𝗪𝗶𝗻𝘀𝘁𝗼𝗻 𝗣𝗼𝗻

🚨 BREAKING NEWS 🚨

With a vision and some elbow grease from the Chinatown Transformation Collaborative, they were able activate and bring this area to life with their annual Edmonton Chinatown Dragon Festival. youtu.be/V1rB8s8T24M?fe…

Well done Chief! Disregard your Mayor, who is just pandering to antisemites and supporters of banned terrorist groups.

@chriscurtola Congrats!

We Did It! 💍

O Canada plays for the first time at #MilanoCortina2026 🇨🇦🥇

Dear Premier @ABDanielleSmith, You have taken full control of Alberta’s health system and appointed four ministers to run it. Right now, their public statements directly CONTRADICT each other. Hospital care is simple: INPUT → THROUGHPUT → OUTPUT • Input: Primary care & prevention (@AdrianaLaGrange) • Throughput: Hospitals & ERs (@MattJonesYYC) • Output: Seniors care & community placement (@JasonNixonAB) If OUTPUT (moving ALC patients who no longer need acute care) is truly improving, then THROUGHPUT and INPUT (moving admitted patients from the ER to a hospital ward bed) must also improve. Right now, we are not seeing that in the front lines. That contradiction sits between your ministers: • Minister Nixon claims ALCs are at historic lows and Alberta leads Canada. • Minister Jones oversees hospitals where: – ER beds remain full of admitted patients – EMS still cannot offload – Waiting rooms remain unsafe – Preventable harm and possible deaths linked to access delays continue to occur BOTH CANNOT BE TRUE. Either: • ALCs are not improving in real operational terms, • Hospitals are not being managed based on reality, • Or the numbers being presented do not reflect what is happening at the bedside. Albertans deserve to know which. Dear Minister @JasonNixonAB, You claim Alberta now has the “lowest ALCs in Canada.” I acknowledge that claim based on your press conference and slides, and I am calling “BULLSHIT” unless it is proven otherwise. If Alberta truly has the lowest ALC rate in Canada, release your current data using the SAME rules you used in AUGUST: • No reclassification • No relabeling • No new categories like “TWA” • No shifting ALC patients to “acute” • No redefining who counts as an emergency inpatient • Just an honest, apples-to-apples comparison Because frontline leaders are reporting: • ALC patients being reclassified as “acute” • ALC patients discharged, returning within days, then counted as acute • Truly ALC patients arriving through ER recorded as acute admissions • Emergency in-patients (EIPs) being renamed as TWAs (Transfers Waiting Admission) That does not fix patient care. That fixes spreadsheets. The real health system performance measure is simple: How fast do admitted patients leave the ER and reach a ward? • World-class systems: 4 hours, 95% of the time • Alberta’s historical target (Stelmach era): 8 hours, 90% • Yet Alberta continues to see boarding measured in days, not hours (see attached slides below - 6 month old data) Two weeks ago, I personally saw patients boarded in ER for 5–6 days. Your timing matters: • There was a sharp drop in ALC numbers on December 15, which you publicly celebrated. • Mr. SreeKumar died on December 22 after eight hours of suffering in an overcrowded ER. • At least six more deaths and multiple serious harms have followed. Is that really success? It's actually system failure. About optics versus reality: • Communications teams may spin this. • But Albertans are not naïve. • Especially rural Albertans, who depend on Edmonton and face the highest risk. • Edmonton receives roughly four times the out-of-region transfers compared to Calgary. So here is the ask, PLEASE: • Stop managing optics. • Stop massaging numbers. • Start managing the flow of real people. Solutions: 1. Focus first on low-acuity ALC patients who can be moved quickly with expanded transition beds, rehab, home care and assisted living. 2. At the same time, prevent the admission of medically well but fragile seniors by supporting 24/7 multidisciplinary home-care teams using the "Home First model" that has already been repeatedly recommended to you. The Danish do this well. 3. Expand multi-discipolinary home care so fragile (non acute) patients do not need to be brought to the ER by EMS in the first place. This is about the safety of Albertan families at the most vulnerable times in their lives, not political optics. Albertans deserve truth, and more importantly, access to the world-class care we are capable of delivering in a timely way. This challenge applies to both ministers: • Minister Nixon: prove ALC success using August definitions. • Minister Jones: please explain why hospitals remain unsafe if ALCs are truly fixed. Either the data are wrong, or the system is being misrepresented. Albertans deserve clarity. As a child, I once misrepresented a quarrel with another friend. My grandfather sat me on his lap and said: “Son, there are three things in this world you cannot hide:The SUN, the Moon, and the TRUTH.” @pfparks @JMeddings @BradenMannsYYC @NightShiftMD @TheSGEM @TheBreakdownAB @ryanjespersen @cspotweet @AndrewSchultzWX @Albertadoctors @UnitedNurses @HSAAlberta #AbHealthCrisis #StateOfEmergency #PatientSafety

