Edmonton zone hospitals told to take extra inpatients to ease emergency room pressure

The hallway protocols have concluded, an Alberta Health Services spokesperson said Thursday afternoon. Hospital units are no longer being asked to proactively take an additional patient, they said, adding the practice may still be in place at certain sites, or within certain units, as a part of normal surge capacity protocols.

A long weekend surge of patients and increasing number of hospital units under stress has prompted Alberta Health Services to purposefully place inpatients in hallways.

A memo sent to doctors Tuesday working in Edmonton zone hospitals says every hospital unit should be taking one more patient than it has room for to help free up space in emergency rooms, and that all units need to have a hallway patient at all times. 

"This is being done to support patient flow throughout the entire Edmonton Zone and keep EMS available in the community," Alberta Health Services spokesperson James Wood said in a Wednesday email.

AHS also told staff to review inpatients to see who could go home or return to long-term care centres to make space in hospitals.

Wood said the measures aren't "the preferred method to provide care" but are necessary for the next 24 to 36 hours.

Hospitals are also seeing more patients who require isolation, he said. He didn't say by publication time whether the hospital outbreaks and patients needing isolation are because of COVID-19.

Dr. Paul Parks, president of the emergency medicine section of the Alberta Medical Association, says it's alarming to see hospitals being told to take surge measures during the summer, which is usually the slowest time of year.

"That's how bad our current state is right now, that we have to implement these policies and processes so that we can care for the next sick people that are out in the waiting room," said Parks, who is also an emergency room doctor in Medicine Hat.

He said the scenario does not bode well for the coming fall, when respiratory infection rates typically prompt more hospitalizations.

Hospitals stretched to their limits and ERs have a trickle-down effect on ambulance services, which have also been taxed in Alberta.

Parks said when there are no beds in emergency rooms, paramedics must wait with their patient until they can hand them off into the hospital's care, and this leads to a shortage of available ambulances.

Although the Edmonton area is the eye of the current storm, he says conditions are similar in emergency rooms across the province.

Some health-care workers are already squeezing inpatients into unconventional spaces such as storage rooms, he said.

"I would say it's absolutely disaster-mode operation kind of level," Parks said.

He said AHS may need to consider cancelling surgeries and moving some less seriously ill patients to hospitals in smaller cities to ease the pressure on urban centres.

Hallway nursing compromises quality of care: nurse

Karen Craik, provincial secretary of the United Nurses of Alberta, said hospitals were resorting to hallway nursing before the COVID-19 pandemic hit in 2020.

The pandemic caused so much staff burnout that the problem has escalated, she said. Difficult conditions like these just add to that burnout and prompt nurses to look elsewhere for work, she said.

"It's distressing," she said. "It becomes a moral distress because you can't look after the patient the way you want to."

Patients in hallways and their families lack privacy, and don't have easy access to a bathroom or oxygen if they need it, she said.

The Calgary nurse has seen patients wait in hallways for days until a room was available.

Wood said AHS has 206 more employees working in emergency departments than the organization did a year ago.

Craik said many of those workers are casual or part-time staff who came back to help with the pandemic, and the figures may not be a meaningful comparison.