The Letter reveals IHA’s dirty little secret

Well, The Letter finally showed up. The one from the Interior Health Authority. 

“I am writing to you on behalf of Interior Health as a valued patient of the Royal Inland Hospital in Kamloops.” 
It’s nice to be valued. But, seriously, while I made light of The Letter last week, it’s not really a laughing matter. 

The Interior Health Authority has a credibility problem, and this business over the dirty endoscopes doesn’t help. Nine thousand men and women are now wondering whether they can ever trust Royal Inland Hospital again. 

Doctors and staff are also getting fed up. Like the staffer who calls the endoscope issue “another nail into the coffin of RIH. Our hospital is now considered the ‘dirtiest’ of hospitals in Canada amongst the healthcare community.” 

The IHA, this staff member claims, has destroyed RIH’s reputation in a mere eight years. 

“The lack of community control over our hospital has played a key part in this. The IHA has placed a series of incompetent senior managers in our facility that have been unable to maintain nor understand appropriate clinical controls.” 

A doctor told me this week, “Interior Health isn’t working. Not for us it isn’t. Kamloops should have independent oversight.” 

He worried that the endoscope caper will cause patients to avoid having tests like colonoscopies because they’ve lost confidence. 

Which brings us back to The Letter. 

“You are receiving this letter because you underwent an endoscopic (scoping) procedure at that facility between March 6, 2008 and July 15, 2010. We want to advise you of an issue related to the disinfection of the equipment used to perform that examination.” 

Risk? Somewhere between one in a million and one in 10 million. No further treatment needed but “for the sake of transparency we believe it is important that you are informed.” 

There follows an explanation of how the endoscopes came to be not quite clean, and the steps taken to clean up the problem. The Letter is signed by Jeremy Etherington, MD, vice president of medicine and quality at IHA. 

While this sudden attack of transparency is welcome — the IHA is one of the least transparent organizations around — the “Patient Information Sheet” Q&A that comes with the letter raises as many questions as it answers. 

The endoscope problem was discovered, it says, when IHA was reviewing reprocessing practices at RIH in July this year “after another hospital had discovered residual disinfectant left in portions of endoscopes during the disinfection process.” 

The hospital isn’t identified, nor does it say when the other hospital made its own discovery. Those would be good things to know. If the other hospital was Kelowna (as I’m told it was), and if it was discovered there in December of last year (as I’m told it was), then how is it that it took seven months to do a check on RIH, and another five months to make it public? 

An answer to the second question is on the sheet: “While this was first raised as a potential issue in July, Interior Health spent the next several months taking steps to confirm there was an issue and determining the actual risk to patients. When this risk was identified — as being extremely low — Interior Health sought advice about notifying patients. Disclosure to patients could lead to increased patient anxiety and since no follow up actions or testing was being recommended for patients, Interior Health wanted to be certain that was the most appropriate action to take.” 

Could that be why no disclosure was made at the unnamed other hospital? 

There’s a growing conviction that IHA is broken, especially when it comes to RIH, and that there are three simple answers: return control of our hospital to our community, give RIH a fair share of the budget, and start actually being transparent instead of just saying it. 

mrothenburger@kamloopsnews.ca
http://www.armchairmayor.wordpress.com