Oncology in Grand Falls and Saint-Quentin: the quality and safety of care must take precedence

Vitalité Health Network strives to meet the highest standards for the quality and safety of our patient care. Our staff and physicians share this concern.

It was with this in mind that, in oncology care, we adopted the BC Cancer Agency’s standards for the certification of our staff and the National Association of Pharmacy Regulatory Authorities’ standards for the transportation of medications. In both cases, these steps were taken—and we can never reiterate this point enough—to maintain the quality and safety of our patient care.

This brings us to our fall 2017 decision to discontinue the services of the oncology clinics at the Hôtel-Dieu Saint-Joseph de Saint-Quentin and the Grand Falls General Hospital. This important decision, although controversial and predictably unpopular, was and remains today grounded in facts and thorough analysis.

Following interventions by community groups and the Department of Health, a compromise was reached last fall whereby the local service will be maintained but delivered by nurses based in Edmundston who will travel to Grand Falls and Saint-Quentin to administer the treatments. Thanks to the large number of treatments they administer each year, this new approach will allow the nurses involved to maintain their skills. The Department of Health allocated an additional position in late 2017 so this solution could be implemented. The hiring and orientation process is under way.

Although a solution has been found, in light of the ongoing public statements by some stakeholders, we would like to take this opportunity to directly explain to the communities involved the concrete factors that formed the basis for this decision.

Safety and the maintenance of certification

According to the BC Cancer Agency’s standards, registered nurses must administer at least 50 chemotherapy treatments per year to maintain their skills. The data for the Saint-Quentin facility in this regard is telling: from April 2016 to March 2017, 43 treatments were administered by their team of nurses. In the case of the Grand Falls facility over the same period, 143 treatments were administered by theirs.

The main challenge for these facilities is to enable more than one nurse to maintain their skills. An oncology clinic needs a minimum complement of trained nurses to operate safely and allow employees to take the leave to which they are entitled. The Network has therefore chosen to offer these services through a team of nurses meeting much more than the minimum requirements of practice. As a result, we want to ensure that each of them develops, through constant exposure to the various oncology treatments, a solid expertise.

Finally, to justify the retention of oncology care, Grand Falls and Saint-Quentin were often compared to the Enfant-Jésus RHSJ† Hospital in Caraquet.  The main arguments put forward related to the size of the facility and of the region served. In the case of Caraquet, 1143 treatments were administered in 2016 2017 and the medications were prepared on site.  The comparisons made were thus not accurate ones.

Transportation of medications

Since there are no pharmacists on duty at the Hôtel-Dieu Saint-Joseph de Saint-Quentin and the Grand Falls General Hospital, the required medications must be prepared at the Edmundston Regional Hospital and transported by shuttle or taxi to Saint-Quentin and Grand Falls.

And there are risks associated with transporting medications. However, thanks to the solution proposed by the Network, the required medications will be transported safely at all times.

No physicians trained in oncology

The general practitioners in the satellite clinics (Edmundston, Campbellton, Bathurst and Caraquet) were all trained at the Dr. Léon-Richard Oncology Centre. They provide the medical follow-up and expertise in the oncology clinics.

In the case of the Grand Falls and Saint-Quentin clinics, trained physicians will be providing any required medical follow-up from Edmundston. However, since these physicians are not on site when the treatments are administered in these facilities, difficulties can arise if complications occur.

Thus, even with the solution being implemented by the Network, the level of medical care in these clinics will not equal that available in the other oncology clinics.  However, with a physician close at hand at all times (in Emergency), it was deemed satisfactory to continue administering chemotherapy medications.

Conclusion

Vitalité Health Network’s decision concerning its oncology clinics was not made lightly. The public is entitled to know and understand that patient safety, the maintenance of employees’ skills, the transportation of medications and the lack of trained physicians in Grand Falls and Saint-Quentin were the reasons that formed the basis for the Network’s fall 2017 decision.
The quality of care and the safety of our patients is our highest priority. That's why we're not just meeting Canadian standards; we're looking to surpass them.

Respectfully,

Gilles Lanteigne
President and CEO
Vitalité Health Network

Co-signed by :

  • Dr. France Desrosiers, Vice President – Medical Services, Medical Training and Research
  • Dr. Denis Pelletier, Medical Director, Northwest Zone
  • Dr. Éric Levasseur, Chief of Staff, Northwest Zone