Opinion: Where is Alberta's promised 'seamless patient experience?'

Last week, a 44-year old father of two died after eight hours in the waiting room of Edmonton’s Grey Nuns hospital. It’s tragic for Prashant Sreekumar, his wife and children, and severely traumatizing for the health-care workers on shift that day. While some are pointing fingers at the triage process or the emergency department (ED), this is a system problem.

The ED is the catch-all for every health system failure. While it’s true that many patients present to EDs because they cannot access a family doctor, improving primary care access alone won’t solve ED overcrowding.

The demand is coming from all directions. People enduring intolerable waits for specialists, CTs, and MRIs go there to expedite testing, or because their symptoms become too much to manage. More people have chronic illnesses, requiring increasingly complex care, and there are more frail elderly — both groups being more likely to need the ED. Surging mental health needs are simply not being met by community resources.

Volumes and complexity are increasing, but the biggest cause of gridlock is after the ED. In Calgary and Edmonton, it’s routine for over half the ED beds to be filled with patients awaiting hospital admission. Hospital capacity frequently exceeds 100 per cent, in part because it’s common for nearly 25 per cent of usable hospital beds to be occupied by people waiting for a bed in continuing care. Recently, it was 40 per cent in some Edmonton hospitals.

The problem has been magnified in Alberta by low COVID and flu vaccination rates, a self-inflicted wound courtesy of the Government of Alberta’s stance on vaccination and public health. It’s left hospitals overwhelmed with respiratory viruses.

But this isn’t a new issue. In September 2024, facing growing concerns that breaking Alberta Health Services into four agencies would create challenges across the system, the government commissioned a report from former health minister Dr. Lyle Oberg. Press releases heralded the launch of the Seamless Patient Experience Review due in March 2025. It was a valid concern and a reasonable move.

Health-care integration — where patients move seamlessly between different parts of the system — is essential, especially for older adults or people with chronic diseases. It’s also critical for seemingly healthy people like Prashant, who desperately needed fast, safe care in the ED — but didn’t get it because no beds were free.

When systems aren’t integrated, complications occur. Balls get dropped. People are harmed. We’re now over a year from the Oberg review’s announcement. Is care more “seamless?”

There’s no sign of the report’s release or even any indication who was selected for the council that would supposedly guide it. Despite your tax money going to external consultants to support Dr. Oberg, the report is presumably collecting dust on some minister’s desk.

Alberta is returning to hospital-based management. Details are scant, but it sounds bad for integration. Alberta ended hospital-based management 30 years ago. Why? Managing each hospital independently created competition for scarce clinicians, and a focus on inpatient care rather than the community supports people need to prevent admission. Care differed based on where patients lived — even though medical evidence isn’t different between Lethbridge and Edmonton.

AHS’s five geographic zones are transitioning to seven corridors. Again, it’s unclear how this will improve local services, but it’s creating a lot of work.

Recently, the premier released mandate letters to the four “health” ministers, vaguely referring to the opaque Integration Council that’s supposed to connect the new pillars and instructing them to work together on integration. But there’s been silence on the strategies to actually do this.

And the Integration Council, mostly comprised of high-level politicians and bureaucrats lacking the expertise to provide operational oversight, shares no information on their meetings, plans, decisions, or even if they’ve met yet.

Worst of all, the sole health-care priority for two years has been “refocusing” the system — pulling apart Alberta Health Services — not solving the problems Albertans experience daily: under-resourced primary care, long ED waits, ever-lengthening waits for surgeries, especially ones needing hospital support, like for cancer. Compared to 2023, 10 per cent more Albertans wait longer than clinically recommended for cancer surgery.

There are affordable fixes for these problems, evidence-based ways to improve integration — a few more hospital and continuing-care beds in areas where ED gridlock is worst, targeted home-care services for those needing them most, and better after-hours primary-care access. But it’s not possible when the health system is constantly distracted by reorganization.

There are lots of proclamations on health care these days — but seemingly no long-range, overarching plan. Empty announcements — like a review that’s nine months overdue — won’t move anyone through the ED safely.

We need pragmatic, detailed plans that aren’t in constant flux. Maybe the mysterious Seamless Patient Experience Review provided those. Maybe we’ll never know.

Dr. Braden Manns is a professor of Medicine and Health Economics, University of Calgary.

Dr. Paul Parks is the president-elect, Section of Emergency Medicine, Alberta Medical Association.

Letters welcome

We invite you to write letters to the editor. A maximum of 150 words is preferred. Letters must carry a first and last name, or two initials and a last name, and include an address and daytime telephone number. All letters are subject to editing. We don’t publish letters addressed to others or sent to other publications. Email: letters@edmontonjournal.com

Bookmark our website and support our journalism: Don’t miss the news you need to know — add EdmontonJournal.com and EdmontonSun.com to your bookmarks and sign up for our newsletters here.

You can also support our journalism by becoming a digital subscriber. Subscribers gain unlimited access to The Edmonton Journal, Edmonton Sun, National Post and 13 other Canadian news sites. Support us by subscribing today: The Edmonton Journal |The Edmonton Sun.