Lack of organization, staff shortages, poor leave management: The first reports of a bad emergency in Quebec show problems in many hospital departments. Newspaper.
The reports are negative, we are telling real things, but at least we are taking care of it, says Dr. Gilbert Pachercher, president of the Association of Specialists in Emergency Medicine in Quebec. 85% management of the problem. We need to better organize ourselves. ”
To tackle long delays in emergencies in Quebec, the Ministry of Health and Social Services (MSSS) has targeted 25 bad companies.
Over the past few months, each hospital has been visited and given a personalized report of the goals to be achieved within the next year. They report problems in the emergency room, but not the front row and access to sites.
Newspaper McRill University Health Center (MUHC) received reports for six hospitals in the Greater Montreal area, including Saint-Jerome and Charles-Lemoine.
Confusion in clinics
An important observation emerges: Care management is “hospital-centric”, we study. Often, a patient who can go home and be followed up at an outpatient clinic is still admitted to the hospital.
“Appointments in clinics are very complicated, very poorly organized and we will keep them,” Dr. Poucher notes.
“When we’re high, there are no rules,” he adds. Do what you can, you take care of the next patient, but no vision. ”
Many hospitals have communication problems and poor evacuation planning and access to beds on the floors.
Dr. Judy Morris, president of the Association of Emergency Physicians of Quebec, believes, “We need to be very competent. There is often a lack of vision and overall management outside of emergencies. People need to be held accountable.”
Lack makes the situation worse. Access to rooms is often delayed because there is no one to disinfect. Sometimes, emergency room nurses care for more patients than care sites, it wrote in a statement.
Hospitals in Saint-Jerome and Saint-Eustach face conflicts between staff and management, we read. Attitude issues, lack of support from managers, lack of “long” staff meetings, the list goes on and on. Although he believes the twist is possible, Dr. Poucher notes a certain reluctance on the ground.
“For the first time since 2000 we have had a manager as the head of the ministry. Nothing complicated, it needs a culture of change,” he said. There are doctors who think it will rediscover the wheel. ”
MSSS refused to send 25 reports Magazine, Because some are not yet finished.
Patients … very patient with missed goals
The STAT team (Support, Change, Access, Field) visited 25 worst emergencies in Quebec. The first report with priority recommendations was issued to each department, which has one year to improve. Follow-up will be provided by the Ministry of Health. Here are the key issues raised in the reports received by Newspaper.
- There is no vacation planning process.
- Physicians ’medical circuits with patients are not structured. They vary according to experts (Charles-Lemoine).
- There are no precise criteria for determining whether a patient is being placed on a stretcher (bear-poucher).
- Experts prefer to do emergency consultation (Honoré-Mercier) rather than an outpatient appointment even if it is not urgent.
- Lack of computer tools for the management of hospitalized users (Laurentites).
- Lack of “all job titles” staff
- Nearly 50% of nurses are missing in the operating room (Charles-Lemoine).
- Lack of physiotherapists.
- Closing magnetic resonance imaging (MRI) at night due to staff shortage (Charles-Lemoine).
- Social worker call only on weekends (Honoré-Mercier).
- Long delays in disinfection rooms due to lack of staff.
- No emergency medical coordinator (Saint-Jerome).
Expired equipment and locations
- Physical places not suitable for the elderly.
- Magnetic resonance imaging is often broken and outdated. Sometimes the tests have to be repeated because they are vague (peer-poucher).
- Infection prevention and control violations.
- Outdated computer systems.
- The corridors are scattered with tools (Saint-Eustach).
The long wait In mental health
- Drug users to the outpatient department (Charles-Lemoine) without nursing supervision.
- “Ruined environment”, “inhumane, unsafe and [qui] Does not promote communication between users and employees ”(Charles-Lemoine).
- 18-24 month delay for a psychological consultation (laryngitis).
- Shortage of a department head for a long time (Saint-Jerome).
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