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:
• 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.
• 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.
• 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.
• 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.