Alberta health agency makes 16 recommendations in wake of December ER death

The Alberta agency in charge of hospitals has released a review making 16 recommendations to the government in the wake of the death of a man who waited hours for care in an Edmonton hospital.

In January, Premier Danielle Smith’s government ordered a judge-led inquiry into the death of Prashant Sreekumar, a 44-year-old father of three.

He died at Edmonton’s Grey Nuns Community Hospital in December, and his family said he had been there for nearly eight hours with chest pains and increasing blood pressure.

Acute Care Alberta’s review recommends increased staffing, expanded emergency department space, and ways to better move patients among different parts of the province to reduce pressure on the system.

The agency says its review is designed to offer practical solutions on the ground level, and system-wide changes that can improve care and prevent similar outcomes in the future.

It says Sreekumar suffered a “critical cardiovascular event” shortly after he was moved to a treatment space to be seen by a doctor.

Two other people died in the hospital’s emergency department on the same day, though the circumstances of those deaths are unclear.

The review points to long emergency room wait times, increasing overcrowding and “clinical decision support” as weak spots in Alberta’s health care system.

“The purpose of the (review) is not to assign blame but to identify ways to make the system better for patients across the province,” Acute Care Alberta said in a news release.

The report is dated Jan. 14.

The next day, Hospitals Minister Matt Jones announced the public fatality inquiry, and said the province was moving to implement a new physician role to help out in the province’s busiest ERs.

It would see triage liaison physicians hired to work alongside nurses to expedite patients as they arrive in the emergency department.

That was also among Acute Care Alberta’s 16 recommendations.

However, that initiative has since been stymied by negotiations with doctors over the terms of the position, including pay and insurance liability.

Opposition NDP Leader Naheed Nenshi, speaking to reporters Thursday afternoon, said the recommendations show that one of the busiest emergency rooms in the province is underfunded and the province’s massive health-care system restructuring has only made things worse.

“We had the system create a preliminary, long list of recommendations, all of which spoke to the government actually treating emergency rooms like emergency rooms and funding them properly, and the minister only announced one of the recommendations, one that he’s been unable to implement,” said Nenshi.

“That’s this government in a nutshell.”

He said the province needs to focus on improving care for patients.

“The government loves to study things and evaluate things and talk about things. They don’t like to actually fix things,” he said.

Many of the review’s recommendations require securing capital and permanent operational funding.

Some speak to long-term planning, some call for changes to staff protocols and some suggest initiatives already underway need a second look.

That includes reducing the number of “alternate level of care” patients who remain in hospital beds despite being more appropriately cared for in other facilities, such as continuing care homes. 

Smith and her government have long said they’re focused on easing that pressure and have made strides.

The review says the government and its partners should work to “assess whether current initiatives are sufficient to achieve the intended release of acute care capacity.”

In a statement, Jones said Acute Care Alberta is working with service providers to implement recommendations from multiple reviews, including one by Covenant Health, which operates Grey Nuns.

“All review recommendations will be utilized to implement systemic improvements that strengthen patient safety,” Jones said.

He added that all adverse patient events are taken seriously, and review processes are in place to guide improvements.

“Our thoughts remain with all families affected by adverse events, and we are committed to ensuring patient safety remains our highest priority.”