December 16, 2017

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Editorial

ER flaws studied to death

Hey there, time traveller!
This article was published 22/4/2016 (602 days ago), so information in it may no longer be current.

The family of Mohinder Singh is still looking for clear answers about why their wife and mother was left to suffer in agony on the floor of the emergency room at Seven Oaks General Hospital last fall. She died a day later of a brain aneurysm, something experts say may have taken her life, but it’s the actions of the ER that remain the issue.

Darshan Singh was driven to desperation by his wife’s evident pain as she laid on the waiting room floor, reeling from the headache that caused her to collapse in her Maples home hours before. Mr. Singh begged nursing staff to help, but no one did. Finally, Ms. Singh fell unconscious and then the medical staff moved to act. She was transferred to Health Sciences Centre and died the next day. What her husband wants now is answers.

According to the results of a “critical incident” review given to Mr. Singh, the 57-year-old woman was not “independently” assessed when she got to Seven Oaks by ambulance. The WRHA says she was triaged, but staff relied on the verbal report by paramedics of her condition. Emergency wards are supposed to have a nurse floating through busy waiting rooms, reassessing patients to catch anyone getting sicker. But Ms. Singh, apparently, didn’t get that, either. Why? And why didn’t Mr. Singh’s pleas for help move triage staff to check for Mohinder’s name in the computer, look up her initial status, and then take the next step? All very basic stuff. Such basic errors seem unimaginable now after the lengthy inquest into the death of Brian Sinclair at HSC in 2008, which sparked comprehensive changes to the way all hospital ERs do their jobs. But here we are again.

The Winnipeg Regional Health Authority, which conducted the review, isn’t making public the details of the Singh case. It will give families a summary of the review’s findings, but will not release the original document. Very little information is available to the public.

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Hey there, time traveller!
This article was published 22/4/2016 (602 days ago), so information in it may no longer be current.

Mohinder Singh</p>

Mohinder Singh

The family of Mohinder Singh is still looking for clear answers about why their wife and mother was left to suffer in agony on the floor of the emergency room at Seven Oaks General Hospital last fall. She died a day later of a brain aneurysm, something experts say may have taken her life, but it’s the actions of the ER that remain the issue. 

Darshan Singh was driven to desperation by his wife’s evident pain as she laid on the waiting room floor, reeling from the headache that caused her to collapse in her Maples home hours before. Mr. Singh begged nursing staff to help, but no one did. Finally, Ms. Singh fell unconscious and then the medical staff moved to act. She was transferred to Health Sciences Centre and died the next day. What her husband wants now is answers.

According to the results of a "critical incident" review given to Mr. Singh, the 57-year-old woman was not "independently" assessed when she got to Seven Oaks by ambulance. The WRHA says she was triaged, but staff relied on the verbal report by paramedics of her condition. Emergency wards are supposed to have a nurse floating through busy waiting rooms, reassessing patients to catch anyone getting sicker. But Ms. Singh, apparently, didn’t get that, either. Why? And why didn’t Mr. Singh’s pleas for help move triage staff to check for Mohinder’s name in the computer, look up her initial status, and then take the next step? All very basic stuff. Such basic errors seem unimaginable now after the lengthy inquest into the death of Brian Sinclair at HSC in 2008, which sparked comprehensive changes to the way all hospital ERs do their jobs. But here we are again.

The Winnipeg Regional Health Authority, which conducted the review, isn’t making public the details of the Singh case. It will give families a summary of the review’s findings, but will not release the original document. Very little information is available to the public. 

Since the Singh family went public with its private tragedy, the health authority has said it is sorry, that mistakes were made. WRHA president Milton Sussman, to his credit, has admitted Darshan Singh did everything right, everything a loved one could have done. "He wanted to do his part. We didn’t." Maybe Mr. Sussman misspoke there, or maybe he was right: the hospital staff didn’t want to do their part.

And that is the heart of the issue. How do you tackle second-rate emergency room care to prevent a repeat of Ms. Singh’s pain and suffering? If it is the culture of the place that is defeating good, caring treatment for patients (such that staff truly don’t want to do their part) then the sporadic spot checks by compliance teams, sent in by the WRHA to look for errors or breaks in protocol, won’t prevent another tragedy. While bad apples infect any workplace, it is unthinkable most of the staff really didn’t care to do their part. Staff, however, can get dangerously discouraged, defeated by things they can’t control — the unending queue of patients they are incapable of helping in a timely fashion, too few beds for the sick, backlogged doctors working lengthy shifts and/or not enough nurses to do the work.

The WRHA says in addition to the new ER spot checks, it is setting up a patient advisory council so Winnipeggers’ experiences can feed into the way care is delivered.

Further, the Seven Oaks hospital will undergo an intense six-week evaluation that will see ER patients followed from arrival to discharge. The last move suggests there is something specific to Seven Oaks — which has been in the public spotlight before over similar complaints — affecting the quality of care there.

Until this week, the WRHA has assured the public Seven Oaks is perfectly capable of delivering good health services to anyone arriving at its doorstep. The treatment of Ms. Singh tells a different story.

The WRHA owes the Singhs and Winnipeggers more answers and soon. The first job of Manitoba’s new health minister should be ensuring they are provided.

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