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Lack of information on deaths in Island care homes criticized

Nov 26 2011

There have been 3,496 deaths in Vancouver Island residential care homes since 2008, but the health authority is unable to say how many were unexpected and due to negligent care or accidents, if any.

The deaths occurred between 2008 and October this year in the approximate 100 facilities funded by Vancouver Island Health Authority across the Island. The information was released by VIHA at the request of the Times Colonist Friday.

Most deaths involving aged seniors are expected to be due to natural causes. However, VIHA couldn't provide data on how many of the deaths were unexpected and due to patient safety concerns, accidents or staff errors, if any.

A lack of readily available specific data means that it is almost impossible for the public to evaluate, track and compare the quality or risks associated with seniors' care homes in the region or across the province, critics say.

"It's another argument for a senior's advocate in B.C.," NDP health critic Mike Farnworth said Friday. Currently, it's easier to access and compare information on the quality of restaurants in B.C. than it is care homes, Farnworth said.

"The information should be standard across the province so you can compare care homes whether in Dawson Creek, Sidney, Victoria, Cranbrook or Haida Gwaii," Farnworth said.

The injury accident rates and causes of death and the resolutions to any these issues should all be easy to access and understand on the Internet, he added.

"There should be fulsome information [about each facility]," Farnworth said.

"And there should be one standard [of reporting] for all health authorities right across the province."

Care systems in Ontario offer centralized websites with timely risk profiles of each residential care facility. In B.C., information is reported in different ways by the province's five health authorities.

VIHA says it reports all incidents and deaths according to the Residential Care Regulation under the Community Care and Assisted Living Act. There is no requirement to refine data to show unexpected versus expected deaths, for example, says VIHA.

Despite the fact "we don't have ready access to the number," every reportable incident at a residential care home, and every death is reviewed by the health authority's licensing branch, said VIHA spokeswoman Shannon Marshall said.

In addition, every unexpected death is reviewed again by a coroner. In some instances the coroner will make patient-safety recommendations, Marshall said. However, the statistical breakdown is not available.

Kim Bruce, VIHA's regional manager of community care facilities licensing, confirmed that all deaths in care facilities are reviewed and any expected or unexpected death that raises concern is fully investigated by the licensing branch and the coroner, who determines cause of death.

"Our job is to determine whether there were health and safety concerns while the person was in care," Bruce said. "We have all the data, it's just not in our information system."

Bruce hopes to be able to make the statistical information available next week, although it's never been collated in such fashion.

"I have confidence we are investigating these health and safety issues and if there are health and safety issues they are addressed," Bruce said.

"If there is one particular facility where there is a peak in issues, we are aware of those issues."

There is good communication within licensing, but admittedly there's always ways to improve in terms of providing information to the public, Bruce said.

"I'm involved in every debrief on investigations," Bruce said.

"I have a pretty good idea of what's going on in the health authority."

While most people in residential care homes are senior citizens, some are younger people with early onset Alzheimer's, debilitating brain injuries or Huntington's disease, for example.

Some of the residential care facilities on the Island are owned and operated by VIHA while others are owned by private, notfor-profit operators or private for-profit service providers, which are funded under contract to VIHA.

Another group are privately owned and operated and privately funded.

However, all facilities have to be licensed and VIHA records reportable incidents for all of these facilities.

"Over the past 18 to 24 months, VIHA has placed a great deal of emphasis on supporting and encouraging the reporting of all incidents as part of our quality goals and objectives," Marshall said.

REPORTABLE INCIDENTS IN ALL VIHA-LICENSED RESIDENTIAL CARE FACILITIES FROM 2008 TO 2011

Aggressive behaviour 891

Attempted suicide 29

Choking 46

Death 3,496

Disease outbreak 46

Emergency restraint 59

Emotional abuse 35

Fall 2,379

Food poisoning 5

Medication error 79

Missing/wandering 307

Motor vehicle injury 3

Neglect 22

Other injury 339

Physical abuse 34

Poisoning 7

Service delivery problems 86

Unexpected illness 3,418

ceharnett@timescolonist.com

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