MUHC chief defends decision to scale back Code White training
The head of the McGill University Health Centre defended on Friday the decision to scale back Code White violent-incident training for nurses and other staff dealing with patients and visitors at the Montreal General Hospital.
For the first time since an ER nurse was nearly strangled by a patient at the Montreal General last September, the interim executive director spoke at an MUHC public meeting about the assault and the need to tighten security at the downtown hospital.
Martine Alfonso’s comments came after the publication of a four-part series by the Montreal Gazette this week highlighting numerous security anomalies at the Montreal General, a Level 1 trauma centre that also has a psychiatric emergency room.
“We understand that people were shaken by what has happened, so we take that very seriously,” Alfonso said during a sombre exchange with a member of the Montreal General’s patient-rights committee.
Evelyn Seligman, a dialysis patient at the public meeting, cited a Gazette story about the MUHC’s decision to drop plans last summer to train 400 staff in Omega crisis de-escalation techniques, as recommended by the Code White training subcommittee.
The estimated cost of that program was $341,000.
The Gazette reported that the MUHC decided to instead offer training in restraint techniques developed by the Crisis Prevention Institute (CPI) in the United States and to only 75 of the 150 nurses, orderlies and security guards identified at the Montreal General.
Alfonso responded that the MUHC does intend to eventually give the CPI training to all 400 staff across the MUHC.
Although she acknowledged that the MUHC did consider the fourday Omega course, it concluded that the two-day CPI training was better suited for the staff in the Montreal General’s ER and psychiatry unit.
Still, Alfonso did not explain why the MUHC chose to train only half the originally identified staff at the Montreal General. Nor did she provide CPI training budget figures.
Stéphane Guay, a trauma expert at the Institut universitaire en santé mentale de Montréal, said in an interview Friday that Omega training is ideally suited for a hospital like the Montreal General.
Guay published a study two years ago demonstrating the effectiveness of Omega training, which was conceived in Quebec and is used by staff at the Douglas Mental Health University Insitute and the Centre hospitalier de l’Université de Montréal.
Asked what he thought of CPI training, Guay replied: “It came before Omega. It’s based on similar principles, but Omega is better for clinical settings and it’s more structured.”
Alfonso denied financial pressures influenced the decision to go with CPI training.
“None of those decisions are made for savings,” Alfonso said.
“It is not a factor in the security at the MUHC. We have asked almost everyone to find ways to optimize, to work in better, more optimal ways, but the decisions that were made for staffing and security and for training were not related to” budget cuts.
Alfonso appeared open to making further security improvements: “We will continue to see if there are not other great ideas in other health-care institutions that we can bring in.”