Quality Assurance Missing at Children's Emergency

Dr. Steven Noseworthy’s piece in the Saturday Telegram was “déjà vu all over again”.  The Janeway emergency room is run by Eastern Health.  We are told by this specialist in pediatric emergency medicine that the Janeway set up “lacks pediatric emergentologists, research activity, quality assurance measures, and a suitable academic environment in which to teach”, and that trainees should be sent out of the province.  Whether the ER is working well or poorly is unknown, because “there are few, if any, quality assurance measures in place” to allow for evaluation.

 Another Eastern Health service in which few, if any, quality assurance measures have been in place comes readily to mind: its pathology lab and hormone receptor testing program.  This is the university affiliated tertiary care centre lab, which former chief Dr. Don Cook told me under cross-examination at the Cameron Inquiry, was nothing more than “a glorified community lab”.  The insider revelations of Dr. Noseworthy now suggest that the emergency department of our flagship children’s hospital is merely a glorified community emergency room.

 This is an issue of patient safety.  A case which remains vivid in my mind as a malpractice lawyer concerned a child whose diagnosis was delayed by an undertrained doctor staffing emergency, while a treatable condition of bacterial meningitis raged through the child’s brain.  This client survived with very significant neurological damage.  Successfully resolving a claim for damages is not a substitute for a high standard of emergency care and proper quality assurance.  Better to avoid injury in the beginning than to seek a remedy in damages later. 

 Eastern Health has dramatically improved quality assurance and patient safety in the pathology lab.  It should put the same effort into improving quality in other services.