The Hospital’s Duty of Care

Arlene Wilgosh admits that hospitals have a duty to protect their patients from acquiring "super bacteria."

Twenty people died in Canada today – but they didn’t have to. They were all in healthcare facilities, hospitals mostly, and the reason they died had nothing to do with what brought them there. They died because of an infection they picked up while in care. And they picked up the infection because the hospital wasn’t following its own hygiene rules – and they admit it.

These preventable deaths happen every day in Canada, all across the country. By the end of the year – and every year — more than 8,000 people die in care, making Hospital-Acquired Infections (HAIs) Canada’s fourth leading cause of death. But it doesn’t stop there as more than 200,000 people are made sick by these infections, often seriously, as lifelong scars or a missing limb attest to.

This past Tuesday, Winnipeg’s Health Sciences Center held it’s (18th) annual “Bug Day,” an event that brings together experts from across the country who publicly address various aspects of HAIs. It played to an attentive and overflow crowd of healthcare workers. The take-home message was the same as it was last year: “Wash your damn hands,” as Winnipeg Regional Health Authority CEO Arlene Wilgosh put it, as 80% of these infections are spread by healthcare workers, or patients and their visitors.

But there’s a problem: the golden rule of washing your hands between every patient visit isn’t followed. Around 70% of nurses comply and a paltry 38% of doctors – if that. It’s been suggested that even these numbers are inflated because staff know when the hand washing police are watching and will thus “buckle up.”

Then came the stunning bit: Arlene Wilgosh said she didn’t know why these compliance numbers are always so low. The admission was stunning because even the nursing student seated next to me said: “We just don’t have the staff. There’s too many patients for each nurse to look after and there’s just too much to do.”

And that’s the dirty little secret that none of the presenters at the day-long event were willing to give voice to.

Not even Arlene Wilgosh, who seemed so compassionate. A former frontline nurse herself, she admitted that staff have a duty of care to their patients and candidly asked the audience: “If these patients were our loved ones, would we still not wash our hands and take proper precautions?”

According to Ms. Wilgosh, the hospital infection issue “poses a … very significant risk to those we care for,” and therefore “Something new has to be done to address it.”

But what is that “something new”? Because if our healthcare leaders aren’t even willing to acknowledge a major cause of HAIs, then where are we supposed to look for a solution?

Is this where we're headed?

How about the law. A sharp-eyed CBC report filed this month put it this way:

Our concern about the WRHA … is the lack of acknowledgement of the systemic nature of the true solutions, apparently devoid of a plan to marshal the required resources.

Under the Manitoba Workplace Safety & Health Act, Sec. 43(1): “A worker may refuse to work or do particular work at a workplace if he or she believes on reasonable grounds that the work constitutes a danger to his or her safety or health or to the safety or health of another worker or another person.”

Who … will be the first health care provider to draw the line and say, “I have too many patients, and

not enough time to follow proper hand hygiene protocols. I am refusing this work on the grounds that it constitutes a danger to the health of another person.”

Will it then be labor legislation that ultimately compels the minister of health and the WRHA to properly resource a systemic solution that will keep patients safe?

The CBC may be on to more than it knows. When professionals breach their duty of care to their patients, and serious, foreseeable, and preventable harm results, year in and year out, there’s a name for what happens next – it’s called a lawsuit. And a class action suit filed on behalf of close to 250,000 patients would not be out of the question for an imaginative and resourceful law firm.

Arlene Wilgosh began her address to us with these words about hospitals and infections: “It’s like going to war every day,” she said. She, too, may be on to something. Because if hospitals carry on shirking their duty to their patients, they will find themselves engaged in yet another theater of war, only this time they’ll be the ones in need of help. And they will dearly hope that the legal professionals in whose hands they’ll be in will properly discharge their duty of care.

Look at it this way. Suppose Ebola was killing 8,000 Canadians a year, every year. And on top of that our healthcare leaders publicly admit we could avoid those deaths if only hospital staff would bother to follow their own hygiene protocols. Yet they don’t, and so the deaths of innocent people continue to pile up. How would we feel about a lawsuit in that case? And so to our issue – how is the runaway train of hospital-caused/associated infection any different than that?

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