Let's talk HC "refocusing" and Premier's latest announcement 🧵 :
- no one is able to articulate the actual plan. NO ONE
- the Premier is being advised in backrooms on health, she comes out and makes an announcement... and then the legions of consultants and bureacrats scramble - and all of these people making their living on implementing orders/plans? they know it WILL NOT WORK
- but no one can/will tell the Empress she has no clothes - that her HC destruction and disintegration will NOT work
- the "consulting" is how they feed their kids...

It would be really interesting to learn who is advising the Premier on her HC "restructuring"?🧵

Current state:
1: Four new silos, with NO operational control between them (none, nada... )
buff.ly/ufR6u6j 2: FOUR Ministers who won't want to take on the headaches of the other silos even when connected.
Ex - continuing care doing something about ALC pts to help ACA (mostly seniors stranded in hospitals requiring continuing care for safe discharge)

This is honestly too much. The Premier talking about 135M HC dollars just wasted and acting like she has NOTHING to do with why we are here. Everything she and her govt has done has brought us to this point, a 🧵to recap:

1/10buff.ly/HuESfWk 1- She has actively dismantled Public Health in AB
2- She was directly involved in the firing of our previous CMOH, not once but TWICE - sending a chill in PH to the point where AB cannot recruit expert leadership to the position
3- Blew up and disintegrated HC system
2/10

CIHI Surgery Wait Times 🧵
First note what we track: hip/knee replacement + cataracts (not life threatening) and Hip Fracture Repair (life threatening)
- so the only surrogate for in HOSP life threatening surgery care we report = hip # repair
- and this metric is worsening
1/10
- you might think that for hip # repair going from 87-80% and 91-88% is minor, and that the gains in eye and joint surgery in the community makes up for this
- but this is the only surogate we have for all in-hospital surgeries and they ALL are getting worse
2/10

Albertans voting "conservative", a 🧵 on thinking vrs reality:
Most ABs will state they vote conservative for values like: small govt, less bureaucracy, balanced budgets, and govt spending taxpayer money wisely (fiscally conservative)
But in reality our govt is the opposite
1/15 1 - largest govt in AB hx with the most Ministeries and govt bloat
2 - moves in HC to make it more bureaucratic and bloated - 4-5x the admin now, and w admin being govt bureacrats over health experts or HCWs, and with WORSENING HC ACCESS and OUTCOMES
2/15

Albertans should be paying attention and be VERY concerned:
Govt is marching forward with privatizing all of our HC system.
Many many concerns w selling off hospitals to private for-profits:
🧵 1/12
buff.ly/NHDveGp 1 - lack of transparency and accountability: these "deals" get done in back rooms and public doesn't see any details - costs, no public reporting of outcomes and access metrics, no accountability... nada. (look at CSFs - they do NOT have to report like hospitals)
2/12

Real Human EDOC Cases in AB continued, Case 6🧵 :
Elderly Calgarian brought in by EMS w cough + severe abdominal pain,
- offload to ED hallway for hours with pneumonia
- CT abdomen pending because of unexplained abdo pain - takes hours to get done as other cases go first
1/5 - Slowly getting worse while alone in the hallway
- Sadly, the pt decompensates further and abdomen becomes rigid with severe pain
- Very difficult to examine and give pain meds in the hallway. Impossible to properly montior.
2/5

Should be very interesting... it only has a chance to potentially work if: there is transparent reporting of objective pt-oriented outcome measures.

Right now ABs are literally dying waiting in hospitals for surgery, while govt priotizes joint sx.
1/8
buff.ly/oMT5AAs This will be on Dr. Eagle and the ACA org to make this work.
Time to ensure prioritizing surgical care in some organized way. Pt's dying of cancer while the quick and easy bone and eye cases are getting done

The system can be agnostic of funding scheme if govt doesn't meddle
2/8

Congratulations Alberta Government! You have OFFICIALLY KILLED AHS. RIP

"response levels to seven questions about patient safety culture also all showed a unanimous decline in satisfaction"

A JUST and SAFE culture no longer exists.
1/11

buff.ly/AhVVEaj Albertans - you should be VERY AFRAID
Govt killed our flawed but functional health authority with NOTHING in place to replace it

Covenant Health is even more of a mess (see data), but for ideological reasons is not on govt's KILL LIST... but it cannot fill the void created
2/11

A couple of key points here🧵 :
- This is a DIRECT PLEA FOR HELP - govt is not listening to the profession. We need Albertans to say "enough" and demand a plan from our govt.
- This can't be dismissed as "seasonal volumes" - this is the unsafe norm
1/7 - govt has been ignoring these conditions in the adult world, but they repeatedly profess they "care about the children"... will this spur them to act?
- EVERYDAY is unsafe for so many pts in our EDs... and it is getting demonstably WORSE over the last 2-3yrs
2/7

Real Human EDOC Cases in AB continued, Case 5🧵 :
- let's talk about "TWA" = transfer waiting admission = very sick pt in the ED and STRANDED for days waiting to become an EIP (Emerg in-pt = OFFICIALLY stranded in the ED)
1/14 - TWA and EIP - we have offical acronyms to dehumanize and normalize absolutely deviant care of HUMAN BEINGS
- these are ABs in their time of need, our loved ones, who get reported to govt as aggregated stats with the suffering hidden behind acronyms that confuse govt
2/14

Hey Alberta, let's talk about this 👇
Honestly? Has the govt lost what it means to provide the CARE in Health Care?🧵
We are currently starving many of our stranded ED hallway pts, but maybe ABs will rise up when they see we are denying kids w cancer?

