SORC
Accepted
Geographic Context of Publicly Posted Complete Obstetric Service Unavailability in Alberta: A Retrospective Archive-Based Analysis
Tung A, Nurmambetova E, Zhang M.
Original Study. Poster Presentation. Accepted, Federation of Medical Women of Canada 2026 Annual Meeting.
Abstract
Background
Complete local obstetric service unavailability may require patients to seek care outside their community. We characterized the duration of publicly posted complete obstetric service unavailability in Alberta and the proximity of affected sites to another currently listed maternity-related service.
Methods
Using Alberta Health Services archived disruption snapshots and news or notice postings, we reconstructed intervals from August 1, 2021, to June 30, 2026, during which all local obstetric services or obstetric coverage were reported as unavailable. Repeated captures were reconciled, recurring schedules were expanded, and overlapping intervals were unioned within each site and calendar year. For each affected site, road distance and estimated driving time to the nearest other facility matching predefined maternity-related terms were calculated using a local OSRM automobile-routing matrix based on the Geofabrik Alberta OpenStreetMap extract and an AHS directory reviewed July 26, 2026.
Results
Thirty-six sites contributed 262,232 cumulative site-hours, representing 67.2% of reconstructed maternity-disruption site-hours. The median road distance to another currently directory-listed maternity-related facility was 77.7 km (IQR 41.2–89.7), corresponding to 61.5 driving minutes (IQR 34.2–72.7). Six sites were at least 100 road km away, and Slave Lake and Wabasca were at least 120 driving minutes away. Sundre, Rimbey, Three Hills, and Westlock contributed 157,896 site-hours (60.2%) but were 38.0–62.4 road km from another currently listed maternity-related facility.
Conclusion
Duration burden and geographic separation were distinct dimensions of publicly documented obstetric-service instability. Most cumulative hours were concentrated at four sites with shorter estimated driving times, whereas several lower-burden communities were more geographically isolated. Distances based on the current AHS directory provide geographic context only and do not establish historical service availability, actual patient travel, or clinical suitability.
SORC
In Progress
Temporary Emergency Department Service Disruptions in Alberta: A Retrospective Archive-Based Analysis of Burden, Distribution, and Stated Causes, 2021–2026
Tung A, Nguyen V, Zhang M, Beamish L, Cross E.
Original Study. In preparation.
Abstract
Background
Temporary emergency department (ED) service disruptions may limit access to emergency care, but their cumulative burden and distribution across Alberta have not been summarized at the system level. We quantified publicly posted ED disruption hours, timing, stated reasons, and geographic context.
Methods
We retrospectively reconstructed Alberta Health Services (AHS) temporary ED disruption postings from August 1, 2021, through July 31, 2026. We reconciled archived service-listing snapshots with the AHS news and notice archive, collapsed duplicate captures, and converted posted wording into dated intervals. Recurring schedules were expanded, intervals were clipped to the study period, and overlapping intervals within each site were merged. We summarized burden by year and site, stated reasons, time of week, timing structure, distance and drive time to the nearest listed ED, and concurrent disruption at that ED. One reviewer checked every reconstructed interval against its source, and a second reviewer audited 200 intervals. Analyses were descriptive.
Results
Forty-nine EDs contributed 160,798.7 unioned disruption hours. Annual burden was highest in 2023 (38,896.3 h) and remained high in 2024 (36,280.2 h) and 2025 (31,088.2 h). The five highest-burden EDs accounted for 93,307.5 h (58.0%). Workforce-shortage wording was linked to 128,902.0 h (80.2%). Reason categories were not mutually exclusive. Night accounted for 83,195.5 h (51.7%) of disruption hours, compared with 37.5% of study-period time, a 1.38 concentration ratio. Scheduled, Sustained, and Intermittent intervals accounted for 52.1%, 32.5%, and 15.4% of hours, respectively. Median road distance to the nearest listed ED was 49.6 km (IQR 40.6–76.9), and median estimated drive time was 40.6 minutes (IQR 34.1–61.3). Seventeen of 49 affected EDs (34.7%) had at least one period of documented concurrent disruption at their nearest listed ED.
Conclusion
Publicly posted disruptions were recurrent, concentrated at a small number of EDs, and often scheduled or sustained. Nighttime disruption was overrepresented, and 17 of 49 affected EDs had documented overlap with their nearest listed ED. These findings reflect public postings and do not establish actual service availability, patient travel, or patient outcomes. More consistent reporting of disruption timing, service level, and stated reason would improve surveillance.
SORC
In Progress
Rural Maternity Service Instability in Alberta: An Archive-Based Analysis of Publicly Posted Hospital Service Disruptions
Tung A, Zhang M, Nurmambetova E, Kornelsen J.
Original Study. In preparation.
Abstract
Background
Temporary hospital disruptions can affect local delivery care, caesarean capability, epidural access, and maternity backup. Alberta Health Services (AHS) publicly posts these changes, but their cumulative burden is not available in a single system-level dataset. We characterized publicly documented maternity-related hospital capability disruptions across Alberta using archived records.
Methods
We conducted a retrospective descriptive reconstruction of AHS temporary service-disruption postings from August 1, 2021, through July 31, 2026. We included postings explicitly affecting maternity care, labour and delivery, caesarean or operative maternity capability, epidural access, or maternity backup. Snapshot and notice records were standardized by site, deduplicated, and reconstructed into dated intervals. Reopening notices and subsequent postings were used only when they provided source-supported evidence of a changed endpoint. Overlapping intervals at the same site were unioned to estimate unique site-level disruption hours. Capability layers overlap and are therefore not additive.
Results
Across 45 sites, 520 reconstructed disruption periods contributed 394,216.2 unioned disruption hours. Annual burden was highest in 2022 at 92,570.5 h and remained substantial in 2023 (85,798.5 h), 2024 (76,257.5 h), and 2025 (74,182.8 h). 38,536.0 h were recorded through July 31, 2026. The highest cumulative burdens occurred in Sundre, Rimbey, Three Hills, Slave Lake, and Westlock. Disruptions affecting all obstetric services and caesarean, epidural, or surgical backup capability were common, but layer-specific hours are non-additive.
Conclusion
Publicly posted AHS records show recurrent and sustained loss of maternity-related hospital capability across Alberta. Several high-burden sites reflect long posted suspensions, including intervals already active at the archive start and therefore left-censored. Capability-specific reporting better reflects operational changes that may affect local delivery access, while these public records do not establish real-time availability, patient outcomes, or a formal rurality classification.