EDMONTON, Feb. 22, 2012 /CNW/ - The Health Quality Council of Alberta
(HQCA) has released its independent review of issues related to the
quality of care and safety of patients requiring access to emergency
department (ED) care, lung cancer surgery, physician advocacy and the
impact of physician intimidation. Dr. John Cowell, HQCA's Chief
Executive Officer, called the ten month review an epic journey into the
The review found the following:
University of Alberta Hospital (UAH) ED physician concerns about
patients waiting unacceptably long times for ED services in 2008,
including waiting for a hospital bed, were justified. Patients' safety
margins were compromised and many suffered. One patient who left the
UAH ED without being seen after a five-hour wait nearly died, but was
able to be resuscitated.
However, no deaths can be attributed to excessive wait times in the UAH
No further action needs to be taken regarding patient charts reviewed or
the lists of patients identified by the UAH ED physicians for the years
2008 to 2010.
Wait times in Alberta's urban EDs are still too long. The way forward
lies in dedicating critical resources into improving acute care
in-patient occupancy rates. Rates are affected by the number of beds
and time patients stay in those beds. This has implications throughout
the system. Until this major block to patient flow is resolved, wait
times and crowding in urban emergency departments will not
Lung Cancer Surgery
The allegation that about 1,200 patients were on a waiting list for lung
surgery in Edmonton is unfounded, as is the claim that 250 patients
died while on a lung surgery waiting list. An extensive review of data,
documents and in-depth interviews with knowledgeable individuals
turned up no evidence of poorer patient outcomes for Edmonton lung
cancer patients; mortality rates for Edmonton and Calgary were the same
and comparable to national averages.
There is no basis for suggesting that knowledge about illegal or
unethical behavior was suppressed by former ministers of Health and
Wellness, the former CEO of Capital Health or the Registrar of the
College of Physicians & Surgeons of Alberta.
The claim that physicians who raised issues about lung surgery wait
times in the former Capital Health were punished, driven out of the
province or paid out in millions because of advocating on behalf of
patients is not supported by the facts.
A public inquiry into these issues is neither required nor recommended.
Physician Advocacy and Intimidation
There have been widespread instances of physicians experiencing
intimidation and muzzling when advocating for patients and evidence of
a culture of fear and alienation across the province. Physicians report
difficulty in knowing to whom and how to advocate.
Massive reorganization at the system level and within Alberta Health
Services has further blurred lines of authority and accountability.
This lack of stability and clarity within the system is intertwined
with the problems found around advocacy, intimidation and lack of a
'just culture' where people are seen to be and are treated
appropriately and fairly and where relationships are built on trust.
HQCA is recommending that no further major restructuring in the system
be done without a clear plan, rationale and consultation.
HQCA is further recommending that the time and money that would be
needed for a public inquiry into intimidation and advocacy should
instead be devoted to:
Establishing a task force to develop recommendations on clear lines of
authority in the system
Instructing AHS' board of directors to make establishing a just culture
in AHS a priority
Developing policies and education about physician advocacy, including an
Conducting an independent review of the College of Physicians & Surgeons
of Alberta's investigative and support roles to address serious
concerns raised by physicians
In total, the HQCA has made 21 recommendations on ways to deal with the
critical issues in acute care inpatient bed management and emergency
department wait times, improving the quality and safety of care, as
well as improvements in relationships between physicians, the health
system and the public.
"The quality assurance teams spent thousands of hours reviewing hundreds
of patient charts, conducting interviews and analyzing data. A total of
2,046 of Alberta's 7,964 physicians answered our survey on their
experiences with advocating for patients and we held in-depth
discussions with another 99 key stakeholders on that issue alone," said
Dr. Cowell. "It's been a thorough, exhaustive process. The HQCA is
satisfied that it got to the bottom of the issues and left no material
"The quality assurance teams have provided the health system with a
detailed road map for the future," said Dr. Cowell. "The issues leading
up to this review emerged from events in Edmonton and the experiences
of physicians. However, our investigation looked broadly and its
findings apply to the whole system and everyone working within it.
There are tremendous opportunities here to create a safer and stronger
health system that will benefit all Albertans."
The review was conducted as a quality assurance activity under section 9
of the Alberta Evidence Act. Under its terms, documents are not released and those who shared
experiences and insights receive anonymity.
The Health Quality Council of Alberta gathers and analyzes information
and collaborates with Alberta Health and Wellness, Alberta Health
Services, health professions, academia and other stakeholders to
translate that knowledge into practical improvements to health service
quality and patient safety in the health care system.
A backgrounder is available along with the complete report and can be
downloaded at http://www.hqca.ca/.
SOURCE Health Quality Council of Alberta
For further information:
Interviews with Dr. Cowell can be arranged by calling Karen Fantin at 403-815-4883