Critics blast new metrics for health-care system
Government has watered down its standards, opposition argues
“It’s another indication that they are completely failing when it comes to emergency health care.”
WILD ROSE MLA KERRY TOWLE
CALGARY — The province has scaled back its standards for emergency room wait times to deflect the fact hospitals continue to fall short of previous goals, opposition parties charge.
In a revamped report card released last week, Alberta’s health authority pledged to hold the medical system to account in 16 key areas, among them hand hygiene, continuing-care placement and hospital satisfaction.
One major change involves the way ER visits are publicly tracked. Alberta Health Services now reports the average wait time for hospital admission, with the goal of getting patients into beds within eight hours. Previously, it aimed to have 90 per cent of patients admitted within that time.
AHS officials say the change isn’t about lowering the bar, but providing Albertans with a realistic portrayal of the province’s biggest adult emergency rooms.
Average wait times are not only easier for people to understand, they reduce the possibility that unusual cases will skew the data, said Dr. John Cowell, the health superbody’s official administrator.
“It’s a judgment call. We still track the 90th percentile and as soon as possible it is going to be shown again. We are not trying to hide anything,” he said.
“We want an accurate reflection of the experience in the ER — and the average is bulletproof.”
The report card shows Albertans are waiting on average 8.7 hours — slightly longer than the national average of 8.5 but a notable improvement from about 11 hours four years ago.
But according to AHS, only 36 per cent to 50 per cent of patients were actually admitted within the province’s eight-hour target at Calgary’s adult hospitals in January.
Wildrose MLA Kerry Towle believes the province is reluctant to publicly strive for the 90 per cent target because it shows that earlier medical goals remain elusive.
“It’s another indication that they are completely failing when it comes to emergency health care,” she said. “Our ER physicians have asked for the 90 per cent benchmark and have lobbied the government for it to remain the benchmark.”
Liberal Leader Raj Sherman agreed, suggesting the new report card “water(s) down the performance measures and is less open and transparent than ever.”
Dr. Paul Parks — who speaks for the Alberta Medical Association’s section on emergency medicine — sounded the alarm years ago about severe overcrowding in Alberta’s emergency departments and overextended hospital wards.
In February 2012, Cowell — then the CEO of the Health Quality Council of Alberta released a damning 428-page report that highlighted sweeping concerns with emergency wait times and a lack of resource planning in the health-care system.
The province and AHS subsequently announced a series of ambitious targets for shorter waits and new benchmarks for surgeries and continuing care.
Parks believes progress has been made because the aggressive targets inspired some improvement. But he is adamant that admitting sick and injured patients within eight hours — 90 per cent of the time — is the only ER marker that works.
It’s a measure that demonstrates the ease in which patients flow through the entire health system, he said.
“It reflects how Albertans get access to health care when they are the sickest. It’s a critical benchmark and (emergency doctors) have never wavered on this,” said Parks.
“If the province wants to report the average wait time so the public can better understand what is happening, that’s their decision. But AHS still hasn’t hit the targets that were set out and we need to get there.”
According to Health Minister Fred Horne, AHS consulted extensively with ER physicians about the new wait time measure.
Most support the change, he said.
Albertans shouldn’t take it to mean the province is softening its standards when it comes to health care goals, Horne added.
“There’s obviously lots of room for improvement and the challenge is the same: to make sure we’re only seeing people in ER departments who need to be there, and we’re not seeing people because they’re not getting access to family doctors or the primary health care in the community,” Horne said.
Liberal MLA Dr. David Swann said he doesn’t object to the province using average wait times, but wants to see the 90th percentile numbers reported to the public as well.