Staff are worried about the care being given in two rural Manitoba emergency rooms, according to a new review of ERs in The Pas and Flin Flon.

Emergency department staff are concerned about “the quality of medical care … and the potential for poor patient outcomes,” according to the 40-page report released to CBC News on Thursday.  

Staff also expressed concerns about “fear of retribution” if concerns are raised and worry those that are raised are “not addressed.”

Reviewers found doctors were ordering lab reports and X-rays but not following up after the fact; some of the diagnostic tests were “not initialled or signed” in patient charts.

The report says hospital policies and procedures were “old and did not support up-to-date evidence based practice.”

In both hospitals, a registration clerk greets people arriving at the emergency department. 

But reviewers say it’s “not ideal to have a non-medical person responsible for identifying clinical concerns upon patient arrival.” 

The reviewers found inaccurate triage levels were sometimes assigned to patients.

The reviewers learned that registration clerks and nurses were also giving health information by phone, a practise considered “unsafe” and one that “should not occur.” 

Staff worry physicians lack skill, knowledge

“The overwhelming concern expressed by staff in both Flin Flon and The Pas was that some physicians lacked the medical knowledge and skill appropriate to deal with the emergent clinical situations in the ED,” said the report, “Nurses were experiencing a great deal of stress working with some physicians.”

According to the report, open conflict among physicians as well as between physicians and other staff has been “publicly displayed.”

Patients and staff also expressed concerns about “poor treatment of Aboriginal patients in The Pas.” 

In an online survey of 260 people living in the region, one respondent criticized the lack of interpreters for Cree-speaking patients and a lack of cultural training for staff.

“Some physicians and nurses and front area clerks are not sensitive and respectful to the traditions and cultures,” said the respondent.

The review took place in November 2013 and included interviews with hospital staff, chart reviews and feedback from the public. 

CBC’s I-Team was first told the review would take place after running a series of stories about patient care and hospital staffing.

The CEO of the Nor-Man Regional Health Authority, Helga Bryant, said the review was planned but became “more necessary” as a result of recent concerns from the community and staff.

“Patient safety is a top priority for all staff in the region, and the recommendations coming from this review will help to improve the quality and safety of all patient visits to our Emergency Departments,” Bryant said. 

Read the full report below