From a number of vantage points, 2023 was the most positive and successful year for the Department of Emergency Medicine since the pre-pandemic year of 2019. Despite a number of new and continuing challenges the Department and its leaders rose to the occasion and took a number of pressing issues head on with impressive results.

Other departmental highlights included:

1. Reduced EMS turnaround times. A dramatic improvement in EMS turnaround times. Paramedic teams, stranded in our ED corridors unable to unload patients for hours due to the ED being bed-blocked was one of the most vexing problems facing our EDs. We did however achieve a seismic breakthrough made possible by reorganizing nursing resources to allow timely handover and return to service for our EMS teams. Although there has been some “give-back” in the last months of 2023 we are very proud of this important achievement. 
2. Improved MD and Nursing staffing. While many other areas of the Alberta healthcare system are experiencing challenges on this front, our department is fully hired from a physician perspective and has seen marked improvement on the nursing front as well. We remain a 24/7/365 service to all Calgarians in need and function as the ultimate safety net for society. We don’t go on diversion and we don’t impose caps on the number of patients we see. 
3. Impact of the Health Action Plan focus on ED wait times. With ED visit volumes still generally below pre-pandemic levels it became abundantly clear that the ED wait time issue was directly the result of EIP burden hampering our staff’s ability to provide safe, effective and timely care. Fortunately, with a refocus on limiting the number of EIPs allowed to linger in the ED and consume precious resources we experienced considerable improvement over the first nine months of the year but those gains were unfortunately lost as Zone hospitals returned to operating at well in excess of 100% occupancy turning the emergency department into what often felt like the overflow department. Without a doubt SHC and PLC have experienced the brunt of this resurgence in EIPs.
4. Alberta’s highest performing urban Zone from an ED perspective. With an aligned and collaborative governance structure, the Zone Department of EM has consistently been able to achieve high levels of operational performance as well as inpatient experience and quality of care indicators in comparison to our neighbors in Edmonton Zone who experience unique challenges. Alberta is now performing as well as or better than any other province with a population in excess of one million inhabitants.
   https://focus.hqca.ca/charts/length-of-time-admitted-patients-wait-for-hospital-bed/ 
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5. Physician and AHS Leadership engagement in landmark Town Hall. Following the publication and coverage of a widely read public letter. https://www.cbc.ca/news/canada/calgary/calgary-doctors-warn-emergency-rooms-collapsing-1.6852938 Senior AHS officials met with a large and engaged group of Emergency Physician to discuss a range of concerns; many of which have translated directly into changes in communication strategies and departmental policies.
6. Completion of the WellDoc Alberta assessment of MD well-being. While the results were not easy to read, you can’t improve what you don’t measure. In 2023, we completed and shared a 2022 assessment of burnout amongst our physician group which confirmed high rates in line with what other Canadian jurisdictions have reported. Here again the results were taken to heart by the ED leadership team and strategies to address them have been put into effect.
7. Return of the ED Gala. After a four-year hiatus, the MD gala organized by a dedicated organizing committee led by Dr. Laurie-Anne Baker returned with a bang. 
8. Our leadership team stable, vibrant and engaged. We welcomed Emma Folz and said goodbye to Karen Foudy in the portfolio lead dyad role for the Zone Department of EM. Emma joins Michael Suddes as the co-operational dyad lead for EM. We said goodbye to long-serving Deputy DH Neil Collins and welcomed James Andruchow in assuming that role. We also welcomed Drs. Andrea Boone and David Mainprize to the FMC Site Chief and Assistant Site Chief roles and congratulated RGH Site Chief Nancy Zuzic for also taking on the Medical Leader Physician Relations and Planning role with Medical Affairs. Late in the year we learned that Dr. Shawn Dowling was the successful applicant and will be taking on the role of Senior Medical Director with the Emergency Strategic Clinical Network.
9. Promotions. We saw the successful promotion of 13 of our clinical faculty to both the Assistant and Associate Professor level, seven of whom identify as women.
   https://cumming.ucalgary.ca/departments/emergency-medicine/kudos/academic-appointment-promotions-emergency-medicine 
10. Research achievements. In a dramatic 50% increase in our GFT contingent we were able to successfully recruit Dr. Jessalyn Holodinsky into our PhD Data Scientist position with a focus on ED crowding and operations research while supporting graduate students and building research capacity in our still non-AMHSP department.

In summary, 2023 was a year of accomplishments and improvement despite considerable challenges for our department. It also allowed us to transform these crises into opportunities and innovations that highlight and cement the critical role that our department plays in providing care for all Calgarians with emergency healthcare needs.

Dr. Eddy Lang
MDCM CCFP(EM), FCFP, CAHS, CSPQ, CSPL
Zone Clinical Department Head