One solution to improve emergency room wait times in Alberta

CTV News Edmonton's Nicole Weisberg explains how patients waiting to move out of hospital impact wait times in the ER.

Amid accounts of, in some cases, dangerously long waits in Alberta emergency rooms, doctors say greater focus needs to be put on moving alternate level of care (ALC) patients out of hospitals.

The Canadian Institute for Health Information describes ALC patients as people who occupy beds but do not require the intensity of services provided by a hospital.

Alberta Health data provided to CTV News Edmonton shows in August, ALC patients made up between 18 and 37 per cent of the beds in Edmonton’s four major hospitals.

The data shows 539 of the 2,325 total beds at the Grey Nuns Community Hospital, Misericordia Community Hospital, Royal Alexandra Hospital and University of Alberta Hospital were classified as ALC.

Emergency physician Raj Sherman said these patients disrupt the “flow system” in 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 told CTV News Edmonton.

“Let’s work with the people in the community. 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.”

More than 90 per cent of ALC patients in Canadian hospitals are aged 55 years or older according to Canada’s Drug Agency (CDA).

The CDA said the median age is 80 years.

Cost comparison

The C.D. Howe Institute reports an ALC patient costs the system between $730 to $1,200 a day compared to about $250 a day for long-term care.

The 2024 memo said cutting down the number of ALC patients and their lengths of stay could not only save billions, it could “significantly reduce” concerns with emergency care.

The August data from Alberta Health showed almost all Edmonton hospitals were either nearing or surpassing 100 per cent capacity even before the spike in flu cases.

Both the U of A and Misericordia hospitals were at 109 per cent.

“Edmonton has not had a new hospital for 38 years, since the Grey Nuns, and we have more than doubled in population,” said Sherman.

“We serve this massively underserviced north and people are older and sicker.”

Hospital crunch not surprising: ASCHA exec. dir.

The executive director of the Alberta Seniors and Community Housing Association (ASCHA) said support for ALC patients has not kept up with population growth.

“The systems haven’t been ready,” Irene Martin-Lindsay told CTV News Edmonton. “And we are seeing many of the elderly are coming to be with their families here in Alberta.”

Knowing that, she said the crunch in hospitals is “really not surprising.”

Martin-Lindsay said the province needs 24/7 homecare, more supportive living and spaces for people with complex needs.

“We are seeing a lot of people that have way more than just the standard health needs,” she said. “It is significant, complex chronic needs and behavioural issues that are really hard to manage in a congregate setting.”

Martin-Lindsay encourages people, especially seniors, to consider what they would do if suddenly faced with a serious health issue.

“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 said.

Government ‘laser focused’ on ALCs

Since the new health agency, Assisted Living Alberta, became operational in September, the minister in charge said it has been “laser focused” on this issue.

At an unrelated news conference last month, Jason Nixon said the number of ALC patients in Edmonton hospitals had dropped 22 per cent.

“Officials have made clear, this is the most communication through these divisions ever,” he told reporters.

In an email, Nixon’s press secretary, Amber Edgerton, told CTV News Edmonton that before Assisted Living Alberta there was no dedicated team focused on finding ALC patients appropriate care.

She said the government is in the process of driving the largest continuing care expansion in Alberta’s history.

There are 383 net new spaces opening in Edmonton in the coming years, Edgerton added, including 71 through the opening of the Good Samaritan Society site.

The province’s Assisted Living Framework promises billions will be spent on tens of thousands of new continuing care spaces over the next decade.

It also vows to expand home care and non-medical support to help Albertans “age well” in their homes.