Tuesday, November 8, 2011

Who's really 'responsible' for the actions of the NHS?

Further to  this post  and  this post  and  this post  about the Doreen Wallace incident at GNGH in Niagara Falls, Ontario...

.... there was a related story by Brett Clarkson of The Niagara Falls Review (Nov.8, 2011) headlined 'Quality of caring missed the mark'...
[...by the way: note carefully how the phrase "health care monopoly" doesn't appear anywhere in Brett Clarkson's narrative; and neither is there any examination of, or even mention about, the role of the Liberals who have controlled the Niagara Health System for eight years, and under whose ideological tutelage this incident occurred... it's as if  Ontario's Liberals have nothing to do with any of this (!)...]:

"The Niagara Health System's internal review of a woman who was told to await an ambulance after she fell inside Greater Niagara General Hospital has found that the hospital's "quality of caring missed the mark."
"That's an understatement," said Gaylene Archibald, the daughter of Doreen Wallace, 82.
Wallace fell in the doorway of GNGH on Oct. 8 after washing her hands at a sanitizer station, breaking her leg.
Wallace agreed with the miss-the-mark description.
At the hospital to visit her then-ailing husband, who died shortly after, the Walmart greeter lay on the floor after her fall, injured and bleeding, for what her family has said was 28 minutes.
Although several staffers helped her out, the family said that other nurses from the hospital's emergency department wouldn't assist Wallace, saying that there was nothing they could do and that they would call for an ambulance.
The incident sparked an outcry that led to national and international media coverage that questioned the rationale of hospital staff telling a patient who was injured inside the hospital to await an ambulance.
The controversy prompted NHS provincial supervisor Kevin Smith to call for a review of what happened.
On Monday, he issued a statement saying the review had been done. He said that "confusion" on the part of the nurses around what to do in that kind of situation caused the incident.
"I think that there was frankly confusion in their mind as to what was the appropriate thing to do," Smith said.
Smith said that going forward, the hospital needs to address "three core elements" to overcome the lack of clarity among staff.
He also said frontline workers have told him they feel there are not enough resources at the hospital to confront the sheer volume of people needing care.
"One, the hospital needs to be really clear about what our standards and expectations and to that end, make sure that people at various sites are clear on what we do when we have a patient in distress," Smith said. "And secondly, I think the hospital is looking very seriously looking at some of the feedback we have from staff who clearly are feeling overwhelmed with the volume and complexity of cases."
The third area of focus, Smith said, needs to accountability and clarity when it comes to implementing policies.
Although the Wallace case was not technically the same as two prior situations over the summer involving Coun. Joyce Morocco and Ridgeway woman Jennifer James, who were both denied care outside the hospital when hospital staff told family members to call 911, Smith acknowledged the optics were similar.
Smith said he takes responsibility for the incident.
"I'm the supervisor of the hospital so certainly I take responsibility for everything to that end," Smith said. "I think what's more important is I think that people involved in the care process are taking responsibility and discussing how do we make sure this doesn't happen, how do we get those issues out on the table."
While Smith's statement said the staffers — a security guard, ICU nurse, and orthopedic surgeon — who responded to help Wallace "acted in exemplary fashion," the overall incident represented "poor judgment by some members of our team" as well as "management's failure to ensure the clarity of our processes and procedures."
Archibald said she had spoken to NHS interim CEO Sue Matthews last week and was told that steps were being taken to ensure a similar incident never happens again.
"If they've done what they said they have, it's a step in the right direction, definitely," Archibald said.
Archibald said she was told two nurses were disciplined and all staff have been instructed about what to do if someone inside the hospital needs care.
Smith said he wouldn't be able to comment on disciplinary matters.
Wallace wasn't ready to give the assessment a ringing endorsement, but she was willing to hope for the best.
"If they do implement it, yes, but it was supposed to have been in place after Joyce Morocco, but look what happened," Wallace said. "So, I don't know. A lot of the conversations with them, they're just clearing their butt. They don't say too much. I don't know, if it works, yes, it would be fine.
Smith's statement:
November 7, 2011
Our organization has completed its review of the incident at Greater Niagara General Hospital.
On Saturday, October 8, Ms. Doreen Wallace fell at Greater Niagara General Hospital Site. The family understandably expressed concerns about the way in which the organization responded to Ms. Wallace's distress.
Our review confirmed that several individuals acted in an exemplary fashion including the security guard and housekeeper as first responders, the ICU nurse who came to the patient's assistance before, and an Orthopedic Surgeon, who assessed and transported the patient to the Emergency Department.
Unfortunately we failed to transfer the patient to the Emergency Department from the lobby until 20 minutes had elapsed. Despite the best of intentions our effort was uncoordinated, resulting in Ms. Wallace receiving less than appropriate initial assessment and institution of treatment. Our quality of caring missed the mark.
In our follow up we have been in regular contact with the family, and are incorporating their suggestions and considering their observations as we improve our approach and processes.
This incident does represent poor judgment by some members of our team, as well as management's failure to ensure the clarity of our processes and procedures for assisting individuals in distress and communication of our standard of care.
I would be remiss if I did not also recognize the significant morale and demoralization reported by some staff, who clearly expressed feeling consistently overwhelmed. This must be a longer term issue we must address, including a review of ER staffing models. You will hear more from me with respect to the process and timeline to do so in the very near future.
Human resource policies have been followed with respect to individual performance in this case. Immediate actions have been taken to re-educate staff and clarify our processes.
NHS's policy for response to any visitor in distress will be to ensure a rapid response and transport to the most appropriate clinical setting, calling a code as appropriate. A small working group has been struck to review all NHS codes to ensure we are aligned with peer hospitals to be completed by November 18, 2011.
Each of us will be called to apply sound judgment to determine the safest, fastest, most effective and compassionate way to support persons in distress. Those needing assistance outside NHS sites will be addressed on a case by case basis, recognizing the risks for patients and staff. We have also worked closely with our EMS colleagues to ensure aligned practices and improved communication with respect to 911 calls.
Dr. Kevin Smith
NHS Supervisor"
Unless Wallace sues, there will be no accountability here, for anything.

