ProtectAB

Urban/rural MD. Acute care and hospital medicine.
"Great power comes with great responsibilities."
No one has the freedom to harm others.
Opinions are my own.

[ProtectAB @protect_AB]

@shandro @jkenney @GoAHealth I just returned from being on-call for a rural hospital for the long weekend. During the past 4 days, I had to resuscitate two people who were in septic shock (a blood infection so severe that one's organs start to fail), 1/n

[Jon Meddings @JMeddings]

GoA suggested a solution to the ER crisis a month ago and still cannot implement their own solution...

Why are they "running" our healthcare system?

https://t.co/1c17swykxc

[alan drummond @alandrummond2]

A reminder to the College and the profession that crowding and the misnamed Hallway Medicine represents a daily breach of patient confidentiality and silence is unfortunate complicity

[Parksy @PfParks]

https://t.co/yKkjPLzRhs

Calling Premier Smith. Does this sound like your HC system is functioning appropriately?

“Once admitted, her mother was squeezed as the third patient into a two-bed hospital room for more than a week, Krawiec said.
1/3

[Courtney Theriault @cspotweet]

“I feel like this health system has failed us completely."

Patients detail ‘disaster’ inside emergency departments of Alberta hospitals

https://t.co/LLNo9FsM6j

[Sean Amato @JSJamato]

Some Chiefs are now calling on Alberta's premier to resign, alleging Danielle Smith has "conspired" with separatists and violated Treaty rights.

"I hope you have your bags packed. Because when this referendum is defeated, I will gladly walk you to the border." #ableg #cdnpoli

[Parksy @PfParks]

Couple of points:

1 - We are not freeing up more ED beds.
If you are so confident in this statement of yours, commit to publishing EIP+Pending consults / funded ED bed base for every major hospital. Not aggregated. In real time on a daily basis (you already collect this).
2/5

[ProtectAB @protect_AB]

The government must stop playing the number games and see the suffering of Albertans through their eyes.

[Dr. Raj Sherman @RajSherman]

Dear Premier @ABDanielleSmith,

You have taken full control of Alberta’s health system and appointed four ministers to run it. Right now, their public statements directly CONTRADICT each other.

Hospital care is simple:

INPUT → THROUGHPUT → OUTPUT

• Input: Primary care & prevention (@AdrianaLaGrange)
• Throughput: Hospitals & ERs (@MattJonesYYC)
• Output: Seniors care & community placement (@JasonNixonAB)

If OUTPUT (moving ALC patients who no longer need acute care) is truly improving, then THROUGHPUT and INPUT (moving admitted patients from the ER to a hospital ward bed) must also improve.

Right now, we are not seeing that in the front lines.

That contradiction sits between your ministers:
• Minister Nixon claims ALCs are at historic lows and Alberta leads Canada.
• Minister Jones oversees hospitals where:
– ER beds remain full of admitted patients
– EMS still cannot offload
– Waiting rooms remain unsafe
– Preventable harm and possible deaths linked to access delays continue to occur

BOTH CANNOT BE TRUE.

Either:
• ALCs are not improving in real operational terms,
• Hospitals are not being managed based on reality,
• Or the numbers being presented do not reflect what is happening at the bedside.

Albertans deserve to know which.

Dear Minister @JasonNixonAB,
You claim Alberta now has the “lowest ALCs in Canada.” I acknowledge that claim based on your press conference and slides, and I am calling “BULLSHIT” unless it is proven otherwise.

If Alberta truly has the lowest ALC rate in Canada, release your current data using the SAME rules you used in AUGUST:
• No reclassification
• No relabeling
• No new categories like “TWA”
• No shifting ALC patients to “acute”
• No redefining who counts as an emergency inpatient
• Just an honest, apples-to-apples comparison

Because frontline leaders are reporting:
• ALC patients being reclassified as “acute”
• ALC patients discharged, returning within days, then counted as acute
• Truly ALC patients arriving through ER recorded as acute admissions
• Emergency in-patients (EIPs) being renamed as TWAs (Transfers Waiting Admission)

That does not fix patient care. That fixes spreadsheets.

The real health system performance measure is simple: How fast do admitted patients leave the ER and reach a ward?
• World-class systems: 4 hours, 95% of the time
• Alberta’s historical target (Stelmach era): 8 hours, 90%
• Yet Alberta continues to see boarding measured in days, not hours (see attached slides below - 6 month old data)

Two weeks ago, I personally saw patients boarded in ER for 5–6 days.

Your timing matters:
• There was a sharp drop in ALC numbers on December 15, which you publicly celebrated.
• Mr. SreeKumar died on December 22 after eight hours of suffering in an overcrowded ER.
• At least six more deaths and multiple serious harms have followed.

Is that really success? It's actually system failure.

About optics versus reality:
• Communications teams may spin this.
• But Albertans are not naïve.
• Especially rural Albertans, who depend on Edmonton and face the highest risk.
• Edmonton receives roughly four times the out-of-region transfers compared to Calgary.

So here is the ask, PLEASE:
• Stop managing optics.
• Stop massaging numbers.
• Start managing the flow of real people.

Solutions:
1. Focus first on low-acuity ALC patients who can be moved quickly with expanded transition beds, rehab, home care and assisted living.

2. At the same time, prevent the admission of medically well but fragile seniors by supporting 24/7 multidisciplinary home-care teams using the "Home First model" that has already been repeatedly recommended to you. The Danish do this well.