1/8buff.ly/yWj5FYr A challenge to every UCP MLA:
Can you look yourself in the mirror and tell yourself you feel confident that your govt is on the right track on HC?
Can you explain to your consituents why you are cutting 500M from frontline HC while overspending on secret contracts?
2/8

With the latest action by govt - having AHS leads file in court an attempt to further discredit the fired CEO - all ABs should be very concerned that HCWs and leaders are actively being silenced and feel threatened.

Why all ABs should care: THE GOVT COVERUP IS CHILLING 🧵
1/17 Let's take a quick look at the 6 seperate and unconnected investigations, where none of them can look at the full picture.
Ever heard the analogy of the 6 blind men and the elephant? Govt is intentionally doing this, blinding each investigation to the other parts!
2/17

Let's highlight why this is yet another blatantly obvious attempt to ensure ABs never find out what is really happening in our HC system 🧵 :
Let's ignore for a second what might be in these emails
Regarding AHS internal review...
1/11
buff.ly/ZIyWVSq Don't worry everyone, we've been assured by the Premier that AHS is going to do an "internal review", and that there will be a "legal conflicts wall", because let us not forget the acting CEO and the MoH were both named in the allegations.
So how's that working out???
2/11

Real Human EDOC Cases in AB continued🧵 :

Case 3
Pt in their 90s with a fall and found to have a devestating brain bleed from their fall.
Mandatory offload to a hallway stretcher by the minor treatment area for 8 hours before initial care
1/6 There were no quiet acute care spaces to place the pt after they got their CT and diagnosis.
The best temporary measure was a stretcher in the hallway next to the minor area - a loud chaotic busy hallway that EMS uses to get to the critical care areas in the ED
2/6

What are we doing here Alberta?
We already barely have any food left in our EDs for those in need - EDs left with some toast and juice at the best of times
Where's the "care" in Health Care in AB?
What's next? Save on electrical bills and turn off the blanket warmers?
🧵 These cuts lie directly at the feet of our govt demanding AHS cut 400M from its budget, all while being wantonly profligate with taxayer dollars in other areas:
- 600M (billions?) in inflated sole-source contracts
- 50M undelivered Tylenot
- 2M covid essays
- trips to Florida

In the leg. the Premier acknowledged that govt is directly operating our hospitals now
She bragged that EMS times are on target, but forgot to mention how the rest of acute care system is in chaos, and what forcing EMS mandatory offload to hit targets looks like to the pt 🧵
1/7 We need to put a human face on what mandatory EMS offload looks like for real pts.

I'm going to share real cases shared with me from various AB EDs to show what kind of suffering our severe ED overcrowding is causing

Govt has the stats, but doesn't see the suffering!
2/7

Can confirm that violence - verbal and physical - is escalating in our EDs. As untenable overcrowding and Access Block worsens, frustrated pts/family are taking out their anger on HCWs
This is a puncture device found on an aggressive pt in my care 🧵
1/8
buff.ly/PwdeL4V In this particular case the pt's violence escalated to the point where he pulled a hatchet out and threatened me and our ED staff. Thankfully security assisted and the police came quickly to deescalate and unarm the pt before anyone was harmed.
2/8

Some key takeaways 🧵(do read the full statement!)
- govt has taken over direct operational control of HC
- if premier/MoH tells any HC leader to do something they CANNOT say no - consequence of doing so is loss of their job and livelihood (& maybe even a permanent ban from AB!) - if current environment persists AB will never be able to recruit skilled and experienced HC leaders.
- Who would ever want to work in this environment? You must follow orders from govt even if you know they are counter to good care, or may even be criminal.

Summary of Govt's statement of defense 🧵 :
- we handpicked a highly competent life long public servant, with an impeccable record, for the ceo role
- turns out she was incompetent
- Why? She wouldn't blindly allow Govt interference
1/9
cbc.ca/news/canada/ed… - the height of her incompetence was an "infatuation" w doing her job competently
- when she became aware that the contracts were inflated, had significant conflicts of interest, and would impare the ability to deliver life-saving care in hosps, she insisted on investigating 2/9

CorruptCare Scandal simplified (got feedback its too complicated for ABs to understand)🧵 :
Surgery: all cases can be done in hospitals, select lower risk cases can be done in for-profit centers
Govt: thinks endless workforce, so they can add for-profits and not affect hosp care Govt: hand picks CEO to push their for-profit mandate
CEO: we have to follow procurement processes (checks and balances for contracts)
G: just sign the secret deals we already agreed to
CEO: but some seem to be inflated and cost too much
G: just sign