Scarborough General Hospital has the highest rate of deaths in the Toronto area – and the third highest in Canada – according to a watershed report that made hospital death rates public last week.
It's the first time in history that a report of this kind this has been done.
The hospital with the lowest rate of deaths in the GTA is the University Health Network, which includes Princess Margaret, Toronto General and Toronto Western Hospitals.
The Canadian Institute for Health Information (CIHI) released mortality rates for 85 large Canadian acute care hospitals and 42 health regions in every province but Quebec, where they don't collect the same data. Health care experts say the figures, which show how effective hospitals are at avoiding preventable deaths, will force medical officials to examine their practices and improve patient care.
For years, Canadian hospital administrators have known what death rates were inside their hospitals, but unlike the United States and the United Kingdom, they were never made public.
The only hospital in the Greater Toronto Area that CIHI did not release figures for was the Humber River Regional Hospital.
"For this report we got our preliminary results back and when we saw them we said: Hold on, we've got some concerns here," said Gerrard Power, a hospital spokesperson.
"It's important all hospitals report the information so they can figure out the problems and fix them," said Dr. Alan Hudson, head of Ontario's wait time strategy.
"This is an absolutely crucial day for the province of Ontario. It is a major step," said Hudson, a neurosurgeon. "The whole process should be transparent. Taxpayers deserve nothing less."
The long-awaited disclosure follows a year-long Toronto Star investigation into medical secrecy that raised questions about a lack of public reporting in Canada. As part of the investigative series Medical Secrets, the Star urged CIHI to reveal hospital names with reportable data.
The provincial government has mandated that the 1st of April 2008 all Ontario hospitals report adverse events and death rates for certain procedures on their websites along with wait time information.
The CIHI study compares the actual number of deaths in hospital with the average Canadian experience. The numerical result is called the hospital standardized mortality ratio (HSMR). A score above 100 means a hospital is above the national average while a score below that figure reflects a lower mortality rate.
The University Health Network scored an 87, or 13 points below the national average of 100. For years, the UHN has reported patient safety data on its website, from hospital-borne infection rates to wait times.
The UHN has also brought in rapid response care teams, which have helped to bring down death rates at its hospitals. These are groups of intensive care doctors and nurses that can quickly respond to a patient experiencing anything from a cardiac arrest to a drastic drop in blood pressure.
Bell has been a vocal supporter of publicizing death rates. "The data reflects the comparative experience of patients in your hospital related to other hospitals," he explained. "This gives hospital caregivers and managers a concrete goal they can set objectives with and they can use to initiate quality improvements."
Many experts believe public reporting allows hospitals to compare patient outcome records, see where they rank on important indicators and spot trends that could lead to changes that better protect public safety. Public reporting also provides patients with access to information about potential risks and problems inside their local hospitals before they seek treatment.
The Scarborough Hospital's General site scored 134, while the Grace site scored 110. The hospital has suffered from management turmoil, as well as allegations of lax oversight of physicians.
Dr. Steven Jackson, chief of medical staff at the hospital, said management is committed to lowering the numbers and beating the national average. "Everyone is buying into this," he said. "Quality is where we are going."
The figures released last week are viewed as a key indicator of patient safety levels in hospitals, an area of growing interest for medical experts. Between 9,250 and 23,750 Canadian adults experience a "preventable" adverse event in hospital and later die, according to a 2004 CIHI study. Over the past three years – the period covered by the new data – more than 254,000 patients died in Canadian hospitals outside Quebec.
"Releasing these numbers across Canada is a big step forward," said Hilary Short, president of the Ontario Hospital Association, representing all hospitals in the province. "It's hard the first time you release a report like this," she said. "But once you start reporting publicly it really accelerates ... and it forces improvement."Now, for the numbers:
Canada's best and worst
The following hospitals had mortality ratios (excluding palliative care) ranking at the top and bottom of the list of 85 larger, acute care hospitals in 42 health regions across Canada (excluding Quebec), according to the CIHI survey of hospital deaths.
Top Five
1. The Moncton Hospital - Moncton, N.B.: 56
2. Foothills Medical Centre - Calgary, Alta.: 61
3. Regina General Hospital - Regina, Sask.: 71
4. Peter Lougheed Centre - Calgary, Alta.: 73
5. Saint John Regional Hospital - Saint John, N.B.: 74
Bottom Five
1. Grand River Hospital - K.W. Health Centre, Kitchener, Ont: 142
2. Niagara Health System - St. Catharines General Site, St. Catharines, Ont.: 135
3. The Scarborough Hospital - General Site, Toronto, Ont.: 134
4. Burnaby Hospital - Burnaby, B.C.: 125
5. Red Deer Regional Hospital Centre - Red Deer, Alta.: 125
5 comments:
I am a registered nurse who has been working since 1979 and 2 years ago my father who was 77 at the time suffered a fall at home. He was admitted to the Scarborough hospital and spent 6 days in the hospital recovering from broken ribs as the only injury diagnosed. The doctor attending to him in Emerg was trying to arrange for him to be discharged to a nursing home from the emerg department but because I alerted them to the fact that he was not having any urine output they inserted an IV. The result was that they pushed him into acute pulmonary edema because they did not keep proper records on his fluid balance. When I realized what crisis they had caused (since pulmonary edema is easy to spot if you have ever worked in ICU)I asked a coroner to look at the records and the coroner said the fluid balance sheets were missing from the chart. Foolishly I met with the hospital public relations person and the doctor in charge of his care and miraculously the fluid balance sheets appeared and were made out in such a way that it was obvious to me that they had been invented. My father drowned on IV fluids because of a failure to diagnose kidney trauma as well as negligence on the part of nurses to keep a legal part of the chart.The night my father went into acute respiratory distress my brother was with him and when he could not summon a nurse to come to the room he ended up calling 911 to ask them to call the emerg department of the hospital to send someone to his room. I also had to call the coroner myself as they did not call him after he died. I did this on the recommendation of his family Dr when he heard what had happened. Under the law anyone admitted to the hospital as a result of an injury and dying within days of admission needs a coroner report. The night my father died the nurse came in 2 hours after he died and after my family had told staff he had died to give him his medication. My family prevented me from taking the issue further as the way he passed away upset them so much. We were all traumatized at the lack of care and due diligence he received for reasonable care.
