Canada's Patient Safety Record

The Canadian Institute for Health Information (CIHI) is an independent, not for profit, organization dedicated to providing essential health information to Canadians. The CIHI gathers, packages and disseminates health information to inform the policy, management, care and research performed by health leaders in the hope of improving the overall quality of health care in Canada. CIHI works with partners and stakeholders throughout the country. Recently they compared several "quality of care" indicators in Canada to those in thirty other countries through the Organisation for Economic Co-Operation and Development (OECD). The data is released every two years and serves as a benchmark of Canadian performance across six dimensions of care:

• Health status,
• Non-medical determinants of health,
• Patient safety,
• Quality of care,
• Access to care, and
• Prescribing in primary care.

The Good: Where Canada Excels

The CIHI data showed Canada was close to the average on 32 of the 57 health indicators and performed better than average on 13 of them.

Canada continues to perform better than other developed countries in many areas related to the quality of care. Survival rates for breast and colon cancer are among the highest in the world, with 88% of women with breast cancer surviving over 5 years and 67% of Canadians with colon cancer surviving over 5 years.

We have also made improvements in reducing in-hospital deaths due to heart attacks and strokes; across the country, rates of these deaths have declined by more than 20% over the past 5 years. Another highlight is that more seniors in Canada (61%) receive a flu vaccine compared with the average in other OECD countries (45%).

The Bad: Where Canada Falls Below the OECD Average

Canada performs below the international average in 4 out of 5 Patient Safety indicators.

• Obstetrical trauma rates are twice as high as the OECD average and are not improving.
• Rates of avoidable complications after surgery, such as lung clots after hip or knee surgery, are 90% higher than the OECD average.
• The rates of obstetrical trauma, or vaginal tears during childbirth, both with and without the use of instruments, were at least twice as high as the OECD average.
• The rate of pulmonary embolism, or lung clots after hip or knee surgery, was nearly double the average.

The Ugly: Avoidable Endangerment of Patients

Rates of foreign objects left behind in patients after surgery increased by 14% across Canada for over 5 years. Between 2016 and 2018, a total of 553 objects, such as sponges or surgical instruments, were left in Canadian patients after surgery. Many of our peer countries, such as the United States, the United Kingdom and Australia, cannot report on this measure, which makes comparisons difficult.

In Canada, 553 foreign objects were left inside a patient’s body after surgery over the past two years. This occurred at a rate of 9.8 for every 100,000 hospital discharges – up from8.6 per 100,000 five years ago, CIHI reported. By comparison, the average OECD rate is 3.8 for every 100,000 discharges.

The number of foreign objects left inside a patient's body after surgery per 100,000 hospital discharges was as follows by province:

Canada	9.8
British Columbia	5.7
Alberta	12.0
Saskatchewan	7.9
Manitoba	8.9
Ontario	8.7
Quebec	15.0
New Brunswick	5.8
Nova Scotia	9.3
Newfoundland and Labrador	9.1
OECD average	3.8

The data does not show why such errors continue to occur, even increasing in numbers, or why they were made. It could be due to doctors not following a process or protocol, communication issues or issues related to physicians’ decision-making and situational awareness. This is something hospitals across the country should be looking at in order to reverse the trend.

At Wise Health Law, we provide exceptional guidance on health law matters to public hospitals, long-term care homes, and other health-care organizations across the province. Our lawyers monitor trends and developments in health so that we can provide forward-thinking legal and risk management advice to all our clients. Contact us online, or at 416-915-4234 for a consultation.

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