Tag Archives: C-Difficile

Outbreak equals opportunity

It’s the things that go wrong in the health system that often preoccupy us.

While we frequently look for big answers, it is often in the everyday efforts that real change is taking place.

In the past we have seen some hospitals react to funding restraint by simply hacking off clinics or beds, as if they were sawing off a piece of sausage.

Many more have been undergoing process changes that appear to be paying off in both savings and quality of care. This story is just one of many.

Recently Lakeridge Health won an international award for its efforts to reduce incidents of hospital acquired C-Difficile.

Rather than cutting off another piece of the sausage, Lakeridge actually added a second pharmacist to its now three-member anti-microbial stewardship team. That investment is paying off.

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OHC Lobby: MPPs reluctant to halt hospital bed cuts

Yesterday 120 Ontario Health Coalition members entered Queen’s Park to meet with 70 MPPs a day after one of the most controversial provincial budgets in recent history. There are a total of 107 MPPs in the legislature.

With health care funding falling below that recommended by the Drummond Commission on Public Service Reform, one opposition MPP told his visitors, “there is a significant bump in the road coming.”

The lobbyists arrived at the MPPs offices to talk about jammed hospitals; thousands on wait lists for nursing home beds, and severely rationed home care. They also expressed their concerns about the prospects for increased privatization.

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High occupancy rates roll the dice on hospital-borne infections

Hospital C-Difficule-related deaths are making the news again in Ontario.

This time hospitals in Niagara and Guelph are reporting deaths related to clostridium difficile, a bacterial infection for which symptoms include diarrhea, fever, and abdominal pain. The OHA is reported to have said that 16 hospitals are now struggling with C-Difficile.

C-Difficile spores are very difficult to clean, and can remain viable outside the body for a very long time.

It’s stating the obvious that hospitals need to maintain rigorous infection control policies – something they appear to be learning following years of ill advised cuts to cleaning staff.

Many countries believe reducing hospital crowding can also reduce chances of infection. In the UK, for example, hospitals are supposed to maintain an average occupancy rate below 85 per cent. Several years ago it was considered a national scandal when it was reported numerous hospitals were operating above that threshold.

In Ontario we continue to roll the dice on the issue of hospital occupancy, maintaining an average rate of more than 97 per cent.

Not only does the evidence suggest that such crowding leads to the spread of hospital-borne infections like C-Difficile, but it also leaves the hospital few options when seasonal surges of demand take place.

The Ontario government is trying to clear out beds occupied by so-called “alternate level of care” patients. These are people who have completed their acute care treatment, but are physically not well enough to go home. Many are waiting for long term care beds, some are waiting for home care.

This may give hospitals some additional capacity and lower occupancy rates – provided the bean counters don’t see any capacity as potential waste and close more beds.

By taking the ALC patients out it may have another unintended consequence: when seasonal surges do take place, the hospital will have less flexibility to clear beds if they are completely occupied by patients who have to be there for treatment. That means more patients in the hallways where cleaning may not be as rigorous and infections more likely.

Hospital-borne infections just make matters worse on the patients, on over crowding, and on the budgets administrators have to work with.

You can’t run a hospital like a hotel. Penny pinching only leads to higher longer term costs, sometimes tragically in the form of lives taken.