– Health North must act! – VG

PETTER TALSETH, EILIF TRÆLNES, NILS JENSSEN, ELLEN SCHJØLBERG, HARALD LIE, ELBJØRG LARSEN, IVAN HAUGLAND, HANS GUNNAR HOLAND, BERIT HUNDÅLA, ANDRÈ MØLLER and TORHILD HAUGAN.

As mayors of the municipalities of Alstahaug, Brønnøy, Dønna, Grane, Hattfjelldal, Herøy, Leirfjord, Sømna, Vefsn, Vega and Vevelstad, we again have to inform the company management in the handling of Helgeland Hospital of matters of great importance to the population of Helgeland.

In January, as is well known, the management of the company almost out of affection, supposedly based on a Facebook post, decided to immediately stop all elective cancer surgeries in the surgical department of Helgeland Sandnessjøen Hospital and move all cancer operations planned to drive in Mo i Rana.

The background for this was the figures released from the cancer registry in September, where the Sandnessjøen hospital has high figures when measuring the number of patients dead within 100 days of cancer surgery. The figures that have been published are a comparison of the years 2016-2018. After a review of the material on which the statistics were based, Helse Nord found no reason in its review to continue with the urgent decisions that the management of the company introduced overnight.

Cancer surgery reopened in Sandnessjøen.

The head of department Ida Bukholm did not agree with this conclusion and, as a result of the case, started a project with a review of patients diagnosed with colon cancer. The purpose described is “to ensure the quality of the activities of the Helgeland Hospital within colon cancer surgery”. After the records were reviewed by local surgeons, they were sent to two external gastro-surgeons for review, at UNN and St. Olav Hospital, respectively.

According to the department head, he had received comments from both external surgeons in early August. Subsequently, the local professional community has requested access to evaluations from external professionals, but the professional director has not complied.

The company’s management kept external evaluations close at hand and, as far as municipalities know, only three key members of the company’s management were made known. Later it was learned that the request for revision, although not described in the project description, was sent to another external surgeon, this time to a gastro-surgeon at OUS.

After the company management also received this assessment, the Helgandssykehuset professional communities were not informed about the content or the subsequent process. The evaluations were still kept strictly secret, before mysteriously suddenly erupting with a detailed post in Rana Blad on Monday afternoon. Clearly the external evaluations have been sent to the newspaper in their entirety, since it was quoted directly from what is written in them.

Assessments contain detailed, easily recognizable patient information, which makes newspaper leakage very serious in our opinion. One can only speculate where the leak came from and the purpose for which Rana Blad was leaked, but we think it is highly unfortunate that the company’s management seems to take this lax handling of sensitive personal information as lightly as their subsequent comments. . witness.

Once again, it appears that the management of the company is acting almost in panic as a result of the media coverage. Immediate measures are notified, emergency telephones are installed and extraordinary meetings of the directory are called with minutes. This seems something to be sought, as the management of the company has known the content of the evaluations for several weeks and therefore may have surprised them on Monday afternoon. However, they found no reason to react in any way until the leak at Rana Blad was a fact.

When department head Ida Bukolm reported to the Helgeland Hospital board Tuesday afternoon, she was still without having reviewed the content of the external evaluations with the professional settings in the units. The professional communities did not have access to the evaluations until Monday night. They have not been given the opportunity to correct obvious mistakes. Errors such as claims that patients are not supervised by an anesthesiologist prior to surgery, or that there are no good routines for selecting which patients will be operated locally. This is incorrect information which, according to standard administrative practice, should have been clarified before the final evaluations of the three external surgeons led to a definitive conclusion.

We believe there is very little comment from company management that the two original hospital-mandated evaluations have widely divergent conclusions. This shows perhaps most of the complexity of this material, although to the inexperienced eye it appears that most of the work has been put into the assessment presented by the UNN representative. This evaluation is 16 pages long, while the evaluation by the surgeon at St. Olav’s Hospital is just under a page and a half. The evaluations themselves will be left uncommented in this round.

The scope of resection, anastomotic leaks, and reoperations are far beyond what we as mayors should try to think of anything sensible. What we see, however, is that the competing environment that has worked most closely with the surgical environment at Helgeland Hospital, our own university hospital, does not reveal that oncological surgery in units is unjustifiable, in a well-reviewed evaluation document. documented.

This is totally rejected by the department head of Helgeland Hospital. The professional environment does not exist in a vacuum, it is built by professionals.

Sandnessjøen Hospital has a professional gastro-surgical environment with two permanently employed gastro-surgeons. Mo i Rana Hospital does not employ any gastro-surgery specialist. The CEO was quick to point out on Monday that professional management should meet as a result of external assessments that had been made public in the media.

It is in the letters that this address will now gather at Rana Hospital. It is a hospital without a professional environment for gastro-surgery, a hospital without gastro-surgeons. This is in line with the CEO’s case presentation which referred to the transfer of all cancer surgeries to Rana Hospital in November. Moving the management of a professional environment to a hospital without specialists seems strange and ill-considered, and patient safety in such a service should, in our opinion, undergo a new assessment. We are the first to want a specialized health service with professional quality and weight for our residents, the patients of Helgeland. This has been our mantra throughout the long and grueling process of the Helgeland Hospital of the future.

However, patient safety is an expression that encompasses many aspects. Patient safety cannot be read directly from statistics on mortality, postoperative infections, or prosthetic solutions, nor can evaluations of patient records by some teachers in alternative hospitals.

The patient safety program states that managing patient safety is about putting quality and management on the agenda. Decisions must be made based on knowledge, not assumptions. Leaders must lead by example, listen to employees, establish a culture of openness, and create a learning organization. Successful companies are characterized by a culture that promotes openness, trust, cooperation, and learning.

Employees work together toward common goals, are heard, have influence, and put patients and users first. Employees are encouraged to report failures and deviations, and to systematically learn from both what is going well and from undesirable events. Good leaders face crises with action, open reflection, and refrain from pointing to scapegoats.

Good leaders respond to comments and take time to understand what’s behind the event. This description is the complete opposite of how the company leadership at Helgeland Hospital now practices management. We believe that the company management at Helgeland Hospital acts once again on all good principles for patient safety. The way this crisis is handled is by no means based on an open and learning organization, and is characterized by management that has a specific agenda.

The professional communities that recognize the work in Sandnessjøen are totally rejected, the process of Helse Nord around the closure in January is questioned and an entire professional community is described as “dangerous” in the local and national media, without even being heard in advance. . We mayors agree that the safety of patients at Helgeland Hospital is now under threat. However, we believe the greatest danger to patient safety is the incompetent handling by corporate management of this somewhat artificial situation, initiated by an “unfortunate” leak at Rana Blad. We are concerned about the reputation of Helgeland Hospital, the overall reputation of Helse Nord and UNN as a teaching hospital, the patient safety experience, and the future climate of collaboration in Helgeland.

This is why we ask Helse Nord to take action again and guide Helgeland Hospital to take a step back, spend time engaging employees and users in a thorough review of the external evaluations that have now been released, before hasty action which will further increase the level of conflict. implemented.

We believe that the management of the company owes it to the entire population of Helgeland, not least to the patients and family members who have been unwittingly turned over in this unworthy media campaign, where patient safety is presented as a cover for wounded pride. and alternative motives.

This publication was first sent as a letter to Helse Nord, Helgeland Hospital and the Ministry of Health and Care Services.