March 22 2012
Poor hospital cleaning revealed as major problem
‘Some hospitals are a real freaking disaster’
The health of hospitalized Canadians and their visitors is being seriously put at risk by hospitals that have cut corners in cleaning budgets to a Marketplace investigation has revealed.
The program took hidden cameras inside 11 hospitals in Ontario and British Columbia. What they found in many of them were surprisingly inadequate cleaning regimens – in short, dirty hospitals that could make you sick.
In many hospitals, Marketplace staffers applied a harmless gel to places that many people would touch – hand rails, door handles, light switches, elevator buttons.
DIRTY HOSPITALS
The full story, Dirty Hospitals, can be seen on CBC-TV’s Marketplace tonight at 8 p.m., 8:30 in Newfoundland.
The gel glows when seen under an ultra-violet light. But most of the time – and this was true in every hospital where Marketplace carried out gel tests – the gel was still there more than 24 hours later, meaning the surfaces had not been cleaned at all.
The program talked to cleaners, supervisors, nurses, doctors, and hospital administrators to get a handle on what has become a major problem at Canadian health-care facilities – a shocking number of hospital-acquired infections.
While Canadians love to crow about their first-rate health-care system, it also leads in one area that doesn’t get the same glowing reviews.
About 250,000 Canadians come down with life-threatening infections while in hospitals every year. That’s the highest rate in the developed world. As many as 12,000 people a year die.
Denise Ball’s husband Gary became one of those statistics last year.
He was admitted to Niagara General Hospital for treatment of pancreatitis. While there, the 63-year-old retired school teacher contracted C. difficile – a life-threatening superbug that is all too common in Canadian hospitals. It ended up playing a role in his death a few months later.
Denise Ball remembers the cleaning regimen in her husband’s room was less than adequate, saying the cleaners would spend only 10 minutes on a room everyone knew was infected with C. difficile. She says a proper cleaning would have taken much longer.
“This has to stop,” she says. “This is Canada.”
More with less
Time and again, hospital insiders told Marketplace that cleaners were being asked to do more with less. “We used to have one person to one wing of a hospital to clean,” one cleaner said. “Now, we have three floors to clean.”
A cleaning supervisor at one hospital told Marketplace host Erica Johnson that it’s “common practice” for cleaners not to change the cleaning solution in the bucket when mopping up. “They just don’t have the time,” the supervisor said.
‘Some hospitals are a real freaking disaster.’—Infectious disease expert Dr. Michael Gardam
Sometimes there aren’t enough cleaning supplies. A nurse, whose identity Marketplace protected, said she’s seen a cleaner mopping common areas after having mopped the rooms of infected patients because she didn’t have enough mops to change. “She’s just cross-contaminated the whole area, so there’s no area that was actually clean.”
Sometimes, only one cleaner would be on staff in an entire hospital during night shifts. “That kind of day-night difference is very common, and it makes no sense,” says Dr. Michael Gardam, an infectious disease expert at the University Health Network in Toronto.
Gardam has seen enough in his time looking at hospital cleaning practices to know that some hospitals are worse than others – much worse. “Some hospitals are a real freaking disaster,” he told Marketplace.”They’ve been told to actually cut their number of housekeeping staff by outside auditors who are trying to help them balance their budgets.”
In recent years, many hospitals have cut the portion of their budget that is devoted to cleaning. Sometimes, they’ve done that by contracting out cleaners or their management.
C. difficile outbreaks common
It’s not like we haven’t seen the devastating results of hospital-acquired illness. Newscasts and newspapers have been filled with stories of hospitals under quarantine because of C. difficile outbreaks. In the last decade, outbreaks have hit hospitals in most provinces. A huge outbreak in 2003 and 2004 led to as many as 2,000 deaths in Quebec.
Last year, there were outbreaks in at least 10 hospitals across Ontario alone. One of the worst was the Niagara Health System in Ontario. More than 100 cases were diagnosed and the infection was a factor in the deaths of 37 patients, including Gary Ball, the patient mentioned earlier in the story.
The man appointed by the Ontario government to get the Niagara outbreaks under control, Dr. Kevin Smith, denies that hospitals have been cutting back on cleaning. “I think they’re experimenting with new models of cleaning,” he says.
When informed that workers in the Niagara hospital system told Marketplace that they still don’t have the time or resources to do an adequate cleaning job, he says, “I haven’t heard that message,” saying “everybody” feels rushed in health care these days.
The outbreaks are officially over in the Niagara Health System. But when Marketplace showed Smith several areas where researchers had applied test gel in three hospitals he supervises, most of the surfaces showed no evidence of cleaning. The ultra-violet light showed uncleaned hand rails outside an isolation room, uncleaned support rails in a public washroom and uncleaned hand rails in a ward with highly contagious patients.
