Lisa Skierka

Mostly human.

[Lisa Skierka @skielark]

And here's the Pincher Creek going strong. #abstorm

[Lisa Skierka @skielark]

Spring is roaring today: Vicary Creek north of Coleman. #abstorm

[Dr. Raj Sherman @RajSherman]

Activity Based Funding Alone Will Not Fix Alberta's Healthcare Crisis:

Alberta is moving forward with Activity Based Funding (ABF), where hospitals and surgical facilities are paid according to the number and complexity of procedures they perform.

Let's start with an important point: this is not inherently a bad idea.

When properly designed, Activity Based Funding can improve efficiency, increase transparency, reward productivity, and reduce wait times for procedures such as cataracts, hip replacements, knee replacements, and day surgery.

High performing healthcare systems in Australia and Scandinavia have successfully incorporated versions of ABF into their funding models.

But those same jurisdictions teach us an important lesson.

They do not rely on Activity Based Funding in isolation. They pair it with robust investments in primary care, prevention, home care, rehabilitation, assisted living, long term care, community-based services, and significantly greater acute care capacity.

These countries maintain approximately 3.8 to 4.2 acute care beds per 1,000 population. Alberta has approximately 1.76 beds/1000, less than half.

This capacity gap, combined with blocked patient flow, is Alberta's fundamental healthcare challenge.

After 35 years in the front lines, I can say with confidence that once Albertans gain access to care, they generally receive world-class care. Access is the problem.

Every day, sick Albertans sit in crowded emergency department waiting rooms wondering why the system is failing them.

Many assume the problem starts in the emergency department. It does not.

The emergency department is where the failure becomes visible.

For decades, Alberta's population has grown faster than its healthcare capacity. Our population is aging, chronic disease is increasing, and medical care is becoming more complex.

At the same time, hundreds of patients who no longer require acute hospital care remain in hospital beds because they are waiting for home care, rehabilitation, transition units, assisted living, or long-term care.

Hospitals are designed to treat acute illness, not to house patients waiting for the next level of care.

Healthcare is fundamentally a flow system and we have a major flow problem, especially in the Edmonton zone.

Patients enter through primary care, emergency departments, and ambulance services. They move through hospitals and, when ready, back into the community through home care, rehabilitation, assisted living, and long-term care. When any part of that flow becomes blocked, the entire system slows down.

That is exactly what Albertans are experiencing today.

Hospitals function best at approximately 85% occupancy. Above that level, delays increase, flexibility disappears, and patient flow slows. When hospitals routinely operate at 100-110% capacity, they do not become more efficient, they become less safe.

The consequences are predictable and preventable.

Emergency departments back up. EMS crews wait to transfer patients into care. Admitted patients board on stretchers waiting for inpatient beds. Surgeries are delayed or cancelled. Patients may be discharged earlier than ideal because of bed pressures, increasing the risk of complications and readmissions.

Most concerning, the risk of medical errors rises when healthcare professionals are forced to work in overcrowded, high-pressure environments for prolonged periods.

Chronic overcrowding contributes to burnout, moral distress, absenteeism, staff turnover and less efficiency. Asking healthcare workers to function indefinitely in crisis mode is neither sustainable nor safe.

Public hospitals managing complex admissions, emergencies, and Alternate Level of Care patients cannot fairly compete in a pure activity-based funding model against facilities focused primarily on lower-complexity elective procedures.

Changing the funding formula will not solve these structural issues.

If Alberta is serious about improving access and reducing wait times, our priorities should be clear:
1. Retain, recruit, and support healthcare workers.
2. Expand acute care capacity, particularly in Edmonton, which serves a vast and underserved northern region.
3. Move Alternate Level of Care patients to the appropriate level of care within 24-48 hours whenever possible.
4. Expand home care, rehabilitation, transition units, assisted living, and long-term care.
5. Strengthen primary care, prevention, and community-based services.

The single most important performance measure in healthcare is not the number of procedures performed. It is how quickly patients receive the right care, in the right place, at the right time.

A patient who requires admission should move from the emergency department to an inpatient bed within six to eight hours, 90% of the time.

Even in the middle of summer, many Edmonton patients are waiting four to six hours simply to be assessed by a physician. Another respiratory virus season is only months away.

Activity Based Funding may improve surgical efficiency and deserves a fair evaluation. But Albertans should not mistake a funding reform for a healthcare solution.

