Resource crisis at Surrey hospital leads to 1 newborn death and countless near misses: frontline workers

A group of women’s health providers at Surrey Memorial Hospital is the latest working on the frontline to raise alarms about British Columbia’s deteriorating healthcare system.

Obstetricians and gynecologists have written an open letter to the citizens of Surrey.

The group says they are in crisis, caused by chronic and pervasive under resourcing.

They claim the situation has led to unsafe conditions and adverse outcomes.

“We view it as our duty to our patients and community stakeholders to disclose the significant challenges we currently face, which are predominantly rooted in the inaction of Fraser Health's executive administration, the Board of Directors and the Ministry of Health,” reads the letter.

The doctors outline three issues that they say require immediate action.

RESOURCE CRISIS IN THE FAMILY BIRTHING UNIT

The letter says the hospital’s family birthing unit is grappling with an acute shortage of supervised beds due to insufficient space and a lack of nursing resources.

Surrey’s unit serves a population that is larger than Vancouver’s—a city with two hospitals that provide obstetrical care: BC Women's and St. Paul's Hospitals.

Combined, Vancouver’s hospitals have 13 antepartum care beds, 47 laboring beds and 35 postpartum beds.

Surrey has only six antepartum beds in shared rooms (two patients per room) designed for single occupancy, 32 laboring beds and 16 postpartum beds.

“Further, as a no-refusal tertiary care referral centre, our catchment extends to all of Fraser Health, east of the Fraser River,” reads the letter.

Surrey’s birthing unit underwent its last expansion a decade ago.

At the time, it was designed to accommodate 4,000 deliveries a year.

It currently oversees approximately 6.000 deliveries per year.

“This critical scarcity of resources has created systemic issues compromising safety for our patients,” reads the letter.

The group says patients often lack access to effective pain management and do not receive the necessary privacy during and after childbirth.

“The strain on our resources prevents our teams from delivering care that is required and expected, directly resulting in poor outcomes which fall sharply below the standard for a tertiary-level maternity care centre in our province,” says the letter.

Those working on the frontlines say the shortages have led to one newborn death, countless near misses and moral injury to care providers.

The letter says the resource disparity between the Surrey and Vancouver regions is stark, even though the former city has a larger population and offers comparable healthcare services.

“It is essential that this issue of funding imbalance is promptly rectified,” reads the letter.

The ongoing nursing shortage is worsening the issues, leaving beds vacant because there is no nurse available.

The doctors argue that the interim interventions provided by Fraser Health lack the scale and scope to create a safe labour and delivery unit.

“The move to non-private postpartum rooms within spaces designed for single occupancy has created workplace hazards for nursing staff, stripped away privacy for families and raised significant concerns regarding infection control,” the letter says.

Frontline staff say they’ve had to limit the number of admitted patients who are not in labor, but require a high level of inpatient care, to ensure that there are sufficient resources to meet the demands of those who are laboring.

The letter argues staff shortages mean patients are frequently diverted to other hospitals for care.

GYNECOLOGISTS HAVE LIMITED ACCESS TO OPERATING ROOMS

“Year after year, the reported surgical wait times prove to be egregiously inaccurate,” reads the letter.

The group says current wait times for surgery at SMH are 23 per cent longer than the maximum amount of time that clinical evidence shows is appropriate.

The average wait times for gynecology services are 77 per cent longer than the benchmark.

“This means that women in Surrey are suffering from significant pelvic disease, at times requiring multiple blood transfusions while awaiting surgery, requiring extended leave from work and with no choice but to use costly medications, not without side effects, while they wait,” reads the letter.

The doctors say case completion times at the hospital do not meet provincially established benchmarks.

They argue that increasing the number of operating rooms is the only viable solution.

SMH has 10 operating rooms, but the letter says it is often only using eight or nine due to renovations or staffing.

LACK OF ADEQUATE ACTION FROM LEADERS

The letter calls out the health authority’s leaders and the provincial government for failing to deliver much-needed capital investment and expansion of physical space at SMH.

“The end result of this perfect storm is, not surprisingly, dismal,” wrote the doctors.

The group argues patients are not receiving sufficient care, putting them at risk of greater morbidity.

It claims the new Cloverdale Hospital will do nothing to address the issues, as there is no plan to add obstetric or gynecological care there.

“In fact, this project, which we feel is deeply misguided, will halt any substantial investment in women's health in our region, setting us back by decades,” reads the letter.

Fraser Health’s CEO and president says the hospital is doing everything it can to minimize risk when possible.

"We are at a point where we do need to transform our care and a big part of that is change and with change it's not going to be seamless or smooth, there's going to be challenges and as we go together," said Dr. Victoria Lee.

A review of the newborn death cited in the letter was conducted, according to Dr. Lee who said recommendations were made following the review. She could not elaborate on what exact recommendations were made, but noted an additional $3 million dollars in funding was added so that, ‘those experiences do not repeat again’.

“It’s not say there isn’t challenges, but the vast majority of the time they (patients) receive good care,” Lee told CTV News.

CTV News Vancouver has reached out to the Ministry of Health for comment.

 With files from CTV News Vancouver's Penny Daflos and Abigail Turner.