It appears the capital region has three fine hospitals to be proud of. In a national comparison conducted by the Canadian Institute for Health Information, Victoria General, Royal Jubilee and Saanich Peninsula all scored well.
Their record for mortalities and in-hospital infections is significantly better than the national average. Fewer patients die during major surgery than in most of sa国际传媒鈥檚 hospitals. Wait times in emergency are shorter by a significant margin.
And in a remarkable turnaround, the proportion of low-risk deliveries by caesarean section is now beneath the national average. Physicians have long known that natural births, where appropriate, are safer for mother and baby alike.
Yet Victoria used to have one of the highest C-section rates in sa国际传媒. Those days, apparently, are over.
These successes are all the more striking because they鈥檝e been achieved without breaking the bank. Across the country, teaching hospitals spend almost 20 per cent more on patient care than Victoria General and Royal Jubilee. Yet our results are better.
For example, per-patient costs at Surrey Memorial in the Lower Mainland are well above those at Victoria General and Royal Jubilee. Yet the mortality rate at Surrey Memorial is 20 per cent higher, the infection rate is 160 per cent higher and 40 per cent more patients die during major surgery. Wait times in emergency are nearly an hour longer.
It might be thought that comparisons like this are risky. What if one hospital serves a population that is old and sick, while another caters to a young and healthy community?
However, factors such as age and gender are screened out before the hospital profiles are published. The health of the surrounding population is also taken into account when calculating mortality rates.
In other words, the comparisons are generally fair. And what they suggest is that money plays only a limited part in providing high-quality care. The main factors are strong management and clinical leadership.
Yet there are enormous difficulties to overcome. Hospitals today are far more crowded than they were two decades ago. At any time, 97 per cent of the beds in Victoria鈥檚 hospitals are occupied.
And the patients are much sicker. Those who are only moderately ill are increasingly seen at outpatient clinics.
The threat posed by infections is a good example of the challenge managers face. The causes are well known. Surgery patients, patients whose immune systems are run down and patients with chronic ailments such as diabetes are all at heightened risk of infection.
The guidelines for treatment 鈥� a strong dose of anti-biotics 鈥� are also well known.
Time is the critical factor. For every hour that treatment is delayed, the mortality rate climbs eight per cent. Early diagnosis is essential.
But how do you ensure that, when nurses and doctors are running from pillar to post all day long?
The solution adopted by Island Health, which runs the Victoria hospitals, is bedside vigilance. Infection kits are kept close at hand, so nurses don鈥檛 have to run to the pharmacy. Medical charts highlight patients at risk of infection.
Staff meetings are held at regular intervals to pound home the message. And monthly scoresheets are posted to focus attention.
Nothing flashy, in other words. No miracle cure. Just plain, hard slogging.
Like much else in a well-run hospital, efforts like these go largely unseen by the public. Yet they make the difference between first-rate care and just getting by. More important, the patient goes home alive.
Our health system isn鈥檛 by any means perfect. It has plenty of blind spots to worry about.
But it鈥檚 reassuring to know that Victoria鈥檚 hospitals are safe and efficient. Congratulations on a job well done.
