Unsafe care claims at Halifax Infirmary 'very exaggerated,' says chief doctor

The Nova Scotia Health Authority is disputing a claim by one of the province's largest unions that patients at the Halifax Infirmary are receiving care that is "not safe."

The Nova Scotia Government and General Employees Union made the allegation Monday after reviewing statistics it obtained on how often a "code census" was called at the hospital.

"I think the insinuations of unsafe care are very exaggerated, I think the care is very, very good," Dr. Samuel Campbell, chief of the emergency department at the Halifax Infirmary, said Wednesday.

A code census is called when an emergency department is overcrowded to the point that it is deemed unsafe. Other hospital departments then have 30 minutes to get ready to accept more patients to free up beds in emergency. 

Last year, there were 146 code censuses at the Halifax Infirmary emergency department, a significant increase from the prior two years, according to the union. 

'Spreading existing risk'

The union said it is not safe for code censuses to be called so often and for patients to wait five times longer than they should to see an emergency department physician. 

But Campbell said a code census is not about dumping patients in different spots around the hospital. He said in some cases it's safer to have a stable patient in a bed in a hallway then have them continue to stay in the emergency room.

"It's really about spreading existing risk, it's not about taking on more risk," he said. "The whole system is overwhelmed and this is not just in Halifax, this is right across North America."   

Part of the problem is some hospital beds are being taken up by patients who need long-term care, but are waiting to get into facilities or find home care. That means there's fewer beds for new patients. 

Campbell acknowledged wait times for emergency and other hospital services are "not good."

"If you're extremely sick you're going to get a bed and you're going to get seen really quickly," he said.

"The problem is that if you are moderately sick you're going to wait longer because the space to treat you is being used by someone who needs to go into hospital and there's no space in the hospital."

The health authority is working every day to find appropriate space in its facilities for patients that need to be admitted, said Brian Butt, the authority's health services director. 

Recommendations in effect or in the works, says hospital

The NSGEU also released a report Monday that offered 15 recommendations to improve the situation at the Halifax Infirmary. It included such suggestions as a review of staffing levels at the hospital and an examination of the number of long-term patients taking up hospital beds. 

A number of those recommendations had already been taken up by the hospital and others were already being worked on, according to Campbell. 

The report also said that patients from P.E.I. are often kept at the Halifax Infirmary for an extended period of time before a bed in their home province opens up or they're able to access home care. 

Butt said that's far less of an issue than the report suggests.  

"Out of 159 patients that came to the QEII [Health Sciences Centre] from Prince Edward Island for care since last April to February, only four of those actually remained after a two-day period waiting for transfer back to P.E.I."