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ER ordered to treat VIPs faster, docs say

EDMONTON — An Alberta emergency room doctor says medical staff in a busy ER were once pressured to provide care for a “VIP” ahead of a waiting room full of very sick people.

Dr. Paul Parks told a public inquiry Wednesday that the order came from an executive at the University of Alberta hospital in Edmonton in the fall of 2007.

“The executive on call called down to the triage nurse and essentially indicated that there was a VIP in the waiting room and that VIP should be moved into an emergency bed immediately and taken care of,” testified Parks, who is now the chief emergency physician in Medicine Hat, Alta.

The ER was snarled with patients and the nurse pushed back, Parks said. The best that could be done was to re-evaluate the person to see if the ailments merited being moved ahead.

They didn’t.

The executive called back.

“The tone was definitely not friendly ... there was a repeated call again where the gist of the conversation was, ‘What the heck are you guys doing down there? What is that VIP doing still in the waiting room?”’

The executive ordered that the person’s family doctor be called to the hospital to provide treatment — something Parks said emergency staff would never do.

Neither the VIP nor the executive was named at the inquiry.

In the end, Parks said, no special care was provided.

He said he and his fellow emergency room doctors agreed afterwards that they would never let anyone jump a queue for care.

“We couldn’t take part in any .... requests for preferential access. We had to just see the next sickest patient in the queue,” he said. “It needs to be that we see patients based on their need, their medical need and the next queue would be the time that they came to see us.”

The inquiry, called by Premier Alison Redford to look into allegations of queue-jumping in the health system, began hearing from witnesses on Monday.

Executives have talked about preferential treatment being an accepted practice under the old regional health boards, but no one has been able to cite any examples.

Capital Health delivered care in the Edmonton area during the time Parks spoke about. All of the health regions have since been rolled into a provincewide superboard called Alberta Health Services.

Parks painted a picture of an emergency room in gridlock — a dead canary in a coal mine of a system in crisis. While other departments in the hospital filled up, the ER could never lock its doors and the patients piled up like cordwood.

People with crushing chest pain in need of being seen within minutes were waiting up to five hours for a doctor, he said. Stroke patients would lose control of their bowels in the waiting room. Their families would have to clean them up and continue to sit there. People with broken bones were waiting hours without pain medication.

The problems stemmed from patients who had been admitted not being moved up into the hospital, Parks said.

Just days before the VIP complaint, Parks said he counted 39 of 42 ER beds being blocked by patients who had either already been admitted to hospital or were going to be admitted after seeing a specialist. Three of those were intensive-care patients.

The VIP request was the “straw that broke the camel’s back.” Parks and a fellow doctor drafted a note relaying what had happened and sent it up the chain. They received no feedback, although there was some suggestion that the letter was not well received, he said.

In the fall of 2010, a letter Parks wrote as head of emergency care for the Alberta Medical Association was leaked to the news media. The missive warned that emergency rooms faced “potential catastrophic collapse” due to long waits and bed blockages.The letter opened a floodgate of stories from doctors and others.

Parks testified that things have improved since then, although benchmarks for emergency room lengths of stay still aren’t being met.

Parks added he has heard general things about queue-jumping since 2007, but doesn’t have any specific examples.

“As far as I know ... I don’t know that it is still going on.”

 
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