Turf war between the authority and hospital is the reason for poor sterilization and a super-bug outbreak this spring at St. Joseph's Hospital in Vegreville in Canada. This has led the Alberta government take direct responsibility of the East Central Health district.
The Alberta government plans to take over the control of standards and monitoring at all hospitals and clinics across the province. Premier Ed Stelmach is making the change to take over operating standards from the individual health regions.
The province's deputy health minister will take over as administrator of the region, aided by a consultancy company, J.L. Saunders and Associates.
St. Joseph's Hospital in Vegreville was closed to new patients for several weeks after an outbreak of methicillin-resistant staphylococcus aureus, or MRSA. In addition, about 3,000 former patients at St. Joseph's and the Lloydminster Women's Clinic were also tested for a number of diseases, including HIV, because of improperly sterilized surgical equipment.
An investigation by the Health Quality Council of Alberta saw dirty tap water used for hospital sterilization. Sterilized equipment left lying around haphazardly and in staff vehicles. Bathrooms were without sinks for hand washing and basic safety procedures routinely ignored in hospitals. Repeated request to improve the situation was made bit it was ignored by the hospital staffs.
In a "culture of frugality" the facility did not even have the proper equipment to sterilize laboratory gear, and ignored requests from the authority because of a turf war caused by fuzzy provincial legislation. In fact, procedures were so lacking throughout the health region, a walkthrough by a provincial expert of its facilities following the closure immediately identified more than 60 major deficiencies in infection control procedures, including such obvious concerns as corrugated cardboard waste being left in the sterilization area and both staff and patients not properly washing their hands.
The report's main recommendation is a review of the provincial legislation to ensure one entity has final authority over hospital health and safety issue.
The report also recommends that the government "define and create a culture of safety" among staff, managers and administrators.
The investigation report made the government take immediate action. The entire board of the East Central Health Authority handed in their resignation.
Health Minister Dave Hancock named two official administrators to oversee the health region's operations, replacing the board. "This is a necessary decision," said Hancock. "The relationship between East Central Health and St. Joseph's General Hospital has proven to be unworkable and so, in the best interest of patient safety and quality assurance, I have appointed two official administrators to be responsible for every aspect of health care delivery in the region. I want to thank the board members for their ongoing commitment, passion and determination to do what's best for their community, but it would be unfair, at this point, to ask them to find a solution to this untenable situation."
The board of management of St. Joseph's General Hospital, appointed by the minister in March, will continue to oversee daily operations at that facility.