Lakeshore hospital ER urgently needs renovation for patient safety, new report finds

There is a risk of more preventable deaths in the Lakeshore General Hospital's emergency room and a dire need for changes there, an independent investigator said Thursday in a new report.

The report highlights problems in the ER and makes 135 recommendations. Foremost among them isthe urgent need for a long-promised renovation that would give patients more space andprivacy and also make it easier for staff to see them and provide care.

"It's urgent to tackle this in-depth renovation," Francine Dupuis, the author of the report, wrote, "and we can't wait a few more years, because we're taking a big risk, with bad results."

The reportwas ordered by Health Minister Christian Dub in February after the Montreal Gazette cast light on patient deaths there. It is the latest in a string of investigations and reports which have, for years, flagged problems at its ER.

"There's no longer any need to continue analyzing the situation: it's time for action," Dupuis wrote.

"We need to put an end to the flurry of recommendations and committees that have been thrown around for years, creating the illusion that they were making progress, when in fact it seems to be creating confusion and paralysis."

Her report, based on nearly 70 interviews, provides colour to the difficult situation at the Lakeshore ER. The Pointe-Claire hospital is the only one in Montreal's West Island, an area with a growing and aging population.

Dupuis, who is the formerassociate executive director of the centre-west health authority,said the mortality rate at the hospital (deaths per 1,000 visits) is the second highest of any community hospital in the Montreal area. She did not say which hospital topped the list.

The rate is high in part because of the institution's layout. The ER is housed in what was originally meant to be a temporary addition to the hospital.

It is crowded. Gurneys line hallways and families struggle to find space to care for loved ones. At a news conference, Dupuis described it as Ste-Catherine Street at rush hour.

The staff also struggle with malfunctioning or broken equipment and the institution suffers from the same problems that plague health-care institutions across the province and the country, like organizational difficulties, aging infrastructure and staff shortages. But the Lakeshore does a poorer job coping with these challenges than other places, Dupuis wrote.

Her 135 recommendations include calls to improve staffing and the communication between the frontline workers and their supervisors and managers, but, she noted that even if these problems were fixed, the root of the issue the layout and age of the crowded space will continue to lead to problems.

Until the ER is renovated, "other unfortunate events risk happening," Dupuis's report said.

New modular ER addition coming in the Fall

Dan Gabay, the CEOof the West Island health authority, said the hospital will be getting some relief in the Fall.

A $13-million replacement emergency unit will be added to the hospital to increase space.

The overflow space should help staff keep tabs on patients, Dupuis said. One of the problems with the current ER is that it is overcrowded and patients in distress are sometimes out of sight.

Responding to a question asking if the ER was safe for patients, Dupuis said it was.

"Yes.There are things that are already in progress and there are thing that will be in place very shortly," she said. "You're asking me if I have a crystal ball and I don't have one. But I'm certain that everyone is very cautious to do the right thing."

But the full renovation of the ER, promised in the leadup to the 2018 provincial election campaign, still remains years away. The project is awaiting approval from the Health Ministry, Gabay said, and will only be finished infour or five years.

Gabay said he will ensure that Dupuis's recommendations are implemented.

"This is why I was appointed," he said. "I dream for Lakeshore. I see a future [for] Lakeshore. A lot of great pieces are already in place and right now I'm very confident that by using the report we're going to be able to work with the clinicians, doctors, nurses, and different professionals, to move forward."