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This year, beleaguered B.C. hospital resorts to its lobby for emergency care

The perpetually beleaguered emergency department of crowded Royal Columbian Hospital has chalked up another dubious achievement, and this one does not involve a double-double.

Last March, the hospital provoked headlines across Canada by treating overflow emergency patients in an adjacent Tim Hortons coffee shop.

This week, it was the turn of the hospital's front lobby to serve as an impromptu emergency ward. In a first for Royal Columbian, five beds and a set of privacy screens were installed in the lobby Tuesday to accommodate a surge of patients with nowhere else to go.

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"It may not be the most private care.… [and] it's not what we would want for our patients and their families, but they need care and we've got to make sure they get it," said Anne Clarke, medical director of Fraser Health Authority's emergency program.

Emergency visits are increasing about 6 per cent a year, with little additional capacity, and this is usually the department's busiest time of year, Dr. Clarke said.

"I've been doing this for 25 years, and I must say, it seems to get a little worse every year," she said.

Although the crisis had eased by Wednesday, deputy NDP health critic Sue Hammell said the congestion was a clear signal of the provincial government's failure to provide enough hospital beds in the fast-growing region.

"The Liberals have known about this for years, yet they continue to drag their feet," Ms. Hammell said. "It's only a matter of time before the next crisis occurs."

Despite the ongoing problems at Royal Columbian, the provincial government continues to sit on the Fraser Health Authority's request for a major expansion of the aging hospital.

Health Ministry spokesman Ryan Jabs said the government needs to weigh the expansion proposal against other capital priorities "and the reality of our fiscal situation."

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Dr. Clarke said patient overcrowding in emergency is particularly acute at Royal Columbian, because the hospital is the region's tertiary care centre. That results in more demand for the hospital's 416 acute-care beds.

"It's not as if many patients we get there can be sent somewhere else," Dr. Clarke said. "RCH desperately needs that expansion."

A total of 20 patients were cared for behind the screens in the public lobby, before being moved to emergency for further treatment.

The hospital's decision to move stretchers into the coffee shop last spring became a feature of the NDP's federal election campaign, as then-leader Jack Layton railed against what he called "Stephen Harper's Tim Hortons health care."

While the outlet remains an option for extreme congestion, it was not used this week because the needs of the patients shunted to the lobby were different, Fraser Health Authority spokesman Roy Thorpe-Dorward said.

"[The lobby] was a place for stretchers to be offloaded from ambulances and wait for triage," he explained.

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During the winter, Fraser Health has an average of 70 to 100 emergency patients every day who wind up in a hospital overflow area, according to Mr. Thorpe-Dorward.

But even Royal Columbian's overflow spaces were full earlier this week, forcing the lobby into service for the first time.

"When we experience surges in winter and post-holiday periods like this, it shows up in the system," Mr. Thorpe-Dorward said. "It also sends a message that Royal Columbian Hospital, in particular, is a priority for expansion."

The temporary ward in the lobby has now been closed, but Dr. Clarke said she expects it will be needed again as winter continues.

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