Better patient care needed

Winnipeg may be solving two problems at once as they discharge elderly emergency patients in the wee hours sending them home alone by cab.

Winnipeg’s Grace Hospital may be solving two  problems at once as they discharge elderly emergency room patients in the wee hours of frigid nights sending them home alone by cab. Though  emptying emergency room beds, if a few of these seniors freeze to death the demand for senior housing is reduced.

Twice in recent weeks the hospital has discharged after midnight elderly emergency room patients  medically unfit for discharge with deadly results.

December 31   David Silver was sent home in a cab by himself at 2:30 a.m. wearing pyjamas and slippers. The temperature was -37°C. Fifteen hours later the 78-year-old was found on his porch frozen to death.

Two days earlier another elderly patient sent home from Grace’s emergency room in a cab also in the early hours was found next forenoon by neighbours frozen to death in front of his home.

Winnipeg hospitals have a mounting history of treating patients inhumanely. In January 2012 a Winnipeg woman died on her doorstep after being sent home in a cab from Seven Oaks General Hospital. An inquest was called into her death to examine hospital policy for discharging patients. Whatever the inquest’s findings, they appear not to have improved outcomes for others.

For months in 2013 a coroner’s inquiry was conducted into the death of 43-year-old Brian Sinclair, a poor, transient aboriginal double  amputee who had been admitted to Health Sciences Centre for his kidney condition 34 times prior to his last visit September 19, 2008.

He was left sitting in his wheelchair for 34 hours without ever being triaged by a nurse or doctor, despite the bustling room and several civilians calling attention to him.

He had been dead for ten hours and rigour mortis had set in when  a security officer reported him dead. No chart had ever been created for him.

How could any Canadian hospital treat patients so heartlessly?

The Sinclair inquest is to consider questions such as:

Is there a morale or stress problem at the HSC Emergency Department that causes medical staff to be indifferent about certain patients?

Are there proper accountability mechanisms in place when people do a bad job, and if not, does the lack of accountability increase the risk of bad health outcomes in the first place?

What accounts for the apparent lack of empathy in this case, and how widespread is it?

Is there any appreciation for the fact that vulnerable people need more affirmative and proactive care in the emergency department, or is there instead an attitude that certain kinds of people are less worthy of care than others?

Part 2 of the Sinclair inquest, to begin February 2014, is intended to look at some of the systemic factors concerning treatment of patients in emergency departments and what can be done to prevent similar deaths in the future.

Manitoba’s health minister proposes to put the onus on cab drivers to escort discharged patients safely to their front doors. Understandably, the cab drivers are rejecting this notion. They are not medically trained to administer emergency care if the need arose; they likely wouldn’t be paid extra to devote ten or fifteen minutes to escorting a patient to his door; cab drivers are not insured to take on this responsibility.

Perhaps Social Services and Health should cooperatively fund a new volunteer service of adult trained sitters who could be on call to escort live-alone patients safely from the hospital to their empty houses, make sure heat was on, and the home otherwise comfortable.