“I’m obviously very disappointed to see that. That is a less than optimal cleaning opportunity. We need to fix it,” Smith said.
There’s something else that some observers think is helping to drive the pressure to skimp on cleaning. In Ontario and British Columbia, for example, hospitals are given bonuses for turning over beds quickly – hundreds of extra dollars each time a hospital gets a patient out of a room before a certain time. More money is dangled for quickly transferring a patient from the emergency ward to a room. Hospital CEOs, already well-paid, receive bonuses that depend, in part, on reducing wait times.
While the goal of such rewards may be admirable, critics say the actual effect has been to speed up cleaning to an unhealthy degree.
“They just don’t get it,” says Denise Ball. “And maybe until one of their loved ones that went in healthy and … a few months later … they’re going to their grave. Maybe that’s what will wake them up.” There is a video at the Source
Related Stories
8 tips to ensure you won’t get a hospital-acquired infection
Opportunistic superbug present in most hospitals
Since the cleaning services have been privatized, the problems began.
The ones now doing the cleaning are not trained well. Poorly paid and over worked. They have to much to do and not enough time.
It is actually costing Canada more to use private companies.
A lesson leaned the hard way. Remember:
About 250,000 Canadians come down with life-threatening infections while in hospitals every year. That’s the highest rate in the developed world. As many as 12,000 people a year die.
The Ontario Ombudsman is the only provincial watchdog in Canada restricted from investigating and resolving issues/complaints in hospitals, long-term care, children’s aid. And there are serious issues that are not being resolved. Please check out how Ontario compares to the rest of Canada:
http://www.ombudsman.on.ca/About-Us/The-Ombudsman-s-Office/Who-We-Oversee/MUSH-Sector.aspx
Please download a copy of this petition and speak to your MPP about expanding the mandate of the Ombudsman to ensure the public is protected and issues of mistreatment, abuse, poor care are addressed properly in these institutions.
http://ontariocfa.com/documents/ombudsman_petition.pdf
Pass this on to all your Canadians friends.
Don’t let Harper privatize any more in Health Care and the privatization that has taken place, must be reversed to save lives. The life you save may be your own.
Update March 27 2012
CBC’s ‘dirty hospital’ report sparks changes
Niagara health authority ends relationship with private U.S. cleaning company Aramark
March 26, 2012
A CBC investigation into unsanitary conditions at the nation’s hospitals has sparked a change in policy by Canada’s biggest health authority and a flood of email messages from concerned viewers.
With hidden cameras, including Canada’s first hidden camera glow-gel test, the consumer show Marketplace visited several hospitals in Ontario and British Columbia, secretly applying a harmless gel to high-touch surfaces, then returning 24 hours later to see whether the gel had been removed, which would indicate the surface had been cleaned.
The program revealed many instances where cleaning had not been carried out, and that sparked a response from the Niagara Health System (NHS), the biggest in the country, whose hospitals have suffered a recent Clostridium difficile outbreak. It has decided to end its relationship with the private U.S. cleaning company Aramark.
NHS authorities wouldn’t specify why they made the move, but did tell CBC News they will be adding “the equivalent of 18 new full-time cleaning positions.” It has been suggested that Aramark was at least partly to blame for the C. difficile outbreaks.
“They made decisions around staffing levels,” Eoin Callan of the Service Employees International Union told CBC News. “They made decisions around what was cleaned, what was not cleaned — how frequently things were cleaned. And they also had an incentive to use cheaper diluted cleaning chemicals that were not as effective because it allowed them to pad their profit margins.”
Ontario Minister of Health Deb Matthews wouldn’t talk on camera, but told Marketplace: “We expect our hospitals to make the best decisions to protect patient safety in their communities.”
The NHS decision may be good news for those awaiting a hospital stay, but cold comfort to people such as Ken Hough, who returned home three weeks ago after a stay at St. Thomas Elgin General Hospital in St. Thomas, Ont.
“You really wouldn’t believe it, unless you’ve seen it,” Hough told Marketplace reporter Erica Johnson, describing rooms where he says dirty bandages and plastic needle covers littered the floor.
The bathroom was the worst, he said.
“Feces on the back of the toilet,” he recalled. “You’d go in to use it, and you’d pivot. I put on rubber gloves to use the toilet seat and just thought, no, I’m not doing this.”
Emails from across the country echoed Hough’s observations.
“The waste baskets in the bathroom were overflowing,” an email from Vancouver read. It took “three days to clean up vomit,” a Calgary viewer wrote. And an email from Winnipeg described “feces left on the floor” for days.
About one-third of hospitals in Ontario outsource their janitorial services, CBC News has learned, and that figure is higher in British Columbia and some other provinces. With files from the CBC’s Erica Johnson Source
That is good news for a change. Now if they could get all the hospitals cleaned up.
With the number of deaths and those who got sick, because of the filth, there were no savings.
Recent
Did You Know 