Dr. Raj Sherman listed seven recommendations, the majority of which he said would help alleviate the strain of alternative level of care patients.Jeff McIntosh/The Canadian Press
The former chair of an Alberta agency that conducts health care research says the province is failing to discharge and transfer hospital patients in a timely manner, increasing safety risks to those who require emergency care.
Raj Sherman, who was appointed as chair of Health Quality Alberta by Premier Danielle Smith last June, resigned last month after serving one year of a three-year term. In his resignation letter, obtained by The Globe and Mail, Dr. Sherman said he is retiring before becoming a grandfather.
He also said, in the Aug. 15 letter addressed to Adriana LaGrange, Minister of Primary and Preventative Health Services, that Alberta must shift its focus to meaningfully transform provincial health care.
“After three major structural governance overhauls and conversations on the balance between public and private delivery, it’s clear that urgent reform must target the real drivers of system performance,” he wrote.
Dr. Sherman, an emergency room physician and former Alberta Liberal Party leader, listed seven recommendations, the majority of which he said would help alleviate the strain of alternative level of care, or ALC, patients. These patients no longer require hospital care but still occupy a bed until they can be transferred to a more appropriate setting, such as a long-term care home.
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In “high-performing systems,” he said, most ALC patients are discharged within 24 hours and admitted patients are transferred to inpatient beds within eight hours. “In Alberta, these targets are missed by significant margins, directly contributing to ER/EHS crises and system-wide safety risks,” Dr. Sherman said.
The United Conservative government has completely overhauled Alberta’s health system, establishing four different agencies, each led by a different minister, to replace Alberta Health Services, which is now a hospital administrator. The changes have led to thousands of work force transfers and many high-level terminations.
Alberta has defended its approach as a way to improve care and reduce waiting times. But opponents of the transformation say it has actually hindered care and caused confusion for health care workers and patients.
Dr. Sherman, in his list of recommendations to Ms. LaGrange, said the government should rebuild primary care as the backbone of the health system “rather than over-reliance on specialty-driven models,” improve community care for seniors and use data and predictive analytics to drive timely decision-making.
He also said there should be investment in prevention and public health with a “robust community-based strategy and a visible, empowered Chief Medical Officer of Health as its champion.”
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Ms. LaGrange, in a statement on Monday, thanked Dr. Sherman for his service. “The priorities he highlighted reflect core areas that government and the health system are focused on and this work will continue,” she added.
Data from Acute Care Alberta, obtained by The Globe, show there were 1,777 ALC patients on Aug. 29, an increase of 19 per cent compared with the year prior. Roughly 500 of those patients were on a waiting list for continuing care.
There are roughly 8,600 acute care beds in the province, according to Alberta Health Services. That means ALC patients, by no fault of their own, occupy about 20 per cent of beds.
Amber Edgerton, press secretary for Jason Nixon, Minister of Assisted Living and Social Services, said in a statement that the government “recognizes that hospital overcrowding remains a serious concern in Alberta.”
She said the government is actively working to remove barriers to safely discharge patients and identify unused beds and expand capacity in continuing care settings.
Dr. Sherman, in his resignation letter, said he was proud of the Health Quality Alberta board for its work over the past year and said he has full confidence in interim chair Angus Watt, a financial adviser. Dr. Sherman declined to provide further comment.
