The Future of Trauma Care in Quebec
A statement from the McGill University Health Centre
Today the Montreal Gazette published an article entitled “South Shore ambulances driving patients farther” (p. A11). The McGill University Health Centre wishes to make the following statement in response to this article.
The MUHC has worked for the last six months with the Agences de santé et des services sociaux de Montréal-Centre et Montérégie, the Ministry of Health and more recently with Russell Copeman, Parliamentary Assistant to the Minister of Health and the MNA for N.D.G. to address the issue of trauma care in Quebec.
Since 1992, pediatric and adult trauma care in Quebec has had a supra-regional designation, which means children living in the regions (for example, Laurentides, Lanaudière, Mauricie, Abitibi, Montérégie) who suffer a serious traumatic injury could be transferred either to The Montreal Children’s Hospital or to L’Hôpital Ste-Justine, and adults to either the Montreal General Hospital or Sacré-Coeur. This agreement has worked extremely well and has allowed the four hospitals to develop significant expertise in trauma care. In fact, prior to the supra-regional designation, the mortality rate among children and adults who had suffered traumatic injuries was around 50%. Since 1992, the situation has improved tremendously with the mortality rate decreasing to approximately 8%, predominantly because of ultra-rapid access to expert care.
“The designated trauma centres of the MUHC (The Montreal Children’s Hospital and the Montreal General Hospital) are concerned about ministerial changes in the referral patterns of patients with severe trauma in Quebec that threaten this success story,” said Dr. Harvey Guyda, Acting Associate Executive Director of the MCH. “We are concerned that the supra-regional designation of trauma care in Quebec is being questioned.”
“If you are severely injured during something like a car crash, the best way to assure your survival is to get to a trauma centre as quickly as possible,” said Dr. Tarek Razek, Director of Adult Traumatology at the MUHC. “In Quebec, we have spent years designing a trauma care system that saves lives. To substantially change the province’s existing trauma system is unwise.”
Most recently, a Ministry of Health directive issued in July 2007, to deal with a problem in providing trauma care on the South Shore, has dictated that ambulances be directed to Ste- Justine and Sacré-Coeur Hospitals. This means that critically injured patients are denied rapid access to well-established comprehensive trauma expertise at The Montreal Children’s Hospital or the Montreal General Hospital of the MUHC. A unilateral ministerial “solution” to address trauma care on the South Shore for the summer has now been in place for five months.
“We do not believe this is in the best interests of high quality, patient-focused trauma care that has proven so successful, “ said Debbie Friedman, Director of the Trauma Programs at the MCH. “Trauma by its very nature is unpredictable, accessibility and expertise must be guaranteed. Supra-regional access is paramount to ensuring excellent care in meeting the needs of the children and the teens of the province. There should be no barriers to timely interventions.”
The MUHC will continue to work with the respective Agences, the Ministry and all of our partners. We are optimistic there will be a speedy return to the previously very successful supra-regional designation for trauma care in Quebec.