Two triage RNs at Royal Alexandra Hospital in Edmonton say they've had 120 patients IN THE WAITING ROOM because there's no room inside the ER. How do you keep track of ALL of them? This week on @cbcwhitecoat podcasts.apple.com/ca/podcast/the…

Alberta ERs are described as "death zones" in a shocking report leaked to #RealTalkRJ. Dr. @PfParks calls out the province following six deaths and 30+ "near-misses" over two weeks. 👀 FULL: rtrj.info/012226Parksy 🎧 FULL: rtrj.info/012226 #abhealth #abpoli #ableg #yeg

Once Albertans get into care, THE CARE IS EXCELLENT thanks to the skill and dedication of frontline STAFF. The crisis is **getting in**. Minister @MattJonesYYC says “the system has not collapsed” and negative outcomes are a “fraction of a percent.” In medicine, collapse means **predictable, preventable harm** because DEMAND EXCEEDS SAFE CAPACITY. There is no acceptable rounding error when human lives are involved! Right now: • Hospitals are at ~110% capacity • ER beds are occupied by admitted patients → critically ill wait hours → at least 6 preventable deaths and many "near misses" have occurred in our ERs in just 2 weeks • EMS is unable to offload → ambulances stuck → delayed 911 response • Surgeries are cancelled or postponed • ALC seniors are warehoused for months • People are dying in waiting rooms That is functional collapse of patient safety. This is a medical and operational definition, not political spin. If the system were safe, we would not debate terminology. We would measure and fix: • ALC clearance time • ER boarding duration • EMS offload delay • Preventable waiting-room harm Solutions are known and proven: 1. Fund the system to match population growth, inflation, aging, and technology, your own data shows we have not. 2. Staff it adequately, impossible without proper funding. 3. Invest where it matters: home care, rehab, community support, primary care, prevention. Is this in @JasonNixonAB 's & @AdrianaLaGrange 's budgets? 4. Publish transparent data and enforce real KPIs with accountability. I don't see this on the new dashboard. Ministers @JasonNixonAB and @MattJonesYYC , yes we do need real reform! Alberta runs a **PUSH** system. High-performing systems run a **PULL** system. Here, community care pushes patients in. Strong systems are rewarded for pulling them out and penalized for pushing them back. Facts from your own data: • 26.3% Edmonton acute beds ALC (655 / 2,486) → hospitals cannot function as acute facilities. • 80–100% ER beds occupied by admitted patients → ERs become inpatient wards. • No bed → no offload → delayed 911 → preventable deaths at home. This is **BIG FLOW FAILURE** - not a FLU problem. Three universal KPIs every high-performing system uses: • 1. ALC cleared within 24–48 hours (90–95%) → beds free • 2. Admitted patients to ward within 6–8 hours (90–95%) → ER restored, harm drops • 3. EMS offload within 45 minutes (90–95%) → ambulances back, response times recover In top-performing systems, politicians are not involved in day-to-day operational control. Clinical and operational leaders run flow, safety, and capacity using real-time data and evidence, not political directives. Alberta’s fragmentation into **four separate health ministries** and **seven regional corridors** creates confusion, accountability gaps, and operational silos - a proven recipe for chaos and disaster, which is what we have now. My question for leadership: Why is this flow logic still disputed when the data are so clear? Premier @ABDanielleSmith , this is the system Albertans are living in. “Trying something new” scribbled on a napkin is not reform. It is gambling with lives and $30 billion of public money. Listening is not reform. **Implementing decisions that restore access is.** We need: • An Emergency Session of the Legislative Assembly • A declaration of a Medical #StateOfEmergency • Return of operations to an independent, expert Authority (Health Services Alberta – HSA) whose sole mandate is flow, safety, and capacity Politics sets values, policy and budgets. Operations protect runs the health system and is held accountable. @nenshi @PfParks @Albertadoctors @UnitedNurses @Jmeddings @BradenMannsYYC @ryanjespersen @TheBreakdownAB @cspotweet @RickBellwrites @Alberta_UCP @albertaNDP

