Edmonton emergency rooms strained by on-call doctor gap

Edmonton's busiest hospitalhas been operating without an on-call emergency doctor 50 per cent of the time over the past five months, a gap front line workers say puts patients at risk.

CBC News obtained the schedule charts that show the shift was vacant about half the time between October and February at the University of Alberta Hospital.

The on-call job, called the trauma team leader, is supposed to be staffed every day to oversee patients who suffer major traumas that threaten lives or limbs.

When the job isn't filled, the work falls to another emergency doctor who may have to put other patients on hold.

"If I've got a heart attack and a stroke that come in at the same time, they've got to wait because I have this trauma to take care of," said one of several emergency doctors who spoke on condition of anonymity.

'Dangerous'

Emergency doctors and trauma surgeons are asked to volunteer to work the trauma leader job on their days off. They are paid $35 an hour for 24 hours, for being on call and are paid an additional fee for service if they actually come into the hospital to work.

Hospital staff say they have noticed a significant drop-off in staffing this position over the past year.

Many chalk it up to the stress of physicians' regular work days: stretched resources, many patients and chronic overcrowding. No matter the reason, physicians say the staffing gap is not sustainable - or safe.

"It's dangerous, is what it is," said another emergency physician.

"When you're loading an airplane and you're short a crew member or the engine doesn't work, the flight doesn't go," he said.

"[In our emergency department] these other things you should have before the plane takes off are often not there."

Performance notes

There were 1,490 major trauma cases admitted to the Royal Alexandra,the Stolleryand the University of Alberta hospitals in 2012, or an average of four per day.

In Edmonton, roughly 70 per cent of major trauma cases go to the U of A and the Stollery.

When asked about the high rate of vacancy for the trauma team leader position in recent months, Alberta Health Services sent a statement.

"Any patient who comes into the ED, and needs to be resuscitated and cared for, will be by the emergency physician and surgical teams. That has - and always will be - the case. To suggest otherwise is inaccurate, misleading and unfair to our hard-working and dedicated ED physicians and staff.

"According to the most recent Alberta Trauma Registry data (2014), the University of Alberta Hospital's trauma service performs well in relation to peer trauma centres across the country."

When it comes to overall performance, however, the province believes Edmonton is lagging.

Hospital backlog

"For whatever reason, patients are simply not flowing through Edmonton," said health ministry spokesperson Steve Buick.

"Measures are much worse here and we can't go on like that."

NDP Leader RachelNotleysaid the issue is one moresign the public should be worried about the state of health-care in the province.

"If we have a 50-per-cent vacancy with the most emergent team leader in the health care system, how many other parts of our system are currently functioning with empty vacancies where people are being asked to do way more than they were ever intended to? And what is that doing for the quality of patient care that people in Alberta receive? I'm very concerned."

Sandra Azocar of Friends of Medicare said not filling the trauma-team leader shift is like removing one more domino that could eventually cause the system to fall off a cliff.

"ER doctors have been saying this for quite some time," she said.

"We put in very temporary solutions to problems and then we don't really address what needs to be addressed. Ifretention and recruiting of doctors into this type of position that will help with thework-flowis not being done, then thedoctors will continue to be stretched to a maximum."

Health Minister Stephen Mandel held emergency meetings with staff at several Alberta hospitals - including the U of A - in December after media coverage of overcrowded hospitals.

The Alberta government is looking at solutions, such asopening up more long-term care beds, but can make no announcements until after the spring budget is released.

Facing a $7-billion shortfall next year, due to a sharp decline in oil royalties, the province has offered several warnings that the budget will likely include public service cuts.

But the health minister's office promised on Monday that it will keep its scissors away from core health services.

"We've told the public we will not accept reductions in frontline care," said Buick.