Expert Nursing Panel Makes 18 Recommendations to Improve Care for Hemodialysis Patients at Humber River Hospital

June 20, 2016

An independent panel of nursing experts has made 18 long-awaited recommendations to improve care at Humber River Hospital’s Hemodialysis Unit, where registered nurses (RNs) – members of the Ontario Nurses’ Association (ONA) – have been raising professional responsibility concerns since 2011.

The Independent Assessment Committee (IAC) recommendations addressed the following areas of concern:

  • RN staffing levels.
  • Fragmented and interrupted care.
  • Professional practice issues, including practice standards and nurse leadership.
  • The need to develop a staffing tool based on patient acuity.

This was the third IAC report released for Humber River regarding patient care concerns raised by its RN staff. In this case, the IAC panel of nursing experts conducted its investigative hearings over three days in April; significantly, the panel made 18 recommendations to improve care for hemodialysis patients. The key recommendation was for the hospital to increase the number of RNs in the Hemodialysis Unit. Another recommendation would establish a formal process to discuss monthly if there are workload complaints, requiring the employer to act.

“The expert panel found that nursing professional practice and workload concerns raised by our RNs are legitimate and justified,” said ONA President Linda Haslam-Stroud, RN. “The panel’s recommendations address what our nurses know is the primary issue – RN staffing levels – leaving our dedicated RNs unable to provide quality care to meet their professional practice standards. It is unfortunate that it took so long to have this investigation take place, and leaving our patients at risk.”

The RN complaints arose due to Humber’s steady cutting of RN positions in the Hemodialysis Unit since 2011, creating significant concerns about the quality of patient care. As a result, in the past five years, ONA members have submitted 187 professional responsibility workload report forms documenting situations where they believed patient care was at risk due to insufficient staffing of RNs.

An IAC is comprised of a panel of three nurse experts chosen to consider concerns from RNs and hospital management and make recommendations to address them. Calling in an IAC is a last resort when nurses and management cannot resolve issues.

An IAC hearing for the Hemodialysis Unit was first scheduled for September 2014 but was adjourned when the hospital put up barriers by filing a grievance, claiming that ONA had not followed proper procedure during the IAC process. This allegation was unfounded and approximately 11 months later, the hospital withdrew its grievance, leaving the patient care issues unaddressed.

The IAC was rescheduled for March 2016, but these dates and a second set of dates for March were cancelled due to the availability of the hospital representative. The IAC finally proceeded April 20 to 22, 2016.

“Our hope is that we can work with Humber’s management to implement without delay the IAC’s recommendations,” said Haslam-Stroud. “With Humber’s new Chief Executive Officer being a registered nurse, who would understand the concerns of front-line RNs, we anticipate that she will share our mutual concern to ensure RNs can provide safe, high quality patient care to this important patient cohort.”

ONA is the union representing 60,000 registered nurses and allied health professionals, as well as more than 14,000 nursing student affiliates, providing care in hospitals, long-term care facilities, public health, the community, clinics and industry.

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For more information: Ontario Nurses’ Association

Sheree Bond (416) 964-8833, ext. 2430; cell: (416) 986-8240;
Ruth Featherstone (416) 964-8833, ext. 2267;

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