Alberta’s plan for ‘triage contact physicians’ could help, but it’s not a cure for bad ERs, doctors say

Some doctors say the Alberta government’s pledge to bring back “triage contact physicians” positions in some emergency rooms could help ensure sick patients are better prioritized.

Dr. Brian Wirzba, president of the Alberta Medical Association (AMA), said the positions would be welcomed by emergency room doctors. He called the role “an important Band-Aid, but it’s not dealing with the root cause.”

Hospital and Surgical Health Services Minister Matt Jones The plan was announced at a press conference on Thursday.

The promise comes after an Edmonton man died in the emergency department at Gray Nuns Community Hospital last month. His family says he waited for nearly eight hours to see a doctor about chest pain.

Jones said Thursday that he asked Alberta’s justice minister to open a fatal investigation into the death of Prashant Sreekumar, a 44-year-old father and husband.

Sreekumar’s death prompted health-care workers to ask the provincial government to declare a public health emergency in response to overcrowding in Alberta hospitals. Jones has said that he does not need the additional powers that such a declaration would give him.

Starting Feb. 1, Acute Care Alberta, which oversees hospital services in the province, will trial triage liaison physician (TLP) positions in five urban emergency rooms: Gray Nuns and University of Alberta hospitals in Edmonton, and South Health Campus, Peter Lougheed and Foothills hospitals in Calgary.

“The positions will be filled with existing AHS (Alberta Health Services) physicians, with a view to starting the roles as quickly as possible,” Jones press secretary Kyle Warner said in an email Friday.

“Recruitment of new physicians will begin as soon as possible.”

Former Edmonton-area health authority Capital Health tried a one-year pilot of triage doctors in 2007.

Warner said the pilot has “demonstrated the potential to significantly reduce emergency department length of stay and the number of patients not seen.”

He said the program did not continue at that time because it lacked a permanent funding source. He said the new iteration of the TLP will be the first provincewide test.

been there North American Studies The value of TLP over the last 20 years. Review Report mixed success with improvements in patient wait times or reductions in the number of patients leaving the ER without being seen.

Triage doctor’s role for times of crisis, says ER physician

On Thursday, Dr. Aaron Low, chief medical officer of Acute Care Alberta, described the TLP’s role as a physician who works with triage nurses and, where appropriate, initiates diagnosis and care in the waiting room. They may order blood tests or medical imaging before the patient gets a bed.

“It will also help us better stratify which patients need to be seen quickly and which can’t wait,” Lo said.

Dr. Raj Sherman, a longtime ER physician who has also served as leader of the Alberta Liberal Party and ran as a United Conservative Party candidate, said he worked with TLP during the pilot years ago.

“It’s an ER doctor who walks into the waiting room and looks for patients who are about to die, and orders tests in other patients,” he said.

It’s an approach designed for crisis situations, which best describes the current state of Alberta ERs, he said.

Sherman said she and other doctors are asking the provincial government to bring back the positions.

However, he said he wonders where health agencies like AHS and Covenant Health will find new ER doctors trained and willing to work in this role.

Sherman also questioned whether TLP would have dedicated nurses to provide the care needed in hospital waiting rooms.

Wirzba said doctors working as TLPs would also have to be paid separately. Instead of billing fee for service, employers must pay an hourly rate or salary, since only the treating ER doctor can bill for the patient’s care.

The hospital minister’s office did not respond Friday to questions about how many physicians the pilot project would need at five initial sites, how many hours a day a TLP would be on shift in each ER, or how doctors would be paid.

Doctors want long-term solutions

Louis Francescotti, an ER doctor at Edmonton’s Royal Alexandra Hospital, said it makes sense to have an experienced doctor on hand to begin any urgent tests immediately.

But the province also needs a health system that diverts non-urgent patients from emergency rooms, he said. Franciscutti said if the ER had the power to send patients with minor illnesses and non-urgent needs to long-term medical clinics, it would help reduce crowding.

The province must also improve disease prevention and promote vaccinations, he said, which helps keep patients out of the ER.

Dr. Scott McLean, who is an ER physician at the Royal Alex as well as Northeast Community Health Center, said overcrowding in emergency departments has become unsafe, adding that he has received capacity warnings from the fire department.

Maclean said he believed the TLP approach could be “misguided”.

“I would argue that my colleagues and I are already taking on this triage physician role,” McLean told CBC. Hanumansingh tonight On Thursday evening.

McLean said he already treats some patients in waiting areas, hoping triage nurses will have time to help care for them.

“That program designation does not provide the resources, does not provide those care locations and does not provide the nursing staff that I need to care for those patients,” he said.

Multiple ER doctors who spoke to CBC News said the province needs a better way to get patients waiting for long-term care out of hospital beds to prevent a backlog in ERs of patients waiting for admission to hospital.

Sherman also criticized the UCP government’s decision to cancel plans for a new hospital in South Edmonton. The province instead intends to add patient towers to Edmonton’s Gray Nuns and Misericordia hospitals and build a standalone children’s hospital.

Sherman said the number of inpatient beds per population in the city is critically low.

NDP hospital and surgical health services critic Sarah Hoffman said there is so little hospital space for Edmonton’s growing population, the province needs to build towers, a new Stollery Children’s Hospital and a hospital in south Edmonton.

“I think everyone is very frustrated and they feel the government doesn’t take their responsibility seriously,” he said on CBC Radio. Edmonton AM Friday morning.