Until we fix the bottlenecks at both the entry and exit doors of our hospitals, our emergency departments and inpatient wards will remain overcrowded and inefficient regardless of how hospitals are funded.

The biggest bottleneck in Alberta healthcare is not the operating room…It's patient flow…It's the hospital entry and exit door.

@ABDanielleSmith @nenshi @PfParks @JMeddings @raghu_venugopal @TheSGEM @TheBreakdownAB @RealTalkRJ @cspotweet @BradenMannsYYC @UCPCaucus @abndpcaucus

[Lisa Skierka @skielark]

@TheBreakdownAB @PaulStewartII Am I the only one who wants a staff shuffle to go along with any ministerial shuffle. Let's move some of the tired bureaucrats around....

[Real Talk Ryan Jespersen @RealTalkRJ]

Who the heck is Bonnie Critchley?

Meet the military trailblazer-turned-political candidate looking to take down Pierre Poilievre in the Battle River-Crowfoot byelection...

📺 FULL: https://t.co/3xHcUx6Sdg

🎧 FULL: https://t.co/eQGTBm0TR7 #cdnpoli

[Nick Blakeney @CameraGuyNick]

Brilliant lightning storm lighting up the sky north of Calgary tonight—flashes every few seconds. Wild to watch. #abstorm #CalgaryWeather #yyc

[Lisa Skierka @skielark]

@MichelleRempel @by__brittany @EqualVoiceCA This is really unfair to the Calgary Equal Voice team who has worked unfailingly to be multi-partisan, both when I was involved and currently.

[Duane Bratt🇨🇦 @DuaneBratt]

Alberta by-elections. So far, with half the ballots in, it looks like no surprises. NDP is holding Strathcona and Ellerslie. UCP is holding Olds-Didsbury-Three Hills. Bad day for the separatists. Alberta Republicans have about 17% of the vote in Olds and barely ahead of the NDP.

[Lisa Skierka @skielark]

@coffeecrew @Shawhelp How did you get @Shawhelp support, everything here redirects to @Rogers and things are not working.

[Merriam-Webster @MerriamWebster]

Take a screenshot of this GIF, and whichever new word you land on is YOUR word for 2024.

Godspeed.

[Jon Meddings @JMeddings]

So should we abolish AHS? If so, what should we put in its place? Given my hard-earned time in medical leadership, I have a few thoughts about this. Here is a short thread outlining my initial thoughts. /1

[First Evening Star @OnaagoshinAnang]

To be an Indigenous woman in Canada today is difficult. It’s hard being confronted with the juxtaposition of my value within my (Indigenous) community vs. society at large.

But, that’s not what this thread is about. I’ve seen a lot of arguments against #SearchTheLandfill /1

[Lisa Skierka @skielark]

The thunder roared and we somehow missed all the excitement. #yyc #abstorm

[Lisa Skierka @skielark]

So proud: Jennifer Jenkins and Tom Skierka at the @calgarystampede accepting the 2023 @BMO Farm Family Award for Jenkins Ranche. (They look pretty good up there under the bright lights.)

[Lisa Skierka @skielark]

@apihtawikosisan Exactly! Last year she had a consult with my family doc but I hadn’t seen her in person since 2021, so we start anew.

[Lisa Skierka @skielark]

@apihtawikosisan Looking up “menopause clinic Calgary” right now. Also just had to get a new referral to the Gynecologist I’ve been seeing for 20 years. All so ridiculous.

[Lisa Skierka @skielark]

@jamespmcleod If they’re going to make AI, AI should be directed to make our systems more effective and reliable.

[Lisa Skierka @skielark]

Ah, that age-old Alberta Advantage.

[CTV News Calgary @CTVCalgary]

Two southern Alberta emergency departments will be closed for parts of the long weekend. https://t.co/uD6P4v1cxK

[Lisa Skierka @skielark]

Well this NP opinion piece is the worst. I’ll believe the catholic hierarchy’s take on reconciliation when they take actual accountability, make actual amends, talk about their own wrongdoings at masses in their own churches, and make full-scale reparations.

[Russ Diabo @RussDiabo]

[Of course the white supremacist Nat’l Post would give space to this Catholic colonizer!]

Ousted AFN chief RoseAnne Archibald obstructed reconciliation | National Post https://t.co/lmpXMXFcoQ

[Your Comrade drlearnalot @DrLearnALot]

Some problems really do have solutions, like homelessness.