Patients who undergo major surgery in Prince George are eight times more likely to die within five days of surgery than they are in Winnipeg - the highest death rate in the country - according to a new online website that compares hospitals across Canada.
The Canadian Institute for Health Information and its Canadian Hospital Reporting Project found the cross-Canada death rate in 2010-11 ranged from a low of 2.2 deaths per 1,000 major surgery patients at Concordia Hospital in Winnipeg to a high of 16.5 per 1,000 at
University Hospital of Northern B.C.
While that might seem a distressing statistic, one that has become the subject of further investigation by local hospital officials, Northern Health Authority chief operating officer Michael McMillan says the numbers quoted are in-hospital mortality rates, which makes a smaller hospital like UHNBC appear more problematic than a large-city hospital that performs three times as many
procedures.
"UHNBC is a 200-bed hospital and when you compare it to other hospitals that have 500 or 700 beds, the number of cases we do compared to the number of cases they do is significantly different," said McMillan. "I don't think people should be alarmed about the rate, it's very small numbers of adverse outcomes. We can have a few unfortunate outcomes and our rate can be very high, so we're actually only talking about a handful of outcomes. When you compare the relative number of cases for all the hospitals, Canada has a very safe health care system."
The average five-day death rate after surgery was 9.26 per 1,000 patients.
People who live in the Northern Health region are statistically considered 20 per cent less healthy than Vancouver or Victoria residents, and McMillan said that could contribute to UHNBC's higher rate.
"We will be pulling every single case [of in-hospital death] and reviewing them and I have every confidence we've already reviewed them through our normal process in surgical care," McMillan said.
The Canadian Hospital Reporting Project database compares more than 600 acute care hospitals in Canada over a four-year period, including smaller facilities that have been left out of previous studies. It tracks information on death rates after major surgery, heart attacks and strokes, the number of patents readmitted after knee or hip surgery, and how many hospital patients suffer bedsores or falls while in hospital care.
The website, which summarizes how hospitals rate against each other in 21 health outcome indicators and nine financial comparisons, crashed shortly after it was launched for the public on Wednesday. It had been available to hospitals for several days.
"We've only had the report for a short period of time so we're drilling into the numbers, fully committed to analyzing and looking for anything it can point to in terms of any changes we need to make immediately," said McMillan. "We'll continue to stay on the course of constantly trying to improve our services."
B.C. hospitals have implemented a standardized checklist before every surgical procedure, similar to the checks aircraft pilots undertake before they take off, and McMillan said that has helped produce better outcomes for patients, preventing such mistakes as having surgery performed on the wrong limb.
"This report validates the direction Northern Health is going in terms of quality improvement - we're one of a number of hospitals in B.C. that are implementing a national surgical quality improvement program similar to the work we've been doing in obstetrical care over the last number of years," said McMillan.
"It's ultimately a very helpful report for all hospital and health authorities. As an organization, I think we've gone beyond struggling to keep our head above water and we are able to invest a portion of our resources and our effort into improving quality and I'm actually very proud of that."
