According to Québec Health Ministry figures, the Lakeshore General Hospital (LGH) has the highest Emergency Room death rate in Montréal. An access-to-information request granted to the Gazette reported that 3.4 individuals died for every 1,000 visits to the Pointe-Claire ER in the first ten months of the 2023–24 fiscal year. The Jewish General Hospital had an average ER death rate of 1.2 over the same period, while the ERs across the whole Island of Montreal had an average rate of 1.39.
With nearly 20 years of experience as a nurse, five of which have been in the Lakeshore’s ER, Nathan Friedland feels as though some explanations are in order.Â
His insights lead to show that unlike the Jewish General Hospital, the Royal Victoria Hospital, the Montreal Neurological Institute, the Sacré Coeur Hospital, and the Montreal General Hospital, Lakeshore is not a true tertiary care facility. Tertiary is one of four levels of care, which involves treating special, complex conditions requiring procedures like coronary artery bypass surgery, dialysis, plastic surgery, neuro surgeries, severe burn treatments, etc. The lack of these resources on-site is a huge problem for the West Island.
"When a patient comes to the resuscitation room (or code room) and is in cardiac arrest, for example, we might be able to stabilize that patient but, the patient will then need to be transferred to a hospital that has a cardiac surgeon and a heart catheterization lab. Lakeshore has neither. That means a highly trained resuscitation nurse must accompany the patient via ambulance to a hospital with the above-mentioned resources," Nathan Friedland explains.
This also takes time, which is of the essence in critical care procedures, and an absence of a crucial staff member contributes to the pre-existing burdens associated with staff shortages. Nathan notes that there are generally only 2 resuscitation nurses on duty for as many as 5 very sick patients in the 3 code rooms. Losing one to a transport for a couple of hours can be very dangerous for the remaining coderoom patients who then only have one nurse to care for them, instead of two.Â
The same procedure ensues if a patient comes to the code room with a cerebral hemorrhage, massive trauma, dissecting abdominal aortic aneurysm, major stroke, or a broken neck. The Lakeshore has no neurosurgeon, no vascular surgeon, and no ECMO (extracorporeal membrane oxygenation)Â equipment, requiring these patients to be transferred downtown.Â
"St Mary's Hospital's ER - which has a lower death rate than LGH's - has, a stone's throw away from it, the Jewish General Hospital which has a state-of-the-art heart catheterization lab. It therefore takes much less time to get a heart attack victim from St Mary's to the JGH than it does to transfer a patient from LGH to the JGH. Time is cardiac tissue. The less time it takes to open a coronary artery, the higher the chance of survival for the patient."
The West Island's population is rapidly aging, and strokes or heart attacks are not uncommon amongst this population. Transporting them downtown is compromising their health, not to mention interrupting the staff's duties, according to Friedland:
"If the government is truly concerned about LGH's seemingly high death rate, it needs to give the aging West Island population the resources it deserves. Transporting elderly patients downtown and hoping they don't die en route or while waiting for an ambulance from the Lakeshore's ER is not a fair solution for patients or the staff, who are trying to save their lives."
Construction of a new Emergency Room is set to begin in the spring of 2025. The project will see the construction of a new 8300m² three-storey building including:
38Â stretchers in cubicles;
a 12-bed Short-term Hospitalization Unit in physical health;
a 6-bed Short-term Intervention Unit in mental health.
The new building will make include added:
examination rooms;
pre-triage and triage zones;
medical imaging rooms;
a 10-seat rapid assessment zone.
