Speaking out for patients

Issue: BCMJ, vol. 54, No. 4, May 2012, Page 165 Editorials

In the summer of 2010 my relative almost died from pseudomembranous colitis when treated with antibiotics for a postoperative pneumonia at a Fraser Health facility. I rationalized that the spread of Clostridium difficile was an accepted antibiotic complication and didn’t really think more about it.

In January 2012 a group of Burnaby physicians wrote a letter to the Fraser Health Authority outlining their concerns around the issue of C. difficile at their hospital. Burnaby General Hospital has a much higher infection rate than normal and despite this fact being known for some time, little was being done to address this matter. These physicians were concerned for the health of their patients and chose to speak out. 

Their letter outlined the issue and made recommendations to remedy it. Within 2 weeks Dr Nigel Murray, the Fraser Health Authority CEO, responded by instituting some improved infection control measures. In early March this letter reached the media and it garnered significant interest. 

In response the health authority released a report by Dr Michael Gardam, an infectious disease specialist from Toronto, outlining 13 recommendations to improve infection control. Dr Murray gave his personal commitment that these recommendations would be implemented. In addition, he said that Fraser Health would hire a senior medical advisor to help reduce infection rates across all of the region’s hospitals. 

Burnaby Hospital also underwent a 2-week “super clean” regimen, with further regional hospitals in line for the same treatment. Monitoring for C. difficile will also be stepped up and further intensive cleans will be instituted as necessary. 

Our patients expect us to act as their advocates and look out for their best interests. We are on the front lines and see the problems firsthand. The Burnaby example shows us that we can make a difference. The lesson is clear—if physicians act and bring attention to issues, change often follows.  

Maybe it’s time for us to become more militant. Do you think the public majority really knows what is going on in our hospitals? Are they aware of the crowding and cleanliness issues? Do they know that men and women sharing a room separated by a curtain is now the norm? Are they aware that food isn’t prepared on site, it is just rewarmed? Are they aware how little physiotherapy and mobilization exists on the wards? 

I don’t blame the hardworking nurses, physiotherapists, hospital workers, cleaners, and more who are doing their best to keep up with demand and a huge workload. But would you want to be a patient in a four-bed room on a general medical ward at your local hospital? 

I thank the dedicated physicians from Burnaby Hospital who have given me hope and motivated me to write this editorial. If issues are brought forward and the public is informed changes can be made. A concerned public makes administrators and pol­iticians uncomfortable. This discomfort can be used as a catalyst for improvement. We need to speak out because many of our weak, frail, and ill patients can’t.

David R. Richardson, MD. Speaking out for patients. BCMJ, Vol. 54, No. 4, May, 2012, Page(s) 165 - Editorials.

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