Most people think having a hospital room all to yourself is a luxury. When you’re sick and have to go to the hospital you’re just thankful to be there, so when they put you in a room with 3 other people you aren’t going to question it.
But medical researchers know something that we don’t: Canadian hospitals are hotbeds for infections. Canada’s Chief Public Health Officer just told us in his Report on the State of Public Health in Canada that over 200,000 patients get infected every year, more than 8,000 of whom die. And that the healthcare-associated MRSA infection rate increased by more than 1,000% from 1995 to 2009 (the latest year for which figures are available).
We also know that infection rates of MRSA and Clostridium difficile increase by about 10% with each exposure to a new hospital roommate. And changing from multi-bed to single rooms in the ICU reduces the rates of MRSA and Clostridium difficile by 47% and 43% respectively. In other words, hospital patients are your enemy!
This is why the Canadian Standards Association recently introduced a private room requirement as part of the Health Care Facilities Standard. It was developed with input from representatives of Health Canada and seven Canadian provinces, and specifies that “all inpatient bedrooms in Class A Health Care Facilities shall be singled bedded.” Moreover, this comports with similar standards now in place in the US, the UK, and Scandanavia.
However good this new standard sounds, it leaves us with a very uncomfortable truth: The standard does not require existing health care facilities to renovate and convert multi-occupancy rooms to private rooms. This matters because most of the hospitals that currently exist in Canada are of an older variety: there are very few new hospitals.
Dr. Michael Gardam, director of infection prevention and control at the University Health Network in Toronto, says a move toward 100% private rooms in Canadian hospitals will “be a relatively slower process unless the government stands up and takes leadership.”
“There are places that have done this, that have had the vision and gone ahead and done it,” such as The Hospital for Sick Children in Toronto, which was built in the 1980s with 100% single rooms, he says.
Dr. Gardam adds that change will have to be driven by demand. “You’re looking to the health care community and to patients standing up and saying that they want 100% single rooms.”
There is another aspect to this debate that bears scrutiny: care of the elderly. A landmark Canadian study published last year told us that 1 in 12 adults in hospital across the country are infected or colonized with the pathogens MRSA (the major offender), C Diff, or VRE. In the back pages of the report was even a more crucial number: the average age of this patient population was over 70.
In other words, it is our seniors who are the most vulnerable and who therefore have the most to gain or lose by the new one patient per room standard.
So if there’s a scramble for single-patient rooms in our hospitals, it seems pretty clear who, in the words of Dr. Gardam, we should be “standing up [for]” and giving those rooms to.