Respite care pause in Calgary shows health system on a ‘knife’s edge’

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The suspension of respite care at a Calgary Children’s Hospital center is a necessary measure to deal with an increase in patients at the Alberta Children’s Hospital, a hospital administrator said.

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Alberta Health Services announced over the weekend that it is temporarily suspending services at the Rotary Flames House, releasing all respite patients to redeploy staff to the struggling children’s hospital.

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“(The decision is) to open up more capacity to take care of our current priority, which is acutely ill children,” said Margaret Fullerton, the senior operations officer at Alberta Children’s Hospital.

“We really sympathize with families who are really disappointed by this … But at this time we have to prioritize those children who need acute care.”

Patients currently receiving respite care are expected to be discharged by Tuesday.

Other services offered by Rotary Flames House — including grief and end-of-life care — will be temporarily moved to Alberta Children’s Hospital.

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Fullerton said respite care will be restored once the pressure at the hospital eases.

The announcement was “horrible” to hear, said Medicine Hat resident Sean Rooney.

Rooney’s son Dominic was admitted to the Rotary Flames House shortly before he died of acute myeloid leukemia in September 2015. He said the facility was invaluable at the time.

“It’s absolutely devastating for a number of families,” Rooney said. “As a citizen, I trust that they are going to make the right decisions to alleviate this pressure, and they have, but this is really a much bigger issue in terms of our health care system.”

Lia Lousier and her son have used services at the Rotary Flames House for the past decade. She is not directly affected by the break, but said she has heard from families who booked respite services months ago who are now unable to access them.

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She said she believes children’s hospital staff will do their best to serve families, but losing the intimate environment of the rotating home will be difficult.

“Not that many of us plan for our children to die, but knowing that Rotary Flames is there as a final destination with full support means a lot when you have a palliative child,” Lousier said.

The pause in respite care is the latest measure by AHS in an effort to ease pressure at the Alberta Children’s Hospital amid an increase in pediatric patients.

It’s a wave that comes as several respiratory viruses, including a particularly virulent flu strain, circulate widely across the province. The tension has led to long wait times at the Alberta Children’s Hospital, which at times stretched as long as 12 hours last month. The hospital is seeing a 20 to 30 percent increase in daily emergency department visits, and its inpatient units are currently over capacity.

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Last week, AHS installed a heated trailer outside the Calgary hospital to serve as an emergency department overflow waiting area when space is needed. Fullerton said staff is preparing that space for use with plans to open it in the next week.

“We will only open that trailer when necessary. If the emergency waiting room line doesn’t go out the door, we’re not going to use the trailer. It is only when the rope becomes a factor that we have to protect patients from the cold,” she said.

“It’s just a precaution, when-we-need-it trailer.”

Health officials also postponed 12 surgeries at the Alberta Children’s Hospital last week, among the more than 170 scheduled. Fullerton said further operations would only be delayed on a case-by-case basis to create capacity.

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Pediatric acute care, and Canada’s hospital system in general, typically operates on a “knife’s edge,” says Dr. Katharine Smart, former president of the Canadian Medical Association.

She said this meant that pressure on one part of the health system would have a negative impact on other services.

“People who run the hospitals have to make decisions about the use of the resources they have to try to continue to meet the needs of children who are acutely ill, but that means we’re getting more and more children who unable to access other essential health care services,” said Smart, a Yukon pediatrician who previously worked as a pediatric emergency physician at Alberta Children’s Hospital.

“The fact that they have to turn away staff from Rotary Flames House, and children who are there for both relief and palliative care, is a true statement of how bad things are.

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“Our health care system always works at the point of being able to drive, and now we’ve been pushed over the edge and we’re not driving anymore.”

Speaking in Edmonton on Saturday, federal NDP Leader Jagmeet Singh dismissed the recent measures taken at the Alberta Children’s Hospital as evidence of a faltering health care system.

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“Our children should not be waiting in trailers. Our children should not wait hours and hours in emergency rooms before they get their care,” Singh said.

“The fact that the hospice and respite services are being closed to free up staff to deal with the crisis in our healthcare system in our hospitals really highlights how bad things are. This is a problem.”

In a Saturday email, Health Minister Jason Copping’s press secretary, Steve Buick, said the province feels for children and families whose care is being disrupted by an early and severe flu season.

“We are supporting AHS in responding to the strain at our two children’s hospitals, including temporary measures to add capacity to care for the sickest children,” Buick wrote.

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Other children’s hospitals across Canada are also struggling with high pressure during the ongoing respiratory virus season.

Ottawa’s Children’s Hospital, CHEO, announced Saturday that it will accept staff assistance from the Canadian Red Cross to weather that storm. AHS said Sunday it did not call the Red Cross for help at the Alberta Children’s Hospital.

Fullerton encouraged parents to visit their HEAL webpage at ahs.ca/heal for information on how to treat children at home, and when to seek care at the emergency department.

She also asked parents to immunize their children against flu and COVID-19.

Smart said vaccinations are essential to combating viral diseases, as well as health measures such as wearing a mask, washing hands and staying home when sick.

She added that it is difficult to predict when the pressure from the increase in respiratory diseases will ease.

“It’s probably going to be a bit of a peak and then a slow burn, but I think what’s challenging is even that is going to be numbers and pressures that are probably beyond what the system is staffed and able to handle. , ” said Smart .

— With files from Dylan Short and Matthew Black

jherring@postmedia.com

Twitter: @jasonfherring