St. Joseph’s Hospital in Comox studying medical scans report

St. Joseph's General Hospital has begun reviewing the final report into a review of the quality of medical scans in British Columbia.

St. Joseph’s General Hospital has begun reviewing the final report into a review of the quality of medical scans in British Columbia.New measures to strengthen physician hiring and oversight and enhance public confidence in the health care system were announced Tuesday by Health Minister Michael de Jong, as he released the report.The review was launched in February by Dr. Doug Cochrane, chair of the BC Patient Safety and Quality Council, after concerns were raised around the quality of medical scans interpreted by four radiologists practising primarily in Powell River, Comox and the Fraser Valley.The process included health authority reviews of thousands of CT scans and obstetrical ultrasounds.”First and foremost, my thoughts are with the patients and families who were touched by these events,” de Jong said in a press release. “It is clear from Dr. Cochrane’s report that the system in which you placed your trust, failed in these cases. That is why we’re committed to go beyond the recommendations in the report and take clear and definitive action to help prevent this from happening again.”While Cochrane’s first report provided assurance that all remaining radiologists in the province were appropriately qualified, he concluded that similar events could occur in the future unless steps are taken to help close the gaps in the existing safeguards around physician practice.In response to those concerns, the Ministry of Health has developed a plan that includes:• Implementing a timely peer review system for diagnostic imaging across the province — starting with immediate action to enhance oversight of newly privileged radiologists including locums and doctors with provisional licences.• Establishing a common electronic provincial physician registry accessible to the College of Physicians and Surgeons of British Columbia, health authorities and the Ministry of Health to track current information about physician licensing, credentials and privileges.• Creating consistent rules around communication and patient notification when adverse events occur.Cochrane’s report contains 35 recommendations directed to health authorities, the College of Physicians and Surgeons of British Columbia and the Ministry of Health, which focus on ensuring that doctors who want to practise in B.C. are screened appropriately, that their skills are assessed on an ongoing basis and that there are clear lines of accountability amongst all of the parties with a responsibility for protecting patient safety.The Ministry of Health has accepted each of the recommendations of the report and will be working with the College of Physicians and Surgeons of British Columbia and health authorities to implement them, according to the news release.The final report is available online at Joseph’s, in partnership with the Vancouver Island Health Authority (VIHA), has re-read 2,721 CT scans on 2,312 patients, which were read by a radiologist — who was identified as Dr. Jose Zanbilowicz in late February — between August 2009 and January 2011.They have found 180 discrepancies and have followed up with each of these patients and their physicians in April or May of this year.While there is no indication of a pattern of concern for X-rays, mammography or ultrasounds, a quality assurance review was completed on these scans, according to the Ministry of Health Services.Of the 1,875 mammograms reviewed, 1,751 showed no abnormalities and 124 required further followup.Of these, further diagnostic assessment was needed for 20 patients, and physicians will continue to monitor these patients. Cochrane concluded that these results indicate an acceptable performance of a screening radiologist.The hospital and health authority also reviewed 1,228 other scans — 905 Radiographs, 42 Fluoroscopes, 52 Mammograms and 229 Cardiac Ultrasounds — that this radiologist performed and concluded there were no significant missed or misinterpreted scans.St. Joseph’s received the report Tuesday.The hospital is reviewing the report and will be looking at each recommendation to develop a very specific action plan moving forward, explained CEO Jane Murphy, adding St. Joseph’s will work with the Ministry of Health Services, VIHA and the College of Physicians and Surgeons to develop this plan.”We absolutely welcome this report,” said Murphy. “We look forward to that work with others on these recommendations with a view to strengthening the credentialing and privileging process in whatever way we can.”Zambilowicz holds locum, or temporary, privileges at St. Joseph’s with the exception of providing CT services or on-call services, according to Murphy.”As part of the Cochrane review, there was a very extensive review of all aspects of care,” she said. “It was determined with the exception of CT service that this radiologist met acceptable standards of care for every other aspect of care.”Murphy has only been at St. Joseph’s since the beginning of September, but she’s been impressed with staff’s commitment to providing a high quality of care.”When there is such a finding as this, we do understand it’s very concerning to the community at large,” she said. “I feel St. Joseph’s takes its responsibility to provide quality care to the community very seriously. Our community really expects and deserves a high standard of care. I think there is a deep commitment to meet that. The organization is working to ensure that the community can have confidence and receives that very high standard of care they deserve.”

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