Alberta Doctors Urge Action to Reduce Emergency Room Wait Times

Emergency room wait times in Alberta have reached a crisis point, prompting calls from medical professionals for immediate action. A significant number of patients classified as alternate level of care (ALC) are occupying hospital beds, which has been identified as a major factor contributing to prolonged wait times. According to the Canadian Institute for Health Information, ALC patients are those who no longer require the high level of care provided by hospitals but remain in beds nonetheless.

Data from Alberta Health reveals that in August 2023, ALC patients comprised between 18 and 37 percent of the beds across Edmonton’s four primary hospitals, including the Grey Nuns Community Hospital, Misericordia Community Hospital, Royal Alexandra Hospital, and University of Alberta Hospital. Specifically, 539 of the 2,325 total beds at these facilities were occupied by ALC patients.

Emergency physician Raj Sherman emphasized that these patients disrupt the flow of care within hospitals. “The problem is, right now, the community works banker’s hours, nine to five, Monday to Friday, so the backlog builds over the weekends,” he stated. Sherman advocates for enhanced cooperation with community health services and the establishment of a 24/7 discharge system to alleviate pressure on emergency departments. “If we invested in home care and if we can discharge people from the hospital 24 hours a day, seven days a week, we can provide safer care in emergency,” he added.

The issue of ALC patients disproportionately affects older adults, with more than 90 percent being over the age of 55, as reported by Canada’s Drug Agency. The median age of these patients is noted to be 80 years. The C.D. Howe Institute estimates that the cost of an ALC patient can range from $730 to $1,200 per day, in contrast to approximately $250 for long-term care. A memo released in 2024 suggests that reducing the number of ALC patients could save billions and significantly ease the strain on emergency care.

In August, nearly all hospitals in Edmonton were either at or exceeding full capacity, prior to the anticipated rise in flu cases. Both the University of Alberta and Misericordia hospitals were reported at 109 percent capacity. Sherman pointed out that Edmonton has not seen the construction of a new hospital in 38 years, despite a significant population increase during that time. “We serve this massively underserviced north, and people are older and sicker,” he stated.

According to Irene Martin-Lindsay, executive director of the Alberta Seniors and Community Housing Association (ASCHA), the support systems for ALC patients have not kept pace with the growing population. “The systems haven’t been ready,” she commented. Many elderly individuals are relocating to Alberta to be closer to family, leading to the current hospital crunch, which she described as “really not surprising.” Martin-Lindsay highlighted the urgent need for 24/7 home care, more supportive living options, and facilities for individuals with complex health needs.

She also encouraged families, particularly seniors, to proactively consider their health care options. “If you’ve already done that homework, you’re a part of those decisions while you’re well and while you’re not in crisis because crisis makes it really difficult,” she noted.

In response to the growing challenges associated with ALC patients, the provincial government has made this issue a priority. Jason Nixon, the minister responsible for the newly established Assisted Living Alberta, announced that the agency has been “laser focused” on addressing the needs of ALC patients since it began operations in September 2023. He reported a 22 percent decrease in ALC patients in Edmonton hospitals, attributing this success to improved communication and coordination among health divisions.

Nixon’s press secretary, Amber Edgerton, stated that prior to the establishment of Assisted Living Alberta, there was no dedicated team addressing the needs of ALC patients. The government is now implementing the most extensive continuing care expansion in Alberta’s history, with 383 net new spaces set to open in Edmonton over the next few years, including 71 through a new site by the Good Samaritan Society.

The province’s Assisted Living Framework promises substantial investments aimed at creating tens of thousands of new continuing care spaces over the next decade. It also pledges to enhance home care and non-medical support services to enable Albertans to “age well” in their homes. This multi-faceted approach aims to alleviate the pressure on emergency services and improve the overall health care experience for residents.