News / Canada

Auditor calls out N.B. hospitals on infection prevention

FREDERICTON - New Brunswick's auditor general says the province's two regional health authorities need to improve infection prevention and control practices at the hospitals they run.

In her latest report to the legislature, Kim MacPherson says health-care workers aren't cleaning their hands as required.

Her audit also found incidents of improper storage of biomedical waste, overcrowding in certain treatment areas, and problems with the delivery, storage, and use of clothing and linens.

Provincial auditors visited eight hospitals and noted inconsistent policies and procedures on infection prevention and control practices at the Horizon and Vitalite health networks.

The Horizon Health Network says it has developed a plan to address deficiencies found by the audit, while Vitalite says it will create a plan after setting up a team to clearly identify where it needs to improve.

MacPherson highlights the significance of infection prevention and control in her report, saying about 12,000 deaths in Canada are caused by infections each year.

During 2013-14, New Brunswick hospitals reported 228 cases of Clostridium difficile infection and three cases of methicillin-resistant Staphylococcus aureus — or MRSA — bacteremia.

MacPherson tied the problem to hospitals controlling their costs as well as better patient care.

"Hospital-acquired infections affect the condition and comfort of the patient," MacPherson said in a statement. "They also cause increased costs due to longer hospital stays, additional procedures, etcetera. Infection control equates to cost control."

The auditor general also looked at the government's oversight of the private wood supply and its silviculture program for Crown forests. Here is a look at her key findings in those areas:

PRIVATE WOOD SUPPLY NEEDS BETTER GOALS, DOCUMENTATION:

The Natural Resources Department has no documented, measurable goals and objectives on its role in the private wood supply, nor does it publicly report on its performance in encouraging a sustainable development of private woodlots, MacPherson said.

"We found the program's performance objectives had not been defined and consequently, the public cannot assess if the department's $5 million annual investment is providing value to the province," she said.

The audit looked at the performance of the New Brunswick Forest Products Commission, which also has a role in the oversight of the private wood supply, finding that it doesn't adequately assess marketing boards to determine if they are meeting their regulatory obligations. The commission also doesn't assess the performance of the boards, MacPherson said.

She identified specific areas of concern on the marketing boards including the weak financial condition of some, risky investments they have made and poor governance practices.

The lack of oversight leaves taxpayers at risk, wrote MacPherson: "Should marketing boards fail, the province, through the commission, may be liable for marketing board obligations."

The department says it agrees that it should publicly report on its goals and performance in overseeing the private wood supply and is promising to develop clear and measurable objectives that it can report on regularly.

It is also promising to review the commission's mandate and structure to establish performance targets, while the commission agrees that it should meet more regularly with marketing boards and will try to randomly attend district meetings of the boards.

EFFECTIVENESS OF SILVICULTURE PROGRAM CAN'T BE MEASURED:

The Natural Resources Department spends $29 million a year on its silviculture program, but MacPherson said it doesn't know if the province is getting value for the money.

There is not enough oversight, management and administration of the silviculture program, she said, although its activities have contributed to increases in the future supply of timber over the past 30 years.

The report found weaknesses in the department's public reporting on Crown forests.

"We believe it is important to the legislative assembly and the general public to know how the department is safeguarding and overseeing the renewal of one of our most valuable resources," said MacPherson.

The department agrees with most of the recommendations made by MacPherson, including one on the need to finalize a silviculture manual that sets out performance standards and best practices to support sustainable harvest levels over the long term.

MacPherson also recommended that the area of Crown forest available for clear cutting be reduced, something the department believes is appropriate for many of the province's forest types. But the department says it expects the industry to shift to more commercial thinning of forests in the future, which will reduce clear cutting.

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