3. Expand multi-discipolinary home care so fragile (non acute) patients do not need to be brought to the ER by EMS in the first place.

This is about the safety of Albertan families at the most vulnerable times in their lives, not political optics.

Albertans deserve truth, and more importantly, access to the world-class care we are capable of delivering in a timely way.

This challenge applies to both ministers:
• Minister Nixon: prove ALC success using August definitions.
• Minister Jones: please explain why hospitals remain unsafe if ALCs are truly fixed.

Either the data are wrong, or the system is being misrepresented. Albertans deserve clarity.

As a child, I once misrepresented a quarrel with another friend. My grandfather sat me on his lap and said:

“Son, there are three things in this world you cannot hide:The SUN, the Moon, and the TRUTH.”

@pfparks @JMeddings @BradenMannsYYC
@NightShiftMD @TheSGEM @TheBreakdownAB
@ryanjespersen @cspotweet @AndrewSchultzWX
@Albertadoctors @UnitedNurses @HSAAlberta
#AbHealthCrisis #StateOfEmergency #PatientSafety

[Ryan Jespersen @ryanjespersen]

Firefighters tell me the Royal Alex ER is consistently at DOUBLE fire code occupancy. Not surprised more frontline workers are speaking out. #yeg #abhealth

[Edmonton Zone Medical Staff Association @EZMSA2]

Release: Jan 26/26

Letter from 5F2 physicians, nurses and allied health professionals at the University of Alberta Hospital

Re: Closing Seniors' Acute Care Unit.

#abhealth #ableg #abpoli

[Chris Berthelot 🇨🇦 @DebatingChris]

Danielle Smith promised to fix healthcare in 90 days.

Over 1000 days later, we've gone from "Hallway Healthcare" to 𝗱𝗲𝗮𝘁𝗵 𝘇𝗼𝗻𝗲𝘀.

The UCP is the worst government Alberta's ever had, and it's only going to get worse if they stay in power.

#ableg #abpoli #cdnpoli

[The Breakdown @TheBreakdownAB]

The government recently and clearly stated that they have all of the tools they need to address the healthcare situation.

But while they say that, Albertans are literally dying needlessly and preventably.

#abpoli #ableg #cdnpoli

[ProtectAB @protect_AB]

These tragedies shouldn't be normzlized.
Our patients deserve bette care.

[Parksy @PfParks]

I collated these anonymized cases and sent it internally, and can confirm the authenticity and veracity.

I feel obliged to state: I did NOT provide this to The Breakdown. But I fully support whoever did, and understand why they would feel it was important to do so.

[The Breakdown @TheBreakdownAB]

Tonight at 8.

ER docs have identified at least an additional 8 preventable deaths in the last ~ two and a half weeks in ER’s across Alberta.

Including another one almost identical to the death of Prashant Sreekumar.

We’re getting into it.

#abpoli #ableg #cdnpoli

[André Picard @picardonhealth]

79-year-old with influenza waited 90 hours in Edmonton emergency department, family says. Patients are languishing for days in makeshift waiting areas to receive care, by @alanna_smithh https://t.co/iuxJeyHT5Q via @globeandmail #CanadaWAITS

[The Breakdown @TheBreakdownAB]

“for more than 90 hours − nearly four full days − her dad was confined to a stretcher in an overflow area of the emergency department waiting room”

#abpoli #ableg #cdnpoli https://t.co/TUzp7DjjIW

[Emma Graney 🇦🇺🤷🏻‍♀️🇨🇦 @EmmaLGraney]

A senior with influenza waited 90 hours in an Edmonton emergency department, one of many patients languishing for days in makeshift waiting areas to receive care as patient demand exceeds bed availability in hospitals across Alberta https://t.co/ApoBbQAhY4 #ableg #cdnhealth

[ProtectAB @protect_AB]

Stop inhumane treatments of our patients! Our patients deserve better!

[Parksy @PfParks]

This story is sadly one of hundreds on any given day in our EDs.

I won’t mince words: treating our sick Albertans like this is INHUMANE

Albertans would not believe the conditions until they or a loved one are thrust into them.

More brave pts/families need to speak out!

[Alanna Smith @alanna_smithh]

For 90+ hours, Carla Peck's 79 y/o dad was confined to a stretcher in a #yeg ED, worsening his condition. Many patients like him are languishing for days in makeshift waiting areas as patient demand exceeds bed availability in AB hospitals. #ableg #abpoli https://t.co/9I3NXxeY1L

[ProtectAB @protect_AB]

At times of acute care bed crises, AHS plans to remove 21 family medicine beds from UAH where patients are already suffering from overcapacity at the hospital.

[Courtney Theriault @cspotweet]

For those doing the math at home, that's 3 days and 18 hours.

Senior with influenza waited 90 hours in Edmonton emergency department, family says

https://t.co/kDnLlDUCiZ

[ProtectAB @protect_AB]

"Many pts like him are languishing for days in makeshift waiting areas to receive care as patient demand exceeds bed availability in hospitals."

Yet AHS plans to remove 21 acute care beds from UAH, stating they are "confident that it will minimally impact family med pts."

[Heme Doc @LabsandMAbs]

Senior with influenza waited 90 hours in Edmonton emergency department, family says https://t.co/nLwrcE1fej