The independent investigator responsible for shedding light on disturbing revelations concerning several deaths that occurred in the emergency room of the Lakeshore General Hospital in Pointe-Claire, makes 135 recommendations in a report tabled Thursday.
In a press conference under a scorching sun outside the establishment, the investigator Francine Dupuis argued that despite the magnitude of the site that awaits the Lakeshore team, she says she is optimistic.
“You have to see it as a staircase that you climb one step at a time,” summed up the nurse by training and former president and deputy executive director of the CIUSSS du Centre-Ouest-de-l’Île-de- Montreal.
Tasks to be accomplished have been identified by profession so that everyone does their part.
“It’s teamwork. It has to be done together. I’m a big fan of decentralization, but that comes with accountability,” she said.
Although the overall picture is quite bleak, the investigator believes that the care offered to the population remains safe. “I’m sure everyone is very careful right now to do the right things,” she replied.
Following an investigation published by the media The Gazette, the Minister of Health, Christian Dubé, launched an investigation on February 28. The ministry then entrusted this mandate to Mr.me Dupuis.
In her report, she explains that her mandate was to “try to identify points of improvement for the future of the emergency”. To achieve this, she points out that she met nearly 70 people from all levels of the hierarchy.
She describes an urgency “crystallized in bad habits,” where communication problems lead to an inability to implement changes recommended in the past.
The author reveals the existence of a “habit of blaming others” at the Lakeshore General Hospital. She reports a “toxic” work environment in the emergency room, where tensions are great both between the various employment groups and between the hierarchical levels.
“A lot of energy is spent defending yourself and blaming the other,” writes Mme Dupuis adding that this leads to a non-respect of the rules.
She insists on the importance of strengthening communication in all directions, ie bottom-up, top-down and cross-sectional. A key element, according to her, “to restore mutual trust” among staff.
Its 135 recommendations to be implemented are divided into six areas, which deal in particular with decentralization, accountability, quality assurance, communication, a concrete action plan and the renovation of facilities.
Walls before culture
In reaction to the Dupuis report, the President and CEO of the West Island of Montreal’s Integrated University Health and Social Services Center (CIUSSS), Dan Gabay, adopted a positive tone and underlined that several recommendations from previous reports were already being implemented.
In addition, he announced three initial actions aimed primarily at the layout of the premises and technology. In particular, a temporary modular unit must be deployed this fall to replace the dilapidated emergency unit until it is adequately renovated.
Currently, the emergency room is set up in the heart of a series of concrete hallways with many blind spots that make it difficult for the staff to properly observe the patients.
There are also plans to set up an outpatient clinic, where patients who do not require urgent care can be redirected and taken care of. Finally, we promise the deployment of a functional electronic medical record within two years.
These measures are certainly necessary, but none of them address the toxic work environment that is eating away at the emergency from within.
In an interview with The Canadian Press, Dan Gabay says he was surprised to read this observation in the Dupuis report. He says he wants to investigate and request a work climate study from his human resources department.
For the nurses’ union, the promises of management are “window dressing”. “The modular unit is all well and good, but are we going to have enough nurses? asks the president of the local unit of the Interprofessional Health Federation (FIQ), Johanne Riendeau.
“There is a huge shortage of nursing staff and there is a lack of expertise,” she explains, adding that sometimes no nurse is adequately trained within the team on duty to respond to serious cases of patients in shock. .
Six disturbing deaths
In a series of reports, journalist Aaron Derfel has revealed disturbing details about several deaths described as “preventable” by healthcare workers. There were also allegations that the establishment’s management tried to “hide the truth” surrounding these incidents.
The series of reports listed six cases since 2019.
“The facts reported are very worrying,” Minister Dubé reacted in a statement sent by his cabinet. Let’s be clear: we do not compromise on patient health and safety. »
A first report had been written by a mediator and submitted in November 2022. She recommended a series of corrective measures to be implemented in the emergency room. She then described the place as “a time bomb” because of the precarious conditions of the place.
Minister Christian Dubé then promised “a very close follow-up of the file”.
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