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Editorial: Restoring trust

An investigation into medical imaging, credentialing and quality assurance paints a derogatory picture of Powell River General Hospital. A report of the investigation by Dr.

An investigation into medical imaging, credentialing and quality assurance paints a derogatory picture of Powell River General Hospital. A report of the investigation by Dr. Doug Cochrane, chair of the BC Patient Safety and Quality Council, outlines how a radiologist was providing services at the hospital that were beyond the scope defined by his licence to practice medicine in BC.

According to the report, when the hospital hired the radiologist in 2002, it was aware of voluntary undertakings placed on his licence by the College of Physicians and Surgeons of Alberta. The undertakings restricted him from reading CT (computed tomography) or obstetrical ultrasound scans until he had taken additional training at an accredited facility. The College of Physicians and Surgeons of BC imposed the same restrictions on his licence.

The radiologist subsequently took CT and obstetrical ultrasound training, but he never informed the College of the training and never asked for a College review of the undertakings attached to his licence. He did inform the Powell River medical advisory committee and completed a hospital form so he could begin reading CT scans, after the hospital installed a new CT scanner, with money raised from a community-wide effort.

Concerns were raised soon after the scanner was operational in April. In September medical staff members raised concerns about the interpretation of CT reports for five patients. These concerns were brought to the attention of Vancouver Coastal Health (VCH) officials, who began an investigation.

The report notes that hospital imaging staff and management knew problems existed from the time the CT scanner was commissioned. The site coordinator knew of the concerns and no actions were evident. “Some staff felt that they were left without support and were fearful of reprisal if issues and concerns were voiced,” the report states.

The report also notes that patients in Powell River said confidence in the medical care system has been lost. Imaging is only one issue that affects patient care, they said, and critical review into the care of patients who have suffered adverse events is lacking and commitments to implement change by administration are not carried out.

The exhaustive report includes 35 recommendations to restore confidence in medical services. Many of those recommendations stem from what happened in Powell River. Local health care officials need to reach out to the community to restore confidence and go beyond systemic changes.