Anna-Laberge Hospital: A Damning Report from the Quebec Ombudsman

An investigation led by the Quebec Ombudsman has shown that several problems at the emergency room at the Anna Laberge Hospital in Châteauguay have had significant impacts on patients’ health and care. The ombudsman hopes that following her recommendations, the provincial government will keep a close eye on this specific case.

Translation Amanda Bennett

In June of 2021, the Quebec Ombudsman published a damning report regarding a situation that has prevailed in the Anna-Laberge Hospital’s emergency room for some years. The investigation, which went on for close to nine months, began following personal accounts and alerts which were made regarding the critical status of the establishment’s ER.    

In their report, delegates Marie Noël Collin and Claudie Morin observed, “many impacts generated by emergency room overcrowding and a lack of hospital fluidity which have affected the quality of care as well as patient monitoring”.

The report takes stock of care not provided, medication errors, a lack of equipment adapted to users’ conditions, a lack of patient monitoring, as well as health care services provided from locations that were not adequate.

The authors’ report asserts that seniors, who make up a significant portion of the emergency room’s clientele, have been particularly affected by this lack of organization. Among their remarks to investigators, hospital staff reported an increase in cases of delirium, frequent falls, risk of malnutrition, immobilization syndrome and agitation among various users.

A Myriad of Problems

As the report indicates, the issues at the Anna-Laberge Hospital emergency room stem from a variety of reasons.

A lack of human resources is a predominant factor in the poor functioning of the emergency department. According to the ombudsman, “all those questioned were unanimous about the workforce shortages, regardless of their level within the establishment’s hierarchy. The MSSS acknowledged the staffing imbalance within the region which is detrimental to the CISSS de la Montérégie-Ouest”.

The investigation also demonstrated failures in emergency management. According to the report, the hospital is experiencing a lack of leadership.   

“Frequent changes of Directors of Professional Services have been observed within the establishment over the past ten years. This kind of situation hinders the development of a long-term vision for the emergency department,” indicated the delegates in their analysis of the situation.

The lack of beds is another major element in the equation. With 201 short-term hospital beds and 32 emergency room stretchers, the hospital is unable to keep up with demand.  

“The need to reserve 39 ‘hot’ hospital beds for COVID-19 positive users has caused additional strain on the emergency room,” the investigators concluded.

The investigation also raised inconsistencies and deficiencies regarding computer equipment, consultations and emergency room admissions.

The Ombudsman’s Recommendations

The hospital experiences many episodes of overcrowding within its emergency room which serves approximately 45,000 people each year. Stretcher occupancy rates are frequently around 175%, sometimes even 200%. The report indicates that the COVID-19 pandemic did nothing to help the situation. In fact, on the contrary it generated additional pressure when it came to efficiency and safety in the emergency department.

In the hopes of resolving the issue, the Quebec Ombudsman has issued several recommendations both to the Châteauguay Hospital Centre, as well as the Ministry of Health and Social Services.

Among the advice, the ombudsman advocates for an increase to emergency room nursing staff, the reorganization of the physical space within the emergency department, the introduction of a de-cluttering plan, more efficient computer tools, a more thorough patient-monitoring system and a better admissions management process.   

The CISSS and the Ministry have assured the Quebec Ombudsman of their full collaboration in this file. They mentioned that they would undertake the necessary follow-ups to adequately respond to the various demands formulated within the report.