Hospital’s silence on ‘dead’ baby draws fire
Ex-official says secrecy rule has been misinterpreted
Humber River Hospital is wrong to use quality of care legislation to keep secret the results of its probe into how a newborn baby was wrongly declared dead, says the former head of the Ontario Hospital Association.
Speaking with the Star, Tom Closson suggested Humber chief executive Rueben Devlin is misinterpreting what can and can’t be revealed under the Quality of Care Information Protection Act.
“He should be telling everybody what they are going to do to make sure that they don’t declare somebody dead,” said Closson, former president of both the University Health Network and Sunnybrook Health Sciences Centre. “Obviously, something went wrong here.”
Humber did not respond to requests for an interview with Devlin Thursday, but earlier this week he told the Star in an email that neither the findings nor the recommendations would be made public or released to the family of a newborn girl discovered alive 90 minutes after she was declared dead in February.
“There is nothing under (the act) that says he can’t tell everybody what he is doing to improve the situation so something like that doesn’t happen again,” said Closson, who believes the act is a “noble” piece of legislation, though he disagrees with Humber’s interpretation.
But others, including Closson’s successor at the OHA, disagree with that reading. And therein lies what some say is a major problem with the law: it is interpreted differently by hospitals across the province.
The quality-of-care act was part of a twopronged 2004 bill — the Health Information Protection Act — pitched by the Dalton McGuinty Liberals as a way to protect patient confidentiality. But it has morphed into a tool that some argue is misused to actually prevent patients from getting details about mistakes made in their care. Hospitals can choose whether to conduct investigations under the act’s protection or not. If they do, results and recommendations can be secret.
The act’s purpose is to encourage medical professionals to speak openly and frankly about incidents without fear of having that information used against them in legal proceedings. Current OHA president Pat Campbell said its interpretation is more in line with that of the Humber CEO.
“As with any legislation, yes, there are probably things that could be done to improve it, but the principle of having a capacity that promotes the open dialogue and active seeking of improvement is an important part of a successful quality-improvement culture.”
Campbell said the act has improved patient care, but acknowledged the evidence for that is anecdotal. There have been no studies on its effectiveness.
Dr. Robert Bell, president and CEO of University Health Network, said UHN’s policy “as we interpret QCIPA” is to share with patients the recommendations that come out of investigations conducted under the act.
“I think there’s a lot of misunderstanding about what’s protected in QCIPA,” said Bell, who is also chair of the quality council at UHN, which includes four Toronto hospitals.
Bell said UHN uses the act to investigate all serious adverse events. It does explain thoroughly to patients what happened and why, when things go wrong, though the more detailed “root cause” analysis that comes out of the QCIPA review is not provided.
The Humber hospital investigation followed an incident in which a baby born outdoors in sub-freezing temperatures was brought to emergency and wrongly declared dead after “extensive” resuscitation efforts.
The Health Ministry was still reviewing information Thursday before commenting, but staff stressed that quality-of-care legislation does not prevent patients from getting the “material facts” about critical incidents.
Further, the act “does not relieve the hospital from any obligation that it may have to investigate and take appropriate action with respect to critical incidents,” Zita Astravas, the minister’s spokeswoman, said in an email.
Earlier this week, Health Minister Deb Matthews said that in health, “we’re always striving to learn from anything. Any incident is a learning experience, is a learning opportunity, so we need to do that.”
However, under the OHA’s interpretation of the act and related amendments, hospitals technically cannot share with other hospitals specific recommendations and lessons learned that come out of QCIPA reviews.