Concerns grow as ER wait times at Alberta's pediatric hospitals balloon

Alberta's pediatric emergency rooms are dealing with unusually long wait times, and while health officials say the sickest children are getting care quickly, some front-line health-care workers are worried about patient safety.

Wait times approaching 10 hours have become fairly common in recent weeks at Alberta Children's Hospital in Calgary. The United Nurses of Alberta said it's aware of one day when the estimated wait time at the hospital surged to 16 hours.

The Stollery Children's Hospital in Edmonton is also under serious pressure.

"The past couple of weeks, and in particular the last seven days, have been some of the busiest time periods that I've seen in the 10 years that I've been working at the children's hospital," said Dr. Stephen Freedman, a physician in the ER at Alberta Children's Hospital and professor at the University of Calgary's Cumming School of Medicine.

"Some children are waiting pretty routinely sometimes eight to nine hours on most days, over the last two weeks, if they are very low acuity."

Freedman said  front-line staff are doing their best to keep up with the influx, adding the most urgent cases are prioritized for care and are ideally seen by a doctor within 20 or 30 minutes.

The backups are starting as soon as families arrive in the ER. Lineups to see the triage nurse, who assesses patients and determines who needs to be prioritized for care, have recently snaked out the doors at Alberta Children's Hospital.  

According to Freedman, a number of factors have combined to create "a perfect storm" — including high levels of COVID-19 circulating in the community and a late flu season with cases peaking at the same time now that public health measures are gone.

"There are a large number of children coming to the emergency department. A lot of them do need to be there."

According to Freedman, there is also an ongoing surge in kids in mental health crisis and a shortage of beds to treat them. Staffing shortages are also playing a role, as is the ongoing need, due to COVID-19, to wear personal protective equipment, which takes time to put on and take off, he said.

ER waits 'unsafe,' Edmonton doctor says

"I'm very worried," said Dr. Shazma Mithani, an Edmonton ER physician who works at the Stollery Children's Hospital.

She said the delays are longer than anything she's seen before, with some kids waiting up to seven or eight hours to see her. 

"It's something we're discussing every single day as a group in terms of what we can do to ensure things stay safe and to prevent any bad outcomes."

Calling the situation "unsafe," she said patients can wait 45 to 90 minutes to see the triage nurse to be assessed.

"The system is so stressed right now that a bad thing could potentially happen today in the waiting room.… It's essentially impossible to make sure that someone isn't getting sicker while sitting in the waiting room," Mithani said.

"The biggest worry is that a child dies. None of us want to see that happen, and that would certainly be an extreme-case scenario. But that is always the worry in the back of our minds."

At the Stollery, additional space is now routinely opened to deal with patient overflow in the ER.

Alberta Health Services (AHS) acknowledged the increased strain on pediatric hospitals and said the sickest patients will always be seen first.

"AHS is experiencing significant pressure on our health-care system, particularly our emergency departments and EMS, due to high volumes of seriously ill patients and the impact of COVID-19, which includes an increased number of patients requiring hospitalization, limited admissions to some hospital units due to infection control requirements, and increased staff absences,"  AHS spokesperson James Wood said in a statement emailed to CBC News.

"This has meant emergency department wait times sometimes reaching winter peak levels, which is impacting Alberta Children's Hospital and the Stollery Children's Hospital."

Lineups, waiting rooms monitored for sickest kids

The health authority said the spike in kids with viral illnesses is causing temporary lineups outside the ER in Calgary.

"This has been a significant factor in temporary lineups outside the Alberta Children's Hospital [emergency department] as we must isolate patients who are presenting with influenza-like illness symptoms, and therefore need more physical space to accommodate safe distancing," Wood said.

"When a lineup does occur, nurses are monitoring the queue and the waiting room to ensure that no patient is in critical condition. We are working on a system to bring the outside queue to the inside of the building. Our goal is to ensure all people are inside and waiting a short as time possible."

Wood said AHS is working to address the problem by moving staff to areas that need it most and prioritizing health-care workers for COVID-19 testing to minimize staffing shortages.

It's also urging parents to visit a website, designed to help them decide when they need to take their child to the ER and when they can safely be treated at home.

The United Nurses of Alberta calls the situation "desperate," saying it has received reports of wait times at Alberta Children's Hospital of up to 16 hours.

"If you're a parent, you can imagine any wait time with a very seriously ill child is frightening … it's also terrifying for the staff," said union president Heather Smith, who noted all of Alberta's major hospitals are facing similar pressures.

Smith said the prolonged wait times — while exacerbated by a recent influx of patients — are a symptom of a larger problem in the system that needs to be addressed.

"When you have 100 per cent or more occupancy, which is what our system is running at, [that] is a clear indication that we don't have enough spaces for patients."