Hospital quality issues picked out from the fast moving stream

We sometimes get asked about how we come up with stories for the Diablogue? For us, it’s not a matter of finding stories, but prioritizing material culled from a fast-moving stream.

Last week we focussed on the outrageous decision by Canadian Blood Services to increase imports of American-sourced plasma products while closing the last dedicated Canadian plasma donor clinic in Thunder Bay.

However, there are many issues out there, and only limited BLOG time for us. Here’s just a taste of some of the stories we missed last week:

Part of the fallout from the provincial budget is the decision to postpone a number of capital projects, including new hospitals. Nowhere is this being more felt that in Grimsby, where the community is upset that the new $138.8 million rebuild of the West Lincoln Memorial Hospital has been put on the shelf. The “Rallying for WLMH Committee” has called for a “massive rally” May 2nd. When the hospital faced closure in 1997, more than 7,000 people came out in a similar planned rally.

A new CIHI (Canadian Institute for Health Information) report raised eyebrows when Lakeridge Health and the University Health Network came out at the bottom of list of GTA hospitals. Lakeridge (with sites in Oshawa, Port Perry, Bowmanville and Whitby) pointed out that according to CIHI data, they were doing better than the provincial average on six of seven clinical performance indicators. That includes 80 per cent better than the provincial average when it comes to readmission after hip replacement surgery, and 30 per cent better on knee replacement surgery. An on-line tool that CIHI developed to rate hospitals crashed after it was swamped with users following a front page story in the Toronto Star.

We often forget that hospital labs can be dangerous places. Grand River found out the hard way last week when an illness-causing fungus was inadvertently released from a specimen container broken during disposal. Decontamination is now complete in microbiology, but as of yesterday, part of the lab remains sealed. Grand River is sending tests that cannot be performed to other nearby hospitals.

Last week the Ontario Health Coalition issued warnings about the impact of a budget freeze on hospitals. Health Minister Deb Matthews denied wait times would lengthen. She told Canadian Press: “I’m asking everyone who works in health care to ask two questions. The first question is, what’s the best thing for the patients? The second thing is, what’s the best thing for the taxpayers? So we need to get better patient care and we need to get better value for money.” To rein in expenses, labour negotiations with both union and non-union employees need to take into consideration the “financial circumstance” of the province, Ontario Hospital Association interim President Mark Rochon told CP.  Meanwhile, cuts are already being felt. Doctors are upset about the possible closure of two hyperbaric chambers at Hamilton General Hospital, which provide 1,400 treatments a year. Hamilton General president Teresa Smith suggested recently that patients could go to area private clinics instead. The doctors told the Hamilton Spectator private clinics aren’t regulated. They don’t tend to treat the same medical conditions as hospitals and for the most part don’t handle emergency or critically ill patients. Health Canada warns on its website that private clinics are “very expensive.”  Hyperbaric oxygen therapy can be used for everything from embolisms and carbon monoxide poisoning to enhancement of healing for wounds.

Given all the studies on the social determinants of health, it is no surprise that a recent study shows that where you live may be a factor in assessing your risk of cardiac arrest. The study, done by Toronto’s St. Michael’s Hospital, found people in central Scarborough, western parts of North York and north Etobicoke – all low-income neighbourhoods – had the highest rates of cardiac arrest – about 500 per 100,000 people. In the wealthier neighbourhoods, that number was closer to 160 per 100,000.

The Diablogue has written extensively on the issue of fresh food in hospitals. We noted that South Grey Bruce Health Centre was eliminating fresh food service at a time when hospitals across North America were returning to it. Both York Central and Scarborough General have generated news stories about improved patient satisfaction through improved food service. A recent feature story in Restaurant News highlights many of the benefits of this new trend, including less food waste and better nutrition for patients. “For years, whenever there was a need to have a budget cutback, the hospital would always take money out of foodservice,” Susan Bull, manager of the nutrition and food services department at Scarborough Genera, told the trade newsletter. In 1998, facing deep cuts, the hospital was forced to remove patient choice on meals. Given the province’s freeze on hospital base budgets, it will be a challenge to maintain patient-centered care when it comes to food service delivery. Meanwhile, OPSEU has asked for costs related to South Bruce Grey’s food services following its switch to frozen rethermalized food service. Letter writers in the regional media continue to criticize the hospital for its backwards move. “Anyone staying overnight or being admitted after designated meal times cannot expect even a cup of tea or toast as the facilities to provide these simple acts of caring have all been eliminated from the premises,” writes Fran Farrell of the Purple Grove Women’s Institute. Watch for more on this story in coming days.

Finally, while we are repeatedly told that hospitals must divest services to the community, we found a story about a hospital that has actually improved services to long-term care patients who are waiting for permanent placement in a nursing home. The Credit Valley Hospital and Trillium Health Centre just opened 21 new interim long-term care beds in West Toronto. Redesigned at the cost of $1.3 million, the facility is modest relief for the thousands waiting for a permanent bed.

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