9,500 patient complaints lodged with B.C. health authorities over treatment quality

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A record number of complaints were filed with health authorities last year over patient care, more than 9,500 according to the Patient Care Quality Review Boards report for 2017/18.

Gerry Kahrmann / PROVINCE

A record number of complaints were filed with health authorities last year over patient care – about 9,500 according to the Patient Care Quality Review Boards report for 2017/18.

That’s up from 8,900 the year before and about 9,000 the year before that.

Patient Care Quality Offices and review boards were formed 10 years ago to give health system users and their families an outlet to voice their frustration. The boards in each health region accept complaints from patients and others only if their concerns about their experiences are not resolved to their satisfaction by Patient Care Quality Offices in each health region.

Less than two per cent of complaints are escalated to the review boards which suggests patients are largely satisfied with how their local health authorities are handling their concerns, said Richard Swift, chair of the Island Health Patient Care Quality Review Board.

Given the fact there are tens of millions of health care interactions, the number of complaints is relatively small, said Swift.

The latest annual report gives scarce information about the nature of complaints and recommended changes but a few of them include:

Island Health

• A complaint pertained to various issues including extraordinarily long wait time for care in a hospital emergency room for which Island Health acknowledged and apologized. The complaint also involved an allegation that a patient was assaulted by a staff member in the ER. The health authority agreed to develop a policy detailing what actions must be taken when such complaints are made, including when police or regulatory bodies for health professionals should be contacted.

• The Island review board recommended a hospital conduct exit interviews with patients to ask about their satisfaction levels with the quality of care and communication. Currently, the health ministry sends out surveys on a random basis which are then reported to health authorities on a quarterly basis. But Swift says more can be done to ensure patients are given opportunities to comment on their care.

Fraser Health

• A care aide escorted a frail patient to the bathroom but then left the patient alone to attend to another matter. The low cognition patient fell in the bathroom. There are more than a dozen policies regarding the prevention of falls, some of which were not followed in this case.

Vancouver Coastal Health

• A complaint was lodged about a vulnerable patient who went to a hospital emergency department. The board said the case was an example of how not to “prejudge patients who appear to be homeless, suffering from mental health, addiction issues and/or other challenges.” In response, hospital staff said there were departmental meetings where staff was reminded about the need to “provide care for the patients as a whole, the importance of listening to patients and their family, and the need to not prejudge patients on any aspect of their presentation.”

• In a case not highlighted in the annual report, a patient bled to death after paramedics could not get access to the individual’s Downtown Eastside building because of multiple security locks on doors and elevators. Health minister Adrian Dix said family members were not satisfied with the way complaints were handled so he has taken the rare step of ordering an independent review. 

The case pertains to Tracey Gundersen who bled to death last November after it reportedly took paramedics over half an hour to get to her sixth-floor suite. Firefighters who have master keys to such buildings were eventually dispatched to get paramedics inside. But a few years ago, B.C. Emergency Health Services changed policies and procedures to cut down on multiple crews attending each call so firefighters are no longer sent as first responders to many cases.

Gundersen’s daughter told CBC her mother was dying while on a phone line with a dispatcher and she’s angry that her mother’s case was not treated as life-threatening and that paramedics didn’t call for firefighters’ help sooner, especially since a firehall was just a block away.

Interior Health

• An incapacitated patient’s valuables and personal effects went missing at a hospital and were never recovered so the health region offered $500 in compensation. The board ordered the health region to have designated staff members whose job entails the safekeeping and documentation of patients’ belongings.

Northern Health

• A long-standing complaint going back to 2015 when Northern Health officials were alerted by a staff member to lapses in medical device disinfection and sterilization procedures related to instruments called endoscopes. Thousands of patients had procedures like colonoscopies that relied on the scopes but a consultation with the B.C. Centre for Disease Control did not show any “increase in specific infection types” during the two year period when the errors took place.

