In 2002, the Quebec Government passed legislation that obliges all authorities to report medical errors.

In March 2004, a class action lawsuit was authorized by the QC Superior Court for 10,000 breast cancer patients who experienced delays exceeding eight weeks in accessing radiation therapy.

 

The common thread: patient safety, and timely access to high quality care. This means available facilities, appropriate staffing, evidence-based standards of care, wait list management, and of course, money. Does this affect workplaces? Absolutely, and quite apart from the common expectation of Canadian plan members that they deserve access to the best quality care from both their provincial and employer-sponsored plans, regardless of cost (1).

 

Medical errors limit availability for work, prolong pain, cause or extend disability, limit effectiveness, add costs to benefit plans, and affect caregivers. It is especially important to morale and safety of healthcare workers, who have the highest absence and disability incidence of all employees. Patient safety is a national issue affecting all Canadians, including plan sponsors and members. It’s not just about WSIB, and it specifically affects productivity, according to the definition of "adverse event" used in a landmark Canadian study published in May 2004.

 

 

In their study of a sample of Canadian hospitals, Ross Baker, Peter Norton and their colleagues defined adverse events as "unintended injury or complication resulting in death, disability or prolonged hospital stay caused by health care management rather than the patient’s underlying condition." Adverse events take many forms and many have serious impacts (2).

 

The study estimated that:

These estimates describe a national tragedy. Strangely, despite rates two and a half times those in the United States, neither the Canadian public, nor our politicians, so far appear concerned about this issue. Ontario announced a paltry $1.4 million over two years for its hospital-based Patient Safety Support Service. That’s about 6 cents a year for each of its residents! Canada has not yet set error reduction targets. In contrast, when the Institute of Medicine released its November 1999 report, "To Err is Human", US President Clinton targeted a 50% reduction in medical errors by 2005 within 90 days of the report’s release.

 

Technology is not a limiting factor: there are electronic order entry systems for physicians and electronic health records for patients, but neither has been widely implemented. Medical interns and many nurses still work 12-hour shifts despite knowledge that fatigue and overwork create huge opportunities for mistakes. Care remains fragmented among many professionals, and patient-level data reside in many different places. While the knowledge is at hand, the ability to design and implement a strategy so far eludes us.

 

 

Dr. Baker noted that in the US, General Motors became concerned when it determined more of its workers died from adverse events than from accidents in its production facilities. GM is part of the Leapfrog Group, (www.leapfroggroup.org) formed by 150 public and private organizations to advance the employer’s voice in health system safety. Industry everywhere has invested heavily in quality, but even 99.99% accuracy is not nearly good enough. In Canada, this standard would still mean over 30,000 prescriptions had errors last year!

 

So the call is out: Canadians need to become informed about patient safety and the incidence of "adverse events" must be reduced. Canadian employers might take a page from their American colleagues and exert some organized and constructive pressure to improve the health and productivity of workers, their families, and our communities.