C. Difficile From The Perspective Of An Ordinary Citizen

By Pat Scholfield

The Niagara Health System has finally admitted we are under an outbreak of C. difficile across all three of the major hospitals in Niagara. We  – the ordinary citizens – have also discovered that what was the hospital site in Port Colborne has three cases and the Fort Erie site has at least one.

Some time in June we discovered through the media that St. Catharines General Hospital had a significantly large number of C. difficile cases and some of these patients had died. Symptoms include diarrhea, fever and abdominal pain. The Niagara Health System (NHS) warned the public to wash their hands frequently and assured us they were doing everything possible to contain this outbreak. No mention was made of problems in the other hospitals across Niagara until the media again published information. It was in Niagara Falls and Welland with a grand total of 63 cases across the NHS (depending on who you believe). They have still not said anything about Port Colborne and Fort Erie.
We were assured by the NHS that C.difficile is an infection common in hospitals and long term care homes and typically affects elderly patients and those with compromised immune systems.

Frank Demizio, NHS vice president of Patient Services with responsibility for Infection Prevention and Control, has assured us, “Our patients and visitors should be reassured that it is safe to come to our sites for scheduled tests, procedures or emergency/urgent care visits.”

Can we believe this? What kind of record does the NHS have regarding telling the truth? We all know the NHS has no credibility with the people of Niagara because they have lied to them numerous times in the past.

Minister of Health Deb Matthews insists that the NHS is doing an excellent job so we have to question her credibility as well. For what it is worth I attended the LHIN board meeting Tuesday, June 28th and there was absolutely no mention of the C.  difficile outbreak in Niagara.

It was as if this disease was so common that it doesn’t warrant the board of the LHIN to be alerted or even concerned. Is it possible that C.difficile is so commonplace as to be found everywhere?

Out of curiosity, I went to West Lincoln Memorial Hospital (WLMH) in Grimsby (close to the LHIN office) and inquired if they have problems with C.difficile and discovered they have never had an outbreak. Their policy is any patient who is transferred there from another hospital or long term care home, or if they have any suspicions they immediately isolate the patient. If they ever have a patient with C.difficile it is only because they arrive with the problem, but are immediately isolated and contained and does not spread to the rest of the hospital.

WLMH is situated in Grimsby where they have a population of 19,000 according to their web site and are located about 15 minutes from Hamilton on one side and 15 minutes from the new St. Catharines hospital on the other side. Much of the 60-bed hospital is 50 years old. Somehow they escaped amalgamation in 2000 and still operate their community hospital with a dedicated hospital board. They have a long list of services they provide including Obstetrics, Gynaecology, Surgery, Intensive Care and Rehabilitation. On their message from the board chair he proudly states WLMH operates as one of the three most efficient hospitals in Ontario and they relieve pressure from the larger hospitals in both St. Catharines and Hamilton by bringing post-operation patients “back home” to rest and recuperate.

In further research I discovered from a British Medical Association report “Tackling Healthcare Associated Infections Through Effective Policy Actions” that high levels of bed occupancy may potentially impact effective infection control policies in several ways:
·    Increasing the proximity of patients and therefore the risk of direct and indirect patient-to-patient contact
·    Making it more difficult to clean thoroughly between patients
·    Reducing the ability to isolate patients when there is an outbreak of infection
·    Increasing the frequency with which patients are moved around a hospital, thus increasing the risk of inappropriate mixing of high risk and low risk patients

I venture to say that the NHS suffers from all these problems basically because of the implementation of the HIP, whereby they cut over 100 beds and accompanying staff and cut emergency departments and closed operating rooms in Port Colborne and Fort Erie. All of these measures have led to congestion and overcrowding across the system. What is their bed occupancy rate? It must be extremely high as they are constantly struggling to find an open bed and Admit No Beds is a frequent alert. In a recent NHS report they acknowledged 90% of the patients wanting to be admitted to the hospital from the ER have to wait 46.5 hours.

In conclusion, I have no medical certificate or PHD in accounting. I’m just an aging housewife searching for the truth and a return back to a hospital system that we can all be proud of.  WLMH has proven a C.difficile outbreak does not have to be considered routine and accepted as a necessary evil and we are to all go about business as usual. We can follow the model of WLMH and correct what is wrong with the NHS.

Pat Scholfield is a south Niagara resident and a longtime advocate for quality hospital services that are fair and accessible for all Niagara residents.

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