Minister orders resumption of quarterly critical incident reports

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This article was published 23/07/2018 (2604 days ago), so information in it may no longer be current.

The provincial Health Department reversed course Monday when it was asked to explain why its reporting of critical incidents involving patients is lagging.

A government official first said Manitoba would be filing critical incident summaries twice annually — instead of quarterly on the department’s website — due to a decline in incidents.

However, a few hours later, Health Minister Kelvin Goertzen said in a statement to the Free Press he had directed his department to resume quarterly summaries, beginning with an update next month.

The last published critical incident summary covered the first quarter of 2017, when 17 incidents were disclosed, including four patient deaths. In one case, according to the three-line account provided, a patient who suffered a heart attack died after 12 hours in care in an unnamed facility as his/her condition deteriorated. “Expected standard of care not met,” the incident summary noted.

Typically, critical incident reports appear roughly nine months or so after the events they describe take place. Asked to explain a 15-month backlog Monday, the provincial bureaucracy issued a statement saying its information would be updated next month.

The statement also said “given the low numbers” of incidents per quarter, the province chose to combine its first-quarter and second-quarter reports and would be reporting twice annually in the future.

When the Free Press sought comment from Goertzen, he issued a statement, countermanding his officials.

“Due to the relatively low number of critical incidents in the first quarter, the department chose to group the individual cases and opted to hold for another quarter. I became aware of the change today, and I’ve directed my department to resume quarterly reporting of these incidents following the release of August’s report, which will cover a six-month period,” the minister said in a statement.

The Manitoba Nurses Union said the decline in the number of critical incidents being reported is likely due to a change in the way the Winnipeg Regional Health Authority now defines critical incidents in long-term care facilities. That’s led to a drop in the number of falls reported as critical incidents.

“Nurses have seen no indication that the number of falls or other critical incidents have declined,” recently elected union president Darlene Jackson said. “Changing the definition only weakens our ability to improve care for Manitoba’s (long-term care) residents.

“(The union) does not support the WRHA’s change in criteria for critical incidents or reducing provincial reporting.”

In a statement, Jackson said nurses understand critical incidents “are all too common,” which is why they recommend increasing staffing levels.

NDP Leader Wab Kinew said critical incident numbers should be disclosed on a timely basis so Manitobans can be confident in the quality of their health care.

In 2006, Manitoba introduced no-blame critical incident reporting across the health system to nurture a culture of openness and learning about such incidents. It’s understood only a fraction of critical incidents are, in fact, reported.

The health department’s website says “critical incidents are not reported to lay blame on individuals,” but to look at how to improve care. The process does not, however, replace disciplinary investigations, including reviews by employers or complaints to professional bodies, it says.

Kinew wondered whether the number of critical incidents is down because health-care staff are under increasing time constraints. Nurses, for instance, have been working increasing amounts of overtime, he said.

“When I hear the government talking about critical incident numbers… it makes me think that maybe the nurses are too overworked or understaffed to be able to devote the time needed to file critical incident reports,” Kinew said.

The 17 critical incidents recorded in the first quarter of 2017 were considerably fewer than in the previous eight quarters, where the numbers ranged from 28 to 58.

larry.kusch@freepress.mb.ca