Although patients were sent letters to inform them of the breeches, the review board recommended a more fulsome public communication plan including direct meetings with patients or even town hall meetings to broadcast the errors, risks, actions, and any mitigating steps. As well, the region has to ensure that when such things happen, all affected patients should have a doctor who can address any concerns and ongoing needs.

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How and where to complain

8500 patient complaints

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Atheist nurse’s fight against mandatory AA will go before B.C. Human Rights Tribunal | CBC News

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A B.C. nurse who lost his job when he refused to attend a 12-step program for addiction will get a chance to argue he was discriminated against as an atheist.

Byron Wood contends Alcoholic Anonymous’s emphasis on placing your life in the hands of a higher power simply won’t work for someone who doesn’t hold any religious beliefs.

That’s an argument worth considering, according to the B.C. Human Rights Tribunal. On Wednesday, it denied Vancouver Coastal Health’s application to dismiss Wood’s complaint alleging discimination on the basis of religion. 

“The tribunal has not [previously] considered whether the 12‐step program utilized by Alcoholics  Anonymous and Narcotics Anonymous … may discriminate against persons with substance abuse disorders who are atheists,” tribunal member Walter Rilkoff wrote.

“In my view, there is a public interest in addressing that issue.”

If Wood was indeed a victim of discrimination, the tribunal will also have to decide what steps his employer would need to take to accommodate his lack of belief.

In the same decision, the tribunal also dismissed Wood’s complaint that he was discriminated on the basis of a mental disability — specifically, addiction — as well as parallel complaints against his union.

In an email to CBC, Wood expressed hope about the prospect of arguing his case before the tribunal.

“At a hearing, I will have the opportunity to introduce expert testimony from addiction experts,” he wrote.

“I’m hoping that eventually the courts will favour the evidence of experts who have a current, science-based understanding of substance use disorders. Only then will employers be forced to change their policies.”

No alternatives

Wood was diagnosed with substance use disorder after a psychotic break landed him in the psychiatric ward at Vancouver General Hospital in the fall of 2013. His professional college was informed, along with his union and Vancouver Coastal Health (VCH), his employer at the time.

He was referred to an addictions specialist, who created a plan that Wood would need to follow if he wanted to return to work. AA was a mandatory component of that plan.

Wood lost his job as a nurse after refusing to continue with Alcoholics Anonymous meetings. (Bethany Lindsay/CBC)

Wood suggested alternatives to the 12 steps, including secular support groups and counselling, but his doctor rejected them, according to emails provided to CBC. 

He also asked for a referral to a new doctor, but his union informed him that it only uses addictions specialists who follow the 12-step model, the emails show.

He says the AA meetings didn’t help, but he lost his job as well as his registration as a nurse when he stopped going.

Researchers who’ve spoken to CBC about Wood’s story say it’s not unusual in Canada, and nurses are regularly required to attend 12-step programs in the interest of protecting public safety.

Medical opinions can be discriminatory

In its submissions to the tribunal, VCH argued the treatment plan designed for Wood was reasonable and supported by medical experts. 

But Rilkoff said expert opinions weren’t enough.

“Relying on medical opinions is not a sufficient defence if the medical recommendations are themselves discriminatory … VCH cannot avoid liability if it relies on discriminatory advice,” the decision says.

The 12 steps require members to “turn our will and our lives over to the care of God as we understood Him,” admit their faults and make amends with those they’ve hurt.

Many people who have recovered from addiction say AA was instrumental in their success.

But scientists who study addiction have long questioned the overall effectiveness of AA. In recent decades, numerous evidence-based pharmaceutical treatments have been developed for addiction, along with non-religious programs like SMART Recovery and LifeRing Secular Recovery.

For his part, Wood says he’s had great success using a drug called naltrexone, which blocks the intoxicating effects of alcohol and opiates. It’s an option he says he wasn’t offered while he was still employed as a nurse.

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