Lethbridge flourishes, Alberta fails - Macleans.ca
 

Lethbridge flourishes, Alberta fails

Getting a hospital bed in Alberta can take 14 hours


 

Lethbridge flourishes, Alberta failsSome good and some bad news regarding Alberta’s health care system. First the bad: the median time it takes to get a bed after arriving at provincial ERs is more than 14 hours, up from 11 in 2007 (by comparison, the median wait time in Ontario is 12.1 hours). Now the good: most patients at Chinook Regional Hospital in Lethbridge get a bed in just three hours, and 30 per cent of those visiting the ER see a doctor within half an hour—far, far quicker than the provincial average of 2.6 hours. “Chinook’s getting better and the province is getting worse,” says Dr. John Cowell, chief executive officer of the Health Quality Council of Alberta.

Diane Shanks, Chinook’s director of emergency care, says the hospital used private consultants, and a grant from the province, to develop a dedicated approach to keeping wait times down. “The in-patient unit, the seniors’ outflow and community care groups, the lab, ICU, everybody is working to make sure we keep people in beds when they should be in beds, and trying not to delay moving them to where they need to go for the best care,” she says.

Following that integrated model, Chinook staff have a daily “bed huddle” that examines expected discharges and admissions, and tries to ensure there will be enough space before patients arrive. The hospital also emphasizes communication between departments to prevent unnecessary retesting and help stop bottlenecks. “In the past, beds were emergency’s problem,” says Vanessa Maclean, medical director for Alberta Health’s south zone. “Now everybody is responsible for how patients flow through the hospital.”

Cowell says the only other hospital in Canada he knows of using a similar program is Northern Lights Regional Health Centre in Fort McMurray, and that it’s had similar success. The best thing Alberta hospitals can do, he says, is follow the two hospitals’ example. “I think it would behoove the rest of the system to take a hike on down there and say, ‘Just what the heck did you guys do?’ ”


 

Lethbridge flourishes, Alberta fails

  1. Wow, good job in managing the flow of clinical care across the system Lethbridge and area!

  2. Median of 14 hours in Alberta, eh? And that's bad? Wow. I shudder to think what it is elsewhere. Like in places with stretchers harbouring sick patients in hallways for DAYS just by the ER because there's not a bed to be had upstairs because those beds are full of patients who should be in a chronic care facility or rehab centre but the wait in THOSE places is incredibly impossible and…

    This is not the case of central planning gone bad. This is the inevitable result of central planning. Lethbridge is the anomaly. Mediocrity (or worse) is the norm.

    • And which places would those be, exactly, btw?

      Mediocrity is the norm with private planning or central planning. That's why it's called "mediocrity". If everybody's care improved, most of them would still be mediocre. It's kind of in the definition.

      • "Those" merely refers to the aforementioned chronic care facilities and rehab centres. Perhaps my all-caps promised a bigger rhetorical deal than delivered.

  3. Unfortunately you are comparing apples with oranges when it comes to small city hospitals and the major urban hospitals. There are too few beds in the larger urban centres to serve the populations that live in the areas. Then you add the people who are transported from areas like Lethbridge and Fort McMurray to take advantage of the “specialized physician care” that is available in the large urban hospital but not in the small urban centre and you can see why there are major problems with wait times in the emergency departments in Edmonton and Calgary. Yes, there are bed huddles in the Edmonton and Calgary hospitals but unfortunately if you are unable to discharge patients because they are too sick, you have no beds to get ready for admissions. Also, due to high rents brought on by our last “boom”, we lost many family docs in the large urban centres and so we have people coming to the emergency department in the big cities because they have no where else to go when they are ill. What might really work well is if we could transport people from Calgary to Lethbridge and use the beds that available there but I do not think patients would go along with that. An interesting study might be to report on how sick you have to be to get admitted into hospital in a large urban centre in Alberta versus a smaller city or rural centre.

  4. Last spring I crawled in to a Calgary hospital at 6:00 p.m. with agonizing lower abdominal pain. There were 27 people ahead of me, and by midnight, there were still 27 people ahead of me, including an woman in her 60's with a visibly broken forearm/wrist. Then there were the later walk-ins, who were standing as all of the chairs were all full. I guess the ambulances were bringing them in the back, and us conscious waiting were triaged/bumped. I was told I might possibly be seen by late afternoon, the next day. At midnight I told the nurse I could no longer sit in an upright plastic chair; should I lie on the floor in the waiting room; and she said there was nothing they could do. I informed her that I would have to go home and lie down, and that if I got into dire straits I would call an ambulance. She then said (with attitude) that if I went home I would give up my place in line, and an ambulance would not get me in any quicker. With that encouragement, I left, went home to lie down, took two pain relievers, crossed my fingers, and was ill but improved slowly over the next two weeks.

    Fourteen hours wait in Alberta now? Is that on a slow night? Welcome to booming Alberta, where the supporting infrastructure appears a decade or two or three after the massive job seeking influx happens. Oh, and 1/4 of all Calgarians do not have a personal physician. If your doctor retires (actually, two of mine did after thirty years), good luck finding another experienced doctor with admitting who will take you. I've been going to walk-in clinics for 20 years now. I was offered a new doctor last week, but one who only recently graduated, with no admitting privileges and zero internal diagnostic experience. At least my walk-in doctor knows it when she sees it, if she's in if I happen to go down. If that fourteen hour figure comes from the horse's mouth, then journalists perhaps need to continue their investigative research.

  5. I live in Lethbridge and I have no idea where you got this info but it's all garbage. About 95% of the time it takes a minimum of 3 hours to get into a room in the ER and after that it could take 1 or 2 hours to see a Doctor. The help you get there is horrible and alot of people I know go to the Hospital in Coaldale a little town East of Lethbridge. My husband broke his nose one day and sat bleeding, passing out ,shaking,and not remembering who he was and all they would say is "Oh that's normal." We waited 31/2 hours before they even got us into the back. Then it was probably another half hour before we saw the Doctor. So this is inaccurate due to poor research.

    • Hi Lisa, I also live in Lethbridge and had a very bad experiene in the Chinook hospita It bothers me that people get these posted facts which are not a true picture of what is really going on in our E.R.So I agree with you that these facts are inaccurate due to poor research.
      I waited 4 hours before going into the back at Lethbridge E.R and a further 2 hours before seeing a doctor. I was in great pain with acute appendics which developed into a ruptured appendics.In all it took them 14 hours before a emergengy operation was done.

  6. That's a bad news. I really feel bad for those who are waiting. This needs attention as soon as possible. Great article Tom.

  7. Accidents, etc. get pretty good care at Lethbridge's ER. But Mental Health care in ER is terrible. (Once you get a patient into the ward its ok. But it is a battle royale to get them to admit. even if the patient is a danger to themselves or orthers. The ER staff have no idea how to deal with Mental Health patients, especially if the patient also abuses substances. The doctors are usually good, but there are a few that treat mental health patients like malingers. And they treat the families, especially spouses — who are somehow made to feel they are to blame –like crap. I know one person who was released to early and wound up tearing the house apart in a delusion. Had to be taken back to the hospital by the regional police. The spouse had to flee the house in the rain to call them in the middle of the night. Took three tries before the patient got the help that person needed. The doctors in ER simply would not listen to the family. Alberta's biggest issue is mental health care, and preventitive care. Our suicide rate, domestic violence rate and addiction rate is sky high. In short, we have stuff, but we aren't very happy campers.

    • I really should have added that the Lethbridge Regional Police saved this person's life by insisting that person was admitted. Finally, they can lead a normal life after years of not being treated.