'The worst it's ever been': Alberta implements triage liaison physicians as emergency rooms continue to buckle under pressure

Dr. Paul Parks described the situation in emergency rooms across Alberta as “unbearable, horrendous and the worst it’s ever been.”

Parks, who is an emergency physician and president of the section of emergency medicine at the Alberta Medical Association (AMA) said emergency departments are dangerously overcrowded and it is difficult to provide timely care.

He said there are some admitted patients who have been stuck in the emergency department for over 100 hours due to overcrowding.

“It’s inhumane to think about leaving a sick person in the emergency department for over seven days,” Parks said.

“The lights don’t go out. It doesn’t ever get quiet. They don’t get the same kind of care that they would get on the ward.”

It’s been nine months since the government promised to implement triage liaison physicians (TLP) across the busiest emergency departments across the province — and the role is finally here.

The role was supposed to be implemented on Feb. 1 but stalled conversations between the government and the Alberta Medical Association (AMA) pushed the deadline back

Acute Care Alberta (ACA) said to Postmedia in a Thursday statement that the details for the TLP program have been finalized and will be operational in the coming weeks. The health agency did not give a specific implementation date.

In a Friday news release, Hospital and Surgical Services Minister Adriana LaGrange publicly announced the role is finally ready to be implemented and TLPs will work directly in the province’s busiest emergency departments to help expedite the process for patients awaiting care.

“When you build a brand new program from the ground up, it’s important to take the time to get it right,” LaGrange said.

“By working directly with physicians throughout the process, we’ve developed a practical, sustainable program that supports front-line doctors while putting patients first.”

ACA said emergency medicine physicians will be invited to join the program and begin filling TLP shifts in emergency departments across Alberta.

Parks said there needs to be an appropriate number of nurses and allied health care workers to support the TLP out front or else they won’t be able to properly do their jobs. He mentioned that at the largest trauma centre in Calgary, it is regularly eight or nine emergency nurses short on the night shift and there are times certain areas of the emergency department are closed due to the inability to staff it.

“In that environment if you were to have a triage liaison waiting room doctor, when you don’t have the right number of nurses in the back in the emergency (room) — you’re just putting a band-aid in an area that isn’t going to be the most impactful or the best area to put our resources,” Parks said.

Former Hospital and Surgical Services Minister Matt Jones announced the TLP role in January following the death of 44-year-old Prashant Sreekumar who died while waiting for care in the emergency room at the Grey Nuns Hospital.

The fatal inquiry into Sreekumar’s death begins Oct. 19.

Maddison McKee press secretary to LaGrange said in a statement to Postmedia that the province welcomes the inquiry and is committed to learning from the findings. She said ACA is working to implement the 16 recommendations from the Quality Assurance Review announced in March.

“Four separate reviews and investigations have been undertaken to understand what happened and identify where improvements are needed,” McKee said.

“Two internal reviews by Covenant Health and Acute Care Alberta have already been completed, while the Office of the Chief Medical Examiner and the public fatality inquiry provide independent assessments.”

Parks said emergency departments are routinely seeing cases like Sreekumar’s where patients are dying before they are able to access care. He hopes the fatal inquiry will provide accountability to deliver and act on recommendations

“They need to publicly declare it the crisis it is and appoint a leader that’s going to help us provincially manage this disaster mode that we’re in everyday,” Parks said.

As the province begins to see flu cases, Parks warns the situation will only worsen.