Poorly sterilized cystoscope, employees who talk or laugh too loudly, members of staff who use their cellphones for non-professional purposes, waiting for several hours for a planned medical appointment, inability to accompany a vulnerable loved one due to instructions from visits that are too restrictive, postponements of surgical operations when the user is already in the operating room: these are some of the complaints filed by users of the Center hospitalier de l’Université de Montréal (CHUM) over the past year.
Sylvie Fortin, local commissioner for complaints and the quality of services at the CHUM, unveiled her 2020-2021 report on Wednesday, another extremely difficult year for staff and patients.
The commissioner handled 1,243 files, including 310 complaint files (in the other files, she provided assistance, intervened directly or was consulted by staff).
The commissioner notes that she handled 8% fewer cases than last year (but the comparison can be difficult, more appointments having been held at a distance).
In total, 171 files studied by the Commissioner relate to the pandemic.
The management of visits and accompaniments aroused various reactions, often tinged with anger and incomprehension.
Sylvie Fortin, local commissioner of the CHUM, who notes that the visit restriction has been “strongly criticized”
In fact, even at the beginning of the summer, the CHUM limited visits much more than what the guidelines of the Ministry of Health and Social Services required. TO Press, people have told of having been unable to accompany a loved one with advanced cancer beyond triage, to the emergency room. Others complained that they were deprived of the last moments with their loved one, who fell unconscious before the visit was finally authorized.
Complaints about care and services
Users have complained of an “undue wait to see the doctor while the appointment is scheduled,” observes the commissioner. This waiting can go up to a few hours of waiting in the room. Overloading schedules and adding extra patients are the most common causes. This element concerns the doctor who manages his list of appointments ”, it is written.
Postponements of surgical interventions, while the user is already waiting on site, in the operating room, also irritate many. “These postponements are difficult for users to accept. Each file submitted was investigated and the postponements were justified either by a surgical emergency or by a complication of a surgical intervention during the day ”, explains the commissioner.
In addition, inadequate pain relief has been “the subject of complaints in various departments. The personnel targeted by these complaints have been the subject of evaluations of their practice in order to avoid the recurrence of such events ”, it is written.
“Multiple complaints” were also filed “in connection with the personal discussions and the loud laughter of the staff at the posts of the hospital units. Some conversations were audible enough for users to pick up the details, ”we can still read.
Several users also object to the automated telephone system for confirming appointments. “Users have difficulty with this system and invoke humanitarian reasons,” emphasizes Commissioner Fortin.
“Some users do not answer when they see that the call displays a confidential number and thus deprive themselves of obtaining an appointment. They finally get an appointment after direct dealings with the appointment center, but ask that we revert to personalized calls, because they do not like interacting with a ‘machine’. “
Poorly planned hospital discharges, impromptu transfers – with, sometimes, “a user not adequately dressed” – were also reported to the commissioner.
Also, “the underestimation of the risk of falling after examinations under sedation was the subject of a re-evaluation of the processes and practice of the employee concerned”.
Cellphones, good manners and empathy
The report also indicates that staff members use their cellphones during work time, mostly to check or send text messages, “while cellphones are prohibited during working hours (except when they are used for work). ) ”.
Inappropriate comments of all kinds are often made to users requesting information. “Many complaints are aimed at clerks in various departments. ”
The lack of empathy on the part of some nurses was also brought to the attention of Commissioner Fortin. “According to these users, we do not take the time to listen to them when providing care. In certain distressing situations, users say that some nurses do not know what attitude to adopt. However, in return, the attitude of other nurses taking over is underlined as being exceptional. ”
Wearing the mask also occupied the commissioner, some users complaining of having to wear it, others observing on the contrary that the staff wore it inadequately, under the nose or under the chin.
“Interventions were carried out to correct the situation. No nursing or medical staff was the subject of these complaints. ”
In her conclusion, the Commissioner salutes “those who worked in conditions which were not always easy in order to treat and protect users during the pandemic”.
Relative independence, according to the users’ committee
Diane Brodeur, president of the CHUM Users’ Committee, also emphasizes the extent to which the CHUM and other care institutions have had to deal with a particularly difficult year.
She adds that what has not changed, however, is that patients continue to fear filing a complaint. “They are very afraid of having reprisals, that their complaint appears in their file”, observes Mme Brodeur.
This former nurse, who worked for 40 years (notably at Saint-Luc hospital, then at the CHUM), denounces the fact that at the CHUM as in other health establishments in Quebec, the complaints commissioner is paid by the ‘hospital.
To guarantee real independence, Mr.me Brodeur would clearly prefer that the commissioner “report, for example, to the Québec Ombudsman” or to another entity outside the hospitals.
It should be noted that this report does not cover complaints against physicians, these files being the responsibility of medical advisers.
230: number of corrective measures requested by the CHUM personnel commissioner
31%… of users’ reasons for dissatisfaction relate to the care and services offered
29%… of users’ reasons for dissatisfaction relate to relations with staff
Source: 2020-2021 Annual Report, local service quality and complaints commissioner