Diversion of emergency surgery patients a growing problem, Calgary doctor warns

An emergency surgery diversion put in place at Calgary’s Rockyview General Hospital this week resulted in one patient being sent to an alternate hospital, according to Alberta Health Services, and while the number of people impacted was low this time, the situation is raising concerns about patient safety.

Staffing shortages prompted the general emergency surgical diversion protocol that started at 5 p.m. Tuesday night and lasted for 15 hours. According to the health authority, a lack of physician coverage meant patients would be diverted to Calgary’s three other adult hospitals 

An AHS spokesperson told CBC News one patient ended up being transported to South Health Campus for emergency surgery through the night and the protocol was lifted as 8 a.m. Wednesday as planned.

“Emergency surgeries can still happen in instances like this where staffing is limited. The diversion simply limits new patients coming to the site to ensure all patients receive the care they need when they need it,” AHS spokesperson Kerry Williamson said in a email statement.

“It is common practice to distribute patient volumes to the most appropriate location to balance system pressures.”

This week’s diversion impacted general emergency surgeries which can include treating potentially deadly problems such as a ruptured appendix, bowel obstruction or intestinal perforations.

Increasingly common

But doctors say diverting emergency surgery patients is not a normal practice in Calgary.

They say its a symptom of a healthcare system under intensifying pressure and, while it is unusual, it is happening with increasing frequency.

“It’s actually really quite uncommon ,” said Dr. Chris Armstrong, a general surgeon at Rockyview General Hospital, who was not working on Tuesday night when the diversion was in effect.

“It’s been happening more frequently in Calgary. There’s multiple pressures from that.”

Dr. Chris Armstrong, a general surgeon at Rockyview General Hospital, says these types of emergency surgery diversions are happening more often and he’s worried about the impact on patients (Submitted by Chris Armstrong)

And diverting these patients is something, until recently, he hadn’t witnessed in his nearly 10 years working as a surgeon in Calgary.

“Any unnecessary delay with surgical care could potentially impact patient outcomes in a negative way. So I think it’s incredibly important to minimize those unnecessary transfers,” he said.

That’s a dangerous thing– Dr. Christopher Armstrong

“When all of the sudden one of those [Calgary hospitals] is diverted, it puts undue pressure on those three other centres that are already busy. That’s a dangerous thing. And it’s a dangerous direction, that if it continues it needs to be addressed.”

The Red Deer Regional Hospital has been under a surgical diversion of its own since April 29 resulting in the transfer of more than 100 patients to either Calgary or Edmonton so far.

That’s exacerbating the pressures in Calgary as hospitals absorb patients from the central Alberta facility.

Armstrong believes there are a number of factors contributing to the shortage of staff, including burnout after two years of the pandemic, a drop in the number of medical trainees who assist the surgical team, and funding changes.

It takes three people to properly run an emergency surgical service safely, he said, including the surgeon and someone to assist in the operating room as well as another provider to care for patients on the ward.

According to Armstrong, there are upcoming nights where surgical teams are short staffed and he’s concerned this could happen again.

“I’m worried. I don’t foresee this situation getting better quickly. I”m worried that its going to get worse and this might become a more frequent occurrence,” he said.

He said staff find ways to treat the most urgent cases — those that can’t wait to be transferred — when they arise.

“Increased awareness needs to happen that we’re struggling. And we need more resources.”

CBC News asked AHS how often these types of diversions have been put in place since December and which hospitals have been impacted.

The health authority did not respond to those questions.

According to AHS, when staffing shortages occur and diversion is necessary, all impacted hospitals are alerted through its centralized call centre.

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