Surgery diversions an ongoing concern in Calgary, doctors say

Doctors say surgery diversions continue to plague Calgary hospitals and there is no end in sight.

Diversions for general surgery operations performed for problems such as appendicitis are being triggered by a shortage of surgical support staff, including medical residents, on an ongoing basis.

Over the weekend,seven patients had to be transferred out when Rockyview General Hospital went on a general surgery diversion, according to Alberta Health Services.

There are times when multiple hospitals can be impactedat once.

• 3 Calgary hospitals without surgical support staff at points this weekend

Dr. Arun Abbi, a Calgary emergency room physician, said general surgery diversions used to be rare in the city, butnow he sees them two or three times a week.

And they impact patients with a variety of health concerns.

"It's appendicitis, a perforated bowel, gall bladder issues," said Abbi, who is president of the Alberta Medical Association's section of emergency medicine.

"I've had a few cases where I have to get them transferred on an urgent basis so they can get to the operating room that evening."

According to Abbi, this can lead to more ER backlogs and further strain on EMS.

"You're taking an ambulance out of the system to transfer the patient to another site. And as we know, ambulances are currently busy already."

AHS said that during the weekend diversion at Rockyview, emergency surgeries continued to be provided on-site.

"During a temporary surgical diversion, all patients are triaged and treated, and our medical teams evaluate all patients who may require surgery, as they always do," spokesperson James Wood said in an emailed statement.

Wood added that surgeons were on staff at all hospitals and available throughout the weekend for urgent and emergency care.

"A combination of factors, including staffing challenges, scheduled and unscheduled time off, and a general shortage of clinical surgical assistants and residents, contributed to the recent general surgical diversion at Rockyview General Hospital," he said.

Orthopedic and cardiac surgery as well as trauma service were not affected, according to AHS.

More surgical support staff needed, doctor says

"It's poor care for Albertans," said Dr. Tony Gomes,president of the Alberta Association of General Surgeons.

"I think most people expect that when they show up at a large hospital in Calgary, they're going to be able to have emergency surgery and for the last three years, that'snot the case."

He said the surgical support staff shortage includes clinical surgical assistants, who are often foreign-trained doctors, and medical residents.

And, according to Gomes, surgeons have been calling for more consistent coverage of these support shifts for three years.

"Any time we are doing time-sensitive procedures, it's a no-brainer there will be adverse outcomes, simply because of the extended wait," he said.

Meanwhile, AHS said it's working to bolster staffing numbers.

"We are actively recruiting skilled clinical surgical assistants. Development and training takes six months to complete to ensure patient safety," said Wood.

"Current recruiting challenges are not unique to AHSand are being experienced nationally and internationally. AHS has a dedicated team in place focused on implementing solutions to support recruitment efforts."

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Gomes believes increasing pay for surgical assistants could help ease the shortage.

And he's worried the situation is going to get worse.

"The question is, what's next? Is it orthopedic surgery? Is it ICU care? Is it something else?" Gomes said.

"These diversions for general surgery are just the thin edge of the wedge. We're seeing a gradual decrease in functionality in all the large hospitals simply because the staffing is not available."