UNI VE RS I T Y OF AL B E RTA

Dr. Douglas Hedden

2D2.24 WMC
Stollery Childrens Hospital
8440-112 Street
Edonton! "#
$%& 2#'
(E) Stollery Childrens Hospital
Dear Dr. Hedden)
*n Septe+er ,! 2014 t-enty-one e+ers o. the di/ision o. pediatri0 surgery et to dis0uss issues
that ha/e in0reasingly ipa0ted the deli/ery o. 0are -e are 0urrently a+le to pro/ide to the population
o. 1orthern "l+erta.
2n re/ie-ing the population data in the Stollery Childrens Hospital 0at0hent area +et-een 200432004
5n 6 824!7'78 and 0oparing this to the re0ent 201732014 0ensus 5n61!04%!7'88! -e note a 709
in0rease in the population o..ered e:pert 0are at the Stollery. $his su+stantial in0rease in population
nu+er is .urther re.le0ted in the '.49 in0rease the 0ity o. Edonton alone e:perien0ed this past year!
a;ing Edonton the .astest gro-ing 0ity in Canada. <urtherore! -e 0an anti0ipate in0reased
utili=ation +y 1orthern "l+ertans -ith the re0ently reported 44!000 deli/eries in the greater Edonton
area o/er the past year. $hese nu+ers do not re.le0t the su+stantial iport o. patients .ro 1orthern
#ritish Colu+ia! Sas;at0he-an! 1orth-est $erritories! and regions o. Manito+a. (e0ent data at the
Stollery reports a 779 adission rate to the intensi/e 0are en/ironents .ro out-o.-pro/in0e!
re.le0ting the e:pertise o..ered at Stollery that is not a/aila+le else-here.
We ha/e +een .ortunate that -e ha/e +een a+le to re0ruit outstanding spe0ialist that o..er 0are
unparalleled in Western Canada! no- a;ing us the se0ond largest pediatri0 >hospital? in Canada
5$oronto Si0;;ids! n6244 +eds8 -ith appro:iately 224 +eds at Stollery. <urtherore! tertiary pediatri0
0enters outside o. "l+erta o.ten ha/e a00ess to >sister? institutions that allo- trans.er o. non-a0ute or
less 0ople: surgeries@ there+y allo-ing 0ople: patients appropriate a00ess to 0are reAuired. "s you
-ell ;no-! this does not e:ist in "l+erta. *ur e:pertise is su0h that no- alost 409 o. our a/aila+le
+eds are 0riti0al 0are le/el. $his disproportionate nu+er o. 0riti0al 0are +eds to in-patient +eds re.le0ts
the 0ople:ity! and there.ore resour0e intense patients that 0oprise our >regular? -or;load.
<urther analysis o. a/aila+le statisti0s -ill deonstrate total operating a0ti/ity in 200432004 5n6%!484
0ases annually8 in0reased signi.i0antly in 201732014 5n6,!0%8 0ases annually8! deonstrating a 789
52!487 additional 0ases per year8 in0rease in o/erall /olue! re.le0ting the population gro-th and
iport o. 0ople: patients. Bn.ortunately! -e ha/e not e:perien0ed a proportional gro-th o. the
Stollery physi0al plant! in parti0ular the in-patient +ed allo0ation. <urtherore! e/aluation o. the
postponeent30an0ellation data o/er the last 4 onths 5"pril C "ugust! 20148 alone deonstrates an
alaring trend. */er this +rie. period -e ha/e e:perien0ed 28, 0an0ellations! o. -hi0h 111 -ere
UNI VE RS I T Y OF AL B E RTA
dire0tly attri+uted to the la0; o. a/aila+le post-operati/e +ed. $he ipa0t o. this 0an0ellation rate on
.ailies 0annot +e ephasi=ed enough.