Smith has completed his internal review; well... big whoop. How about this incident being investigated by someone from the outside?!

The health care monopoly relies on everyone buying into the great untouchable Liberal monopolist medicare myth, and not rocking the boat.

The golden rule is that no one is really to blame - for anything; we're supposed to believe 'that's just how the system is', and move on... that, apparently, is Kevin Smith's 'Canadian Way'.

Liberal-enforced ideological single-payer health-care monopolism, and the cozy, lazy, protective can't-blame-me entitlements it brings and encourages, are never questioned, by anyone in the Liberal-friendly Niagara press.

Liberal monopolists such as Jim Bradley, Kim Craitor, and Deb Matthews are held harmless from liability, although they fully control the hospital system; the Liberals rely on incidents such as Wallace's to be downplayed and swept under the rug as one-off anecdotes, as simple misunderstandings, as mere inconvenient little oversights, in Tommy Douglas's Great Radiant Medicare Future.

Supervisor Smith says 'he takes responsibility' for the Wallace incident, but, what does that really mean? Is he actually accountable? What consequences does Smith suffer for his so-called "responsibility"?!! Or is all this just simply a placebo of monopolist rhetoric?

In all this "confusion", it's certainly confusing, isn't it, how the Liberal political monopolist establishment is never held "responsible", for anything!

Aren't Liberal monopolists Jim Bradley, Kim Craitor, and their Liberal-appointed LHIN's "responsible" for anything here?! Isn't Deb Matthews "responsible" - after all, she's only Ontario's Liberal Health Minister! What does any of this have anything to do with her, eh??!

Why isn't  the Liberal-besotted Niagara press asking?!
How much longer will Niagara press barons Williscraft's and Metcalfe's papers continue to cover the Liberal's butts?

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