Patient-centred care is the first of eight priorities for the province’s health system, yet the strategy wasn’t apparent in a recent incident involving patients treated at the Prince Rupert Regional Hospital.
After more than 100 patients received a letter from Northern Health informing them they were treated with an improperly cleaned endoscope, some patients were left more confused by the information they were provided.
The Ministry of Health laid out framework to improve patient-centred care in February 2015, and although it stated that it will take time to implement such changes, more than a year later, Northern Health still shows signs for improvement.
One of the core principles of patient-centre care is information sharing. “Participative communication of timely, accurate and complete information with patients and families on what decisions are to be made, and validating with patients and families what they have heard and understood,” states the B.C. Ministry of Health in the framework document.
In the recent case, 104 patients were sent a letter by Northern Health informing them that there was a process error in the cleaning steps after the endoscope was used to examine the nose and throat at the Prince Rupert Regional Hospital. The letter didn’t inform them of what cleaner was used in error, how many were affected, during what period of time and why “the risk of exposure to any viruses is extremely low.”
As a result, one of the patients, Joan Dudoward approached the Northern View to vent her frustration after seeking more complete information from Northern Health. Northern and rural critic to the provincial government, MLA Jennifer Rice, was also inundated with concerned patients who were looking for more answers.
“From my point of view, there are two issues: one is the lack of proactive response from the health authority. Patients have contacted me to say that they’ve called and asked, ‘how many people were impacted’ and were told, ‘well, we can’t answer that’,” Rice said.
The other issue she raised was that although Northern Health states in the letter they are informing the patient “for the sake of transparency” they’re not answering people’s basic straightforward questions, even when patients called the number for the director of acute care services that was provided with the letter.
Affected patients were told to contact their family physician if they have any questions about treatment or testing but as Rice pointed out, it often takes several weeks to make an appointment to see a physician in Prince Rupert — and some people don’t have a family doctor and have to go to the emergency room at the hospital to see one.
Rice said that a senior manager at Northern Health informed her that the BC Centre For Disease Control sent specialists to Prince Rupert to brief physicians on the situation, and Rice wants to know why they weren’t made available to the pubic.
“People are sent in all these confusing directions when the experts were here and they could have provided an opportunity to clarify instead of create confusion,” she said.
From Northern Health’s perspective
In a follow-up conversation with the vice-president of medicine for Northern Health, Dr. Ronald Chapman, he stated that they generalized details in the letter on purpose to encourage patients to bring the discussion to their physician.
“If people want more details they’re welcome to ask for it but basically that was the reason we just kept it at the general level,” Dr. Chapman said stating that the wrong cleaning solution was used. “The descaling solution also basically kills bacteria and viruses just not to the same degree as the other disinfecting cleaner.”
The letter did not mention that a descaling solution was used nor did it explain that it also kills viruses. These details are what some of the patients, including Dudoward, was looking for.
Northern Health had a similar process error between 2012 and 2014 when more than 10,000 procedures were performed at the University Hospital of Northern B.C. in Prince George using an improperly cleaned endoscope. The notice to patients was released on Jan. 14, 2015 to inform them of the error that occurred in the pre-cleaning step.
“If it’s a procedural problem or is it a lack of training problem then what we try and do is improve the procedures or we improve our training to make sure that doesn’t happen again. For us it’s important that we want to avoid mistakes, but we want to make sure we learn from them so that we hopefully don’t repeat them again in the future,” Dr. Chapman said on Tuesday.
After the mistake occurred in Prince George and a similar mistake was then repeated in Prince Rupert, Rice sent a letter to the Minister of Health, Dr. Terry Lake, to voice her concern.
“The responses that patients and family members of affected patients are receiving from the health authority in the wake of receiving this correspondence is not helping to resolve their worries, but rather is adding to them,” Rice wrote adding that the health authority needs to rebuild lost trust with patients.