Doctors say Alberta's plan for ‘triage liaison physicians’ can help, but isn't cure for slammed ERs

An Alberta government pledge to bring the position of “triage liaison physicians” back to some emergency rooms could help ensure sick patients are better prioritized, some doctors say.

Alberta Medical Association (AMA) president Dr. Brian Wirzba said the positions will be welcomed by emergency room doctors. He called the role “an important Band-Aid, but it’s not dealing with the root cause.”

Hospital and Surgical Health Services Minister Matt Jones announced the plan at a news conference on Thursday.

The promise comes after an Edmonton man died in the Grey Nuns Community Hospital's emergency department last month. His family says he had waited nearly eight hours to see a doctor about his chest pain.

Jones said Thursday that he asked Alberta’s justice minister to call a fatality inquiry into the death of Prashant Sreekumar, a 44-year-old father and husband.

Sreekumar’s death prompted health-care workers to ask the provincial government to declare a public health emergency in response to overcrowding in Alberta hospitals. Jones has said he doesn't need the additional powers that such a declaration would afford him.

As of Feb. 1, Acute Care Alberta, which oversees hospital services in the province, will pilot test triage liaison physician (TLP) positions in five urban emergency rooms: the Grey Nuns and University of Alberta hospitals in Edmonton, and South Health Campus, Peter Lougheed and Foothills hospitals in Calgary.

“To launch the role as quickly as possible, the positions will be staffed with existing AHS (Alberta Health Services) physicians,” Jones’ press secretary, Kyle Warner, said in an email on Friday.

“Recruitment for new physicians will begin as soon as possible." 

The former Edmonton-area health authority Capital Health tried a one-year pilot of the triage doctors in 2007.

Warner said that pilot “demonstrated the potential to significantly reduce emergency department length of stay and the number of patients leaving without being seen.”

He said the program didn’t continue at the time because it lacked a permanent funding source. He added that the new iteration of TLPs would be the first provincewide trial.

There have been North American studies of the value of TLPs over the past 20 years. The reviews report mixed success with improving patient wait times or decreasing the number of patients who leave the ER without being seen.

On Thursday, Acute Care Alberta’s chief medical officer, Dr. Aaron Low, described the TLP role as a physician working alongside triage nurses, and beginning diagnosis and care in the waiting room where appropriate. They can order bloodwork or medical imaging before the patient gets a bed.