It's good that doctors in Alberta are raising concerns about patients dying while waiting in ERs. Doctors across Canada should be doing the same. It's been happening across the country for years and we've been documenting waitlist deaths in our annual "Died on a Waiting List" reports. Even better though – health reform to prevent the problem. Here's today's news release – secondstreet.org/2026/01/20/doc…

Leaked Report: Albertans Dying Waiting for Healthcare x.com/i/broadcasts/1…

I'm still scratching my head that our Province's Minister of Assisted Living doesn't seem to fully understand a CRITICAL ASPECT of hospital/ED overcrowding, and that it is HIS team that must understand this... Couple things worth repeating for @JasonNixonAB and ALL ABs: 🧵

Again: Doctors finally crack the shell of secrecy around deaths from long ED waits. These tragedies say hidden unless families speak out, as one did in the Edmonton case. Now docs test privacy limits. Column. calgaryherald.com/opinion/column… #abhealth #ableg #abpoli #cdnpoli #yyccc #yeg

My letter in today's Globe:

PLEASE REPOST to MINISTER @JasonNixonAB (Policy Advice #2. ALC & the ER CRISIS are a REHAB & HOME CARE CAPACITY FAILURE. Minister Nixon, Premier @ABDanielleSmith suggested we meet and we did. This is the advice that was given, but not implemented. Minister @MattJonesYYC & The acute care system depends on YOU to get this right! ALC (fragile seniors in acute care beds) is not an LTC (Long Term Care) shortage problem. 1. We have now established that the ALC patients under your care are the cause of the ER/EMS crisis, surgical delays, prolonged waits for critically ill patients, and preventable harm and deaths in waiting rooms...and the reason everyone is calling for a medical #StateofEmergency to restore safety to the health system. 2. Your ALC strategy MISUNDERSTANDS FLOW, starting with the longest-stay ALCs slows system relief. Saying “there are no ALCs in the ER” is simply false. We call them “failure-to-thrive.” 3. You fix flow by moving the FASTEST & EASIEST first (“low-hanging fruit”) not the longest and hardest to place as is your policy. 4. For a fragile NEW ALC patient who could go home, every unnecessary day in acute care increases the chance they never will and after one week, the risk of permanent loss of independence rises sharply. 5. Whether intended or not, this policy converts independent seniors into permanently institutionalized patients. 6. The unintended consequence is a COLLAPSE of the SAFETY of the acute care system. 7. Edmonton ALC reality (your data attached): Total ALC: 655. Short-stay and easily movable: 426 (65%) • <72 hrs: 93 • 3–7 days: 93 • 8–30 days: 240 8. These fragile seniors are the: - least de-conditioned - most likely to return home - fastest to place - highest impact for freeing beds. - Edmonton has 275 ER beds. - Move these patients and ER/EMS flow is restored, surgical delays fall, and preventable waiting-room harm and deaths decrease. 9. ALC isn’t a “bed problem", It’s a PATIENT SAFETY + FINANCIAL FAILURE for fragile seniors problem: - Delirium —> permanent cognitive decline - De-conditioning —> loss of mobility - Falls —> fractures/head injuries - Hospital infections —>prolonged illness/death - Malnutrition/dehydration —> weakness/confusion - Pressure ulcers —> pain/infection - Loss of continence/confidence —> permanent dependency - Conversion from independence to institutionalization For many seniors, the hospital stay becomes the disabling event. “An ALC bed is a slow injury unit.” 10. Cost reality (approx). Setting Cost per day: - Acute care (ALC in hospital)$730–$1,200 - Long-term care$225–$250 - Transitional / rehab care (temporary) $300–$450 - Expanded home care$80–$200 (often less) That’s 3–5X the COST for WORSE outcomes, more dependency, and an ER/EMS/Acute care/Surgery crisis. We are spending the most money in the place that causes the most harm, to seniors who mostly don’t want OR need to be there. 