and frustrated because they can see pts suffering but can do very little to help them.

Picture living in a province where no health authority can quantify how many people are “unattached”, that is they do not have access to a family doctor…. No medical home… no routine primary care…
That’s Alberta.
Maybe the idea is it isn’t a problem if we don’t measure it? 2/ How can policy makers address the issue if they can’t even start by quantifying it?
Maybe some geographical locations are worse then others?
Wouldn’t it be good to know?
I’ve asked @AHS_media / @JasonCoppingAB / @CPSA_CA / @HQCA @Albertadoctors
Numbers not known…