SICKENING SITUATION
A doctor is sounding the alarm about overcrowding at the Abbotsford Regional Hospital’s ER, including stabilized patients (faces blurred to protect identities in this 2016 photo) who are being ‘warehoused’ in hallways of the department.
As Abbotsford Regional Hospital faces questions about patient deaths, a hospital doctor has come forward to claim that the facility is dangerously overcrowded.
The Abbotsford Emergency Room is used to “warehouse” admitted patients whose condition has already been stabilized, the doctor said. This reduces the ER’s capacity to treat people who arrive at the hospital with potentially urgent injuries or illnesses, the doctor said. The overcrowding crisis in the hospital’s ER raises the question of whether in some cases potential patients are turned away by ER staff pressured to quickly judge whether these people are at risk, or not.
Already this February, families of two Abbotsford hospital patients have questioned whether the deaths of their loved ones could have been prevented. Nimrat Gill, 3, died on the morning of Feb. 7, during her second visit to Abbotsford Regional Hospital in as many days. Gill’s family suspects that she died of pneumonia that went undetected during back-to-back hospital visits.
On Feb. 2 Mary Louise Murphy, 56, died at her apartment hours after being discharged from the hospital’s ER. Her family says she waited about five hours to see an ER doctor, and was told she was experiencing muscle spasms, and was discharged with a shot of morphine. They believe she may have died of a heart attack in her home.
Both cases are under review by hospital administrators.
The Abbotsford doctor was very careful not to link overcrowding in the hospital’s ER with patient deaths. But the doctor said that current ER conditions are creating risk.
“Because of the volume of patients that are in the ER taking up valuable stretcher space, when you come in with an acute lifethreatening problem, there will be competition for the space that you need,” the doctor said. “The decision-making needs to happen quickly and efficiently in every single case. What the crowding burden does, is it makes it more difficult to happen quickly and efficiently and correctly, in every case. And therefore, the margin for error is slimmer, and the potential ramifications are there.”
The doctor asked not to be identified, citing fears of repercussions. Postmedia has interviewed the doctor several times in recent months and confirmed the doctor’s identity and position. A second doctor at the hospital confirmed details in this story.
Neil Barclay, regional medical director for emergency care in Fraser Health, responded to the first doctor’s claims.
“I don’t think that patients are sent home inappropriately,” Barclay said.
“Physicians are smart enough to know when a patient needs to be admitted, and they will admit them whether the hospital is congested or not. Does congestion make for difficult working conditions? Absolutely. Are there delays when the ER is congested? Yes, for some patients there are.”
The Abbotsford doctor said the hospital’s staff and administration have long been aware of the ER conditions. For years doctors have advocated that the hospital’s seven other wards should share the excess patient load, the doctor said.
It would make sense that each ward take four or more extra patients if the hospital is over capacity by 30, the doctor said. “But right now all 30 are held in the ER.”
In the worst cases, between 50 and 60 patients are warehoused in the Abbotsford ER, the doctor said.
Another solution would be to treat excess in-patients in the hallways outside wards.
“For a period of time, a year or two, the hospital was trying to accommodate the extra load of patients by putting them in the hallways upstairs in the wards,” the doctor said. “But someone at some point, has made an edict that can’t happen.”
The doctor said, and Postmedia has confirmed with visits to the hospital in recent months, that the “no hallway edict” applies to Abbotsford hospital ward areas, but not to the areas surrounding the ER. Patients are stacked side-byside in makeshift beds in lounge areas bordering the ER, as if they “are in a fishbowl” the doctor said. This is especially bad for mentally ill patients warehoused in the ER area as they wait for psychiatric ward beds, the doctor said.
Barclay confirmed the authority’s decision to prohibit treatment of excess in-patients in wards or ward hallways, because they don’t believe it is “good medical care.”
Statistics from Fraser Health show the Abbotsford hospital has registered its worst ever reading for a key measure that shows how efficiently hospitals are moving patients through the system. Only 30 per cent of emergency patients were admitted to the hospital within 10 hours during the first half of 2016, the latest data shows. Fraser Health has a target for success of 55 per cent.