Does overcrowding in hospitals and clinics lead to medical negligence?

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By Sabrina Almeida

Almost a year ago, in May 2016, the NDP raised the issue of overcrowding in Ontario hospitals. Documents obtained by the New Democrats showed that some major hospitals were operating with 100 percent of their acute care beds occupied and trying to squeeze in more patients. The NDP warned about the potential hazards including lengthy wait times in the ER and the risk of inadequate care.

Later in November, a report by Ontario Auditor General Bonnie Lysyk once again slammed the provincial government and hospital management for overcrowding at community hospitals. Instances of excessive wait times causing harm to patients were also stated in the scathing report. Trillium Health Partners, Rouge Valley Health System and Windsor Regional Hospital were three hospitals that were reviewed in depth. While the Ontario Ministry of Health and Long-Term Care aimed to transfer 90 per cent of patients needing intensive care to the ICU within ‘eight hours’, the actual time taken at these hospitals was found to be ’23 hours’. The report also said that those needing a regular in-patient bed in the said hospitals waited for 37 hours.

Going back to a 2012 online survey by Leger Marketing in which 94 percent of respondents stated universal health care was an important source of collective pride, today many Canadians might not feel proud or privileged. The impact that overcrowding is having on Ontario’s healthcare quality, for instance, can no longer be cloaked by any statistics indicating we are better off than other provinces.

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The case of the 11-year-old Mississauga girl who lost an arm and a leg after contracting a serious bacterial infection that doctors initially diagnosed as influenza raises serious questions about the link between medical negligence and overburdened medical staff. While some medical experts have gone on record to support their colleagues saying the case was an anomaly and that early symptoms can be misleading, one cannot help but wonder whether a less-crowded ER and more time spent listening to patients and their families might have made the critical difference.

Media reports Nupur Mate’s family first took her to Trillium on February 21 where they waited four hours to see a doctor. She went home to rest after nurses dismissed it as flu, only to come back to the ER next morning with severe pain in her left arm and right leg. With tests reports coming back clear, the doctor diagnosed her as having influenza B and sent her home again. As her conditioned worsened, her mother called 911 on Friday evening. After being stabilized at Trillium, she was then taken to Sick Kids. On life support for more than a week, and after having spent 17 days in the intensive care unit, Nupur’s blood tests revealed she had a bacterial infection caused by streptococcus A. According to CDC definition that came up on my Google search, group A is strep as a type of bacterium that can cause many different infections ranging from minor illnesses to very serious and deadly diseases. Which both explains how it could be missed but also calls for caution.

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In a statement provided to CBC Toronto, Trillium Health Partners said they would not comment on the case due to patient confidentiality.

Colleagues and friends shared their negative experiences in community hospital emergency rooms as Nupur’s sad story broke. Many felt that they were hustled along to deal with the large number of waiting patients.

In Mississauga, for instance, there are just two hospitals to deal with a fast-growing immigrant population. This surely has a big part to play in the lengthy wait times which have become worse over the years.

A couple of years ago, when Milton was still developing, many of my neighbours went to the hospital there to avoid having to wait for hours. With Milton, having grown so much since then, that is no longer an option.

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Judging from the overcrowded family clinics in my area, both the medical staff here and at the hospitals are definitely overburdened. One gentleman shared how his family physician paid more attention (a whole 10 minutes) to him on days with inclement weather when patients were few. At other times, he felt the doctor was barely listening to him and would have him out the door in approximately 5 minutes.

Nursing cuts in 2015 are likely to have made a bad situation worse.

Free healthcare might account for some of our woes. Many immigrants exploit the privilege they never had in their home countries. Having to pay a token amount or deductible for visits to the family practitioner, tests or the ER might cause them to be less wasteful. This would perhaps also put an end to unethical practices where tests are ordered either by patients or doctors when not required. A small price to pay for better quality of care and faster medical services when we really need it.

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