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pediatric respite care pause in calgary shows health system on a 'knife's edge'

'we really are sympathetic to families who are really disappointed by this ... but at this time we have to prioritize those children requiring acute care'

exterior of the main entrance of the alberta children's hospital in calgary on sunday, december 4, 2022. jim wells/postmedia
suspending respite care at a calgary child’s hospice centre is a necessary measure to handle a surge in patients at the alberta children’s hospital, a hospital administrator said.

alberta health services announced this weekend it is temporarily putting services at the rotary flames house on hold , discharging all respite patients in order to redeploy staff to the struggling children’s hospital.

“(the decision is) to open up more capacity to care for our current priority, which is acutely ill children,” said margaret fullerton, the senior operating officer at the alberta children’s hospital.
“we really are sympathetic to families who are really disappointed by this … but at this time we have to prioritize those children requiring 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 relocated to the alberta children’s hospital.
fullerton said respite care will be reinstated as soon as pressure at the hospital abates.
the announcement was “horrifying” to hear, said medicine hat resident sean rooney.
rooney’s son dominic was admitted to the rotary flames house shortly before dying from acute myeloid leukemia in september 2015. he said the facility was invaluable during that time.
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“it’s absolutely devastating to a number of families,” rooney said. “as a citizen, i trust that they’re going to make the right decisions to alleviate this pressure, and they’ve done this, but it really is telling of a much larger issue in terms of our health-care system.”
 exterior of rotary house near the alberta children’s hospital in calgary on sunday, december 4, 2022.
exterior of rotary house near the alberta children’s hospital in calgary on sunday, december 4, 2022. jim wells/postmedia
lia lousier and her son have used services at the rotary flames house for the past decade. she isn’t directly impacted by the pause but said she has heard from families who had booked respite services months ago who now aren’t able to access them.
she said she believes children’s hospital staff will do their best to serve families but losing the intimate setting of the rotary house will be tough.
“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,” said lousier.
the pause in respite care is the latest measure from ahs in an attempt to ease pressure at alberta children’s hospital amid a surge in pediatric patients.
it’s a wave that comes as several respiratory viruses, including a particularly virulent influenza strain, circulate widely throughout the province. the strain has brought long wait times at the alberta children’s hospital, stretching to as long as 12 hours at times last month. the hospital is seeing a 20 to 30 per cent increase in daily emergency department visits, and its in-patient units are currently over capacity.

last week, ahs installed a heated trailer outside the calgary hospital to serve as an overflow waiting area for the emergency department when space is needed. fullerton said staff are preparing that space for use with plans to open it in the next week.

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“we will only open that trailer when required. if the emergency waiting room queue isn’t going out the door, we’re not going to use the trailer. it’s only when the queue becomes a factor that we need to shelter patients from the cold,” she said.
“it’s just a precautionary, when-we-need-it trailer.”
 exterior of the emergency entrance at the alberta children’s hospital in calgary on sunday, december 4, 2022.
exterior of the emergency entrance at the alberta children’s hospital in calgary on sunday, december 4, 2022. jim wells/postmedia
health officials also postponed 12 surgeries at alberta children’s hospital last week, among the more than 170 which had been scheduled. fullerton said further surgeries will only be delayed on a case-by-case basis in order to create capacity.
pediatric acute care, and canada’s hospital system broadly, typically operate on a “knife’s edge,” said dr. katharine smart, past president of the canadian medical association.
she said that means pressures on one part of the health system will have negative impacts on other services.
“people that are running the hospitals are having to make decisions about pivoting the resources they have to try to continue to meet the needs of kids who are acutely ill, but that means we’re having more and more children who aren’t able to access other essential health-care services,” said smart, a yukon pediatrician who previously worked as a pediatric emergency medicine physician at the alberta children’s hospital.

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“them having to pivot staff away from rotary flames house, and kids who are there for both respite and palliative care, is a real statement about how dire things are.
“our health-care system is always operating on the edge of being able to manage, and now we’ve been pushed over the edge and we’re no longer managing.”

speaking in edmonton saturday, federal ndp leader jagmeet singh decried the recent measures taken at alberta children’s hospital as evidence of a floundering health-care system.

“our kids shouldn’t be waiting in trailers. our kids shouldn’t be waiting in emergency rooms for hours and hours before they get their care,” singh said.
“the fact that the hospice and respite services are being shut down, in order to free up staffing to deal with the crisis in our health-care 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 kids and families whose care is being disrupted by an early and severe flu season.
“we’re supporting ahs in responding to the strain at our two children’s hospitals, including temporary measures to add capacity to care for the sickest kids,” wrote buick.
 exterior of rotary house near the alberta children’s hospital in calgary on sunday, december 4, 2022.
exterior of rotary house near the alberta children’s hospital in calgary on sunday, december 4, 2022. jim wells/postmedia

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other children’s hospitals across canada are also contending with high pressure during the ongoing respiratory virus season.
ottawa’s children’s hospital, cheo, announced saturday it will accept staffing help from the canadian red cross to weather that storm. ahs said sunday it hasn’t called red cross for help at alberta children’s hospital.

fullerton encouraged parents to visit their heal webpage at ahs.ca/heal to access information about how to treat children at home, and when to seek care at the emergency department.

she also asked parents to immunize their children against influenza and covid-19.
smart said immunizations are vital to combat viral illness, as are health measures like mask-wearing, hand-washing and staying home when sick.
she added it’s hard to predict when pressures from the surge in respiratory illness 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 deal with,” smart said.
— with files from dylan short and matthew black
twitter: @jasonfherring
jason herring
jason herring

jason herring is a reporter and editor at the calgary herald and calgary sun, joining the papers in 2019. he graduated from the university of calgary, where he was the editor of the school's student newspaper, the gauntlet. he is an avid cinephile and an amateur crossword puzzle constructor.

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