"lthough it is tepting! +ased upon the last se/eral onths o. a0ti/ity! to +lae our liitations on the
0ondition o. our operating .a0ilities! and the liited nu+er o. -or;ing theaters! 2 -ould propose to
you that our signi.i0ant 0an0ellation rates are a sypto o. a u0h greater issue. "s suggested! -e
ha/e greatly in0reased our operati/e a0ti/ity o/er that last ten years despite the liited spa0e -e ha/e
a/aila+le in the pediatri0 operating area. With the planned re-de/elopent! -e -ill see an in0rease in
theater nu+ers and a su+stantial ipro/eent in *( Auality! and as su0h -e are li;ely to see an
e:aggeration o. the real issues -e .a0e! that +eing the inadeAuate a/aila+ility o. in-patients +eds. 2
-ould suggest the 0ulprit that a..e0ts the a+ility to pro/ide >+est? 0are is no- .irly rooted in the la0;
o. physi0al spa0e. "gain! it -ould +e tepting to suggest that perhaps there is a need .or ore intensi/e
0are +eds. Ho-e/er! 0onsider that .or se/eral -ee;s this suer! as any as 11 o. 14 D2CB patients
-ere a-aiting trans.er to the in-patient -ard! -ith the resultant 0an0ellation o. surgi0al 0ases. Ho-e/er!
the issue -as not anpo-er! or -illingness o. ser/i0es to attept 0reati/e solutions! +ut rather
una/aila+ility o. physi0al +eds on the -ards. Without the a+ility to a00oodate eergen0y edi0al
and surgi0al patients on the -ards! intensi/e 0are patients -ill +e relegated to prolonged! e:pensi/e and
unne0essarily long stays in the 2CB en/ironent! and ele0ti/e surgeries -ill +e 0orrespondingly
delayed30an0elled. $his does not re.le0t a standard o. 0are to -hi0h our institution should stri/e! -hile
attepting to pro/ide e:pert 0are to "l+ertans in a tiely .ashion. Bltiately! it is the patients and
.ailies that su..er. <ar too o.ten our patients -ait una00epta+ly long periods .or surgery! endure
eotional 0onseAuen0es and the .ailies ust .a0e .inan0ial hardships as a 0onseAuen0e o. tie a-ay
.ro -or; and tra/el! only to e:perien0e a postponeent in his3her 0hilds surgery. We! as a di/ision!
su+it to you! -ith our strongest 0on/i0tions that the status Auo 0annot 0ontinue and that appropriate
attention is dire0ted to ipro/ing and updating the physi0al plant su0h that -e 0an deli/er e:pert 0are
to .uture generations o. "l+ertas 0hildren. We loo; .or-ard to your thought.ul response.
$han; you .or your tie and 0onsideration. Dlease .ind the signatures o. the di/ision o. pediatri0
surgery. Ea0h e+er has re/ie-ed this letter! and is in agreeent -ith its 0ontent.
#ryan Di0;en 52nteri Chie.! Dediatri0 Surgery8 Easer "l (aFhi 5Dediatri0 *tolaryngology8
Geith "rony; 5Dediatri0 1eurosurgery8 2oana #ratu 5Dediatri0 Surgery8
Mathe- Carroll 5Dediatri0 &astroenterology8 Donald Di0; 5Dediatri0 *rthopedi0 Surgery8
UNI VE RS I T Y OF AL B E RTA
Su;hdeep Dulai 5Dediatri0 *rthopedi0 Surgery8 Eduard E;steen 5Dediatri0 *tolaryngology8
Hady El-Ha;i 5Dediatri0 *tolaryngology8 Mar; E/ans 5Dediatri0 Surgery8
(egan &uil.oyle 5Dediatri0 Dlasti0 Surgery8 Hien Huynh 5Dediatri0 &astroenterology8
Dar0ie Giddoo 5Dediatri0 Brology8 &ordon Hees 5Dediatri0 Surgery8
Iohn M02/or 5Dediatri0 *rthopedi0 Surgery8 Ji/e; Mehta 5Dediatri0 1eurosurgery8
Deter Met0al.e 5Dediatri0 Brology8 Mar0 Moreau 5Dediatri0 *rthopedi0 Surgery8
Iaret *lson 5Dediatri0 Dlasti0 Surgery8 Eli=a+eth Dedersen 5Dediatri0 *rthopedi0 Surgery8
(a+in Dersad 5Dediatri0 &astroenterology8 Ie.. Dugh 5Dediatri0 1eurosurgery8
Carlos Solarte 5Dediatri0 *phthalology8 $rina B-iera 5Dediatri0 *tolaryngology8
&ordon Wil;es 5Dediatri0 Dlasti0 Surgery8