Alberta emergency rooms 'unbearable, horrendous' as triage liaison program finally launches

Alberta's promised triage liaison physician (TLP) program is ready for implementation, but emergency medicine leaders warn it will fail without adequate nursing support.

Dr. Paul Parks, emergency physician and president of the section of emergency medicine at the Alberta Medical Association, described Alberta emergency departments as "unbearable, horrendous and the worst it's ever been." Parks said departments are dangerously overcrowded and difficult to provide timely care to patients. Admitted patients have been stuck in emergency departments for over 100 hours due to overcrowding.

"It's inhumane to think about leaving a sick person in the emergency department for over seven days," Parks said. "The lights don't go out. It doesn't ever get quiet. They don't get the same kind of care that they would get on the ward."

The TLP program was promised nine months ago with an original implementation date of February 1, but stalled conversations between the provincial government and the Alberta Medical Association delayed the rollout. Acute Care Alberta (ACA) announced Thursday that TLP program details are now finalized, with operations beginning in coming weeks. Minister Adriana LaGrange announced Friday via news release that the program is ready for implementation, though no specific date was given.

TLP physicians will work in the province's busiest emergency departments to expedite the process for patients awaiting care. "When you build a brand new program from the ground up, it's important to take the time to get it right," LaGrange said. "By working directly with physicians throughout the process, we've developed a practical, sustainable program that supports front-line doctors while putting patients first."

ACA has invited emergency medicine physicians to join the program and begin filling TLP shifts. However, Parks raised a critical concern: appropriate numbers of nurses and allied health care workers are necessary to support the physicians. Without adequate support staff, TLP effectiveness will be compromised.

Calgary's largest trauma centre regularly runs 8 or 9 emergency nurses short on night shift, with certain emergency department areas closed due to staffing limitations. "In that environment if you were to have a triage liaison waiting room doctor, when you don't have the right number of nurses in the back in the emergency (room) — you're just putting a band-aid in an area that isn't going to be the most impactful or the best area to put our resources," Parks said.

The TLP role was first announced in January by former Minister Matt Jones following the death of Prashant Sreekumar, 44, who died waiting for care in the Grey Nuns Hospital emergency room. A fatal inquiry into Sreekumar's death is scheduled to begin October 19. Press secretary Maddison McKee said the province welcomes the inquiry and is committed to learning from its findings.

ACA is also implementing 16 recommendations from a Quality Assurance Review announced in March. HighOnCity reported in July that Alberta ERs were still waiting for promised triage liaison physicians six months after the program was announced.