11. Key truth: ~75% of ALC patients could go home with: * Expanded home care * Rehab * Transitional care * Hospital-at-Home * CHOICE Program - respite career for the caregiver 12. Only ~25% of ALC patients truly need LTC. ALC is not an LTC shortage issue, It’s HOME-CARE CAPACITY FAILURE disguised as a hospital crisis. This is your responsibility. 13. With respect to LTC, the data shows that unfortunately 50% of seniors in LTC die within 2 years. Please audit the current beds to ensure that they are at full capacity to place the longer stay patients. 14. Lower Cost Solutions (no new buildings required): A) 24/7 multidisciplinary community teams linked to ERs to prevent “failure-to-thrive” admissions (home care can’t be banker’s hours). B) Immediate transfer pathways at ALC designation (home care / rehab / transitional / Hospital-at-Home/respite care for the caregiver) before seniors decondition. C) 24/7 RNs in assisted living + NP/PCN linkage + mobile lab/X-ray to pull seniors out of hospital faster (Denmark does this well). I am happy to meet you again, to discuss further low cost and high impact solutions. P.S. #1 Below are the slides: 1. Your ALC data Dec 11th. 2. August Hospital capacity >100% 3. August Emergency Left without Treatment. 4. August ER CTAS Acuity (1,2 and 3 are up) P.S. #2 Premier Smith, I will also share this with you directly by text. @AdrianaLaGrange @AHS_media @albertadoctors @UnitedNurses @PfParks @JMeddings @BradenMannsYYC @NightShiftMD @TheSGEM @TheBreakdownAB @ryanjespersen @cspotweet @DonBraid @RickBellwrites @albertaNDP @Alberta_UCP #AbHealthCrisis #ALC #PatientSafety #ERCrisis #YEG #StateOfEmergency

Alberta govts & AHS have known for at least 10 years that Edmonton is dangerously short on hospital beds. I wrote this article about it 3 years ago. The UCP cancelled the South Edmonton Hospital and started an Alberta is Calling campaign. #ableg ctvnews.ca/edmonton/artic…

Primary Care, Recovery, and Assisted Living Ministers don’t say anything as they don’t even think they’re part of the solution to the crisis… Fast forward to today: Minister Jones admits there’s still work to do… Maybe it was the Premier who was misguided? 10/10

Fast forward to a crisis of capacity and overwhelming pt volumes: docs say there’s no integrated control, GOVT says “there has to be and of course we are using it”, AHS and CH say nope we don’t have it. ACA says “we’re just about governance”. 9/10

Premier happy cuz AHS has been slain, and moves on to visiting Trump or appeasing separation, and doesn’t care about integrated operational control or making sure the HC system works as a system... 8/10

What role did the new ACA play, and could it control some of the other silo's functions in real time when needed?… and so on and so on… But what we got regarding integrated control is FUBAR. 7/10

To quote a very senior and experienced HC leader, “with refocusing the govt F’d this up”. They were asked again and again who would do this role? How would the IOCs connect among many service providers, and four different silos, and across all the broken apart corridors? 6/10