Here is what we have endured and are still trying to get some answers for.
A story about the Health Care System and the great lengths they will take to intentionally cover up their negligence.
The last year my mothers' life unfolded tragically due to the negligence of our health care system, specifically the Regina General Hospital. Our nightmare unfolds...In February 2007 Wendy McIntyre age 57 was taken into the Regina General Hospital Emergency department after falling and hurting her back at home. After examination she was sent home with no significant injuries and a prescription for morphine. My mother being a renal patient took her prescribed morphine pill at home that night. The following morning when she woke up she couldn't stand or walk on her own and she was incredibly disoriented. We called the ambulance who took her back to the hospital. The same doctor couldn't believe that this was the same woman he had seen the day before and she was admitted to the 3rd floor. She was given some sort of antidote to combat the effects of the morphine. For the next 2 weeks she remained in a state of dementia and was told that she may have suffered a stroke. During her confused state my mother thought that her room was on fire and after buzzing for nurses who never came she climbed out of bed, fell and fractured her back in 2 spots.Should this have happened...not really. She had become extremely weak during the 4 week stay and our family expressed concerns about getting her some physiotherapy and rehab after she left the hospital. She was discharged and told that she wasn't weak enough for rehab, even though we were told to buy her a walker and think about a wheel chair for her.
Keep in mind she was 57, why wouldn't the health care system want to attempt to rehabilitate her? She went home and 4 days later and was found unconscious on the floor due to a diabetic reaction. Again the ambulance was called and she was admitted into the hospital for the next two months. After many meetings and being very persistent we managed to convince the hospital that she needed some additional care. She was granted a 4 week stay at a rehabilitation center, only catch is that as soon as you are accepted the patients 4 week time period starts. Much to our horror we were told from the hospital that there were no beds available and Mom would have to stay in the hospital until a bed became open, this never happened and she spent the entire 4 weeks in the hospital. On week 3 we were told that a bed had become open and that Mom had spiked a temperature which meant she had to give the bed up. During her time away from the hospital Wendy continued to go three times a week for her dialysis treatments.
On August 27/07 she was admitted into the hospital because her sodium levels were low and her electrolytes were not functioning properly. A few days later her condition had improved and the doctor discussed discharging her. Only because my father expressed a concern for her mobility was she kept in the hospital.
On Sept.2/07 my mother took the walker that was given to her by the hospital outside. My mother at the time was weak but was encouraged by the nurses to use the walker for exercise. The walker started to get away from her and when she went to stop it by applying the brakes they failed. As a result she fell broke her hip and suffered a serious head injury. When asked what had happened she replied "the walker started to get away from me and it didn't stop", when told about this we took the serial number and wrote it down. We assumed that because the nurses realized her extreme lack of mobility they would keep an eye on her, instead she was provided with a walker that had faulty breaks. How can a hospital give a person a piece of equipment and not know if it was working? Little did we know that after her hip surgery she was never going to be responsive again.
We feel that Wendy never did recover from the surgery and that the fall was a direct cause of her death. It also seems that because she fell on hospital property while a patient in the hospital every effort has been made by the hospital and the doctors to cover up the facts and the true cause leading to her death. We feel that if she had fallen at home and suffered head trauma and a broken hip and died a few days later the hospital and health system would be very fast to point to that as a leading contributor to her death. Somehow the Regina General Hospital has managed to deny that the faulty walker was used (they located the walker that matched the serial number we provided them with but a nurse claims that she used a different walker the morning of her fall), they have botched the autopsy that they told us to have, they have provided three separate causes of death, they can't confirm that the anesthesiologist was aware of her head trauma and they have said that the coroner was involved in September when she died and then deny that the coroner wasn't involved until December. The hospital has manipulated the facts and lied to us from the moment she fell on their property. The very fact that the hospital was reacting to her head injury and not telling the family about her condition is cause for alarm.
Patients deserve better treatment than what my mother received. When a loved one is sick or injured and in the care of the hospital, the care that they receive should never have to suffer.
Every patient has a voice but unfortunately for my mother her voice was taken away the minute she fell on hospital property. Every step from her fall on is either conflicted with another explanation provided from the hospital and then covered up. Wendy McIntyre did not get a chance to voice her concerns so her family is now doing it for her.
Many arguments have been made to try and explain to us what the hospital wants us to believe. What they have forgotten is that her medical records, autopsy results, coroners role, causes of death and various other information tells a different story. We can all understand the strain that is put on our Health Care System and it's recent limitations, what we can't understand is why short cuts that cause negligence are covered up. If the almighty machine known as the Regina General Hospital is going to cover-up a patients care or lack of they should ensure that they have not ever given the family the documents to prove that a cover-up has taken place.
All the information that we have provided and the additional information that we still have is documentation provided from the hospital. I would hate to think that other families are going through the same thing as ours and have no ideal that they are entitled to ask questions and fight back.
Just to let you know this family has just filed a claim against the Regina Quepelle Health Region.
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Many, many times. You know it well. Every marketing guru has spoken about this topic. I’m sick of hearing it. But it STILL bears repeating.
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