After life-saving cancer surgery, doctors at London Health Sciences Centre’s Victoria campus wouldn’t allow Saydeh Daher to return to Windsor for nearly a month because it wasn’t safe.
The dialysis which Daher needed three times a week takes place at Windsor Regional Hospital’s Ouellette campus, which is four kilometres away from the cancer clinic at Met campus, where Daher would be recovering. Leaving the clinic so frequently would increase her risk of infection, says her oncologist Dr. Caroline Hamm.
“London wouldn’t let her come back because we don’t have dialysis at the same hospital,” says Hamm. “Rather than have her in a critical state, going back and forth across the city, she stayed in London for the whole month.” Normally, a patient returns to Windsor within days after a stem-cell transplant.
The extended separation from her family added to what was already a stressful situation. “My family was on the highway back and forth all the time,” says the Windsor grandmother. “I was worried about them. I was really upset, but there was nothing I could do about it. I had to stay there.”
Every year, about 1,500 patients are transported between Windsor Regional’s two campuses. It’s a by-the- numbers reality for a hospital divided by its specialized services.
And each trip puts a patient at risk for infection, physical injury and missed medical doses according to researchers at the Canadian Patient Safety Institute (CPSI).
Transfers of care pose one of the highest risks to patient safety, according to the Ottawa-based organization.
For someone who is ill, they increase potential exposures to life-threatening infections. And patient handovers between hospitals include a transfer of information – whether electronically or on paper – that leaves more room for medication errors, such as missed doses.
“From a general safety perspective, transfer of care is one of the highest patient safety risks. Transfer of care, handovers or handoffs between care providers, settings and teams creates opportunities for gaps in care, teamwork and communication breakdowns,” says Sandi Kossey, a senior director with CPSI. “There are standardized precautions that sometimes can break down when you are being transported. It’s not optimal care for that patient or the family.
“Health care is a really scary environment,” says Kossey. “If you don’t fully know what’s going on, where you are going or for what purpose and it causes a lot of distress in the patient care team.”
Windsor Regional doctors and nurses say transfers are inconvenient, time- consuming and stressful for medical staff, who no longer “have eyes” on their patient.
“This is not good for patients. They are so weak and some of them are dying. These patients are suffering,” says Dr. Padmaja Naidu, a hospitalist – or internal medicine doctor – at the Met campus. “Imagine your loved one being critically ill and shipped to another location because the hospital they are in doesn’t have what they need. It doesn’t make sense having two different hospitals in one city.”
But for now, transports are necessary. If a cancer patient at Met has a heart attack, needs a shunt reprogrammed or develops renal failure, the patient must go to Ouellette. If a patient at Ouellette has a pregnancy-related complication, it’s a ride by ambulance or transport shuttle to Met.
The hospital pays about $550,000 a year for the private shuttle transfers. Ambulance transports are a separate cost.
What’s done at Met, Ouellette
Both Campuses: emergencies, ambulatory care, medicine and surgery
- Regional Cancer Services
- Paediatric Services
- Family Birthing Centre
- National Intensive Care
- Complex Trauma
- Renal Dialysis
- Cardiac Care
- Stroke and Neurosciences
- Acute Mental Health
Windsor Mayor Drew Dilkens Feels for the Hospital Staff
“You have great people doing the best they can with the facilities they have, but there is no denying – you have a room where there are five beds and the washroom is down the hall. We know that infection rates higher than in newer facilities with private rooms,” says Dilkens. “This is about providing modern service to the residents here.”