Northern Health responds to CIHI report on post-surgery deaths

FORT ST. JOHN, B.C. — Northern Health has responded to the release of the Canadian Institute for Health Information’s (CIHI) report on post-major surgery deaths, saying there’s more context residents should be aware of. 

Eryn Collins, the regional manager for public relations for Northern Health, told Energeticcity.ca that without context, the numbers do seem “alarming.” 

According to CIHI’s report, Northern Health’s rate of in-hospital deaths post-major surgery within 30 days is 3.3 per cent, approximately 58.82 per cent higher than the provincial average of 1.8 per cent. 

Collins said one of the biggest factors contributing to the percentages for 2021 and 2022 being so high was the COVID-19 pandemic. 

“The data for that year coincides directly with the year that COVID-19 was having some of its greatest impact in the North, and we were seeing relatively high rates of COVID-19 infection, hospital admission, and critical care needs,” Collins said. 

Collins also said that other factors such as pre-existing conditions, chronic illness, or whether or not the deaths occurred within the same hospital visit may also play a role in percentages being so high.

Collins stated that the smaller sample size of hospitals, like in the case of Dawson Creek and District Hospital, and the volume of surgeries undertaken may impact how the numbers appear. 

For example, while the city of Prince Rupert has a comparable population size to Dawson Creek, the Prince Rupert Regional Hospital only had a 1.5 per cent indicator. 

While the population may be comparable, Collins says the volume of major surgeries may differ. 

“It’s potentially comparing some apples to some oranges without knowing exactly what types of procedures CIHI is counting in or factoring into that category,” Collins said. 

CIHI did release an abstract with its new numbers, with links to its methodology documents. The methodology does have a list of what procedures count as major surgeries, but they are listed in CMH+ code. 

CIHI also indicated in its abstract that the numbers were measured at a rate of per 100. 

Collins pointed out that not every hospital within Northern Health is detailed in the numbers, as is the case with Fort St. John Hospital. 

Furthermore, Collins stated that Northern Health does not report everything to CIHI directly. 

According to Collins, CIHI sometimes gets their information from the federal or provincial sources that Northern Health reports to.

While she could not provide exact numbers, Collins did say that the percentage of deaths in-hospital following a major surgery within Northern Health were on a decline compared to the 2021 and 2022 numbers put out by CIHI. 

“What I can tell you is that our own quality improvement and data folks have taken a look at the rates for the data rather for as far as we can into 2022 [and] 23, which is nearly up to the end of that fiscal year,” Collins said. 

“It does indicate that that post-surgical mortality has dropped back closer to numbers that were being seen in the years prior to the COVID-19 pandemic.”

Collins added that data reported by organizations like CIHI are a chance for medical organizations like Northern Health to find places to improve. 

“Quality measurement and quality improvement are an ongoing priority for us. So we look to see what we can learn from sources like the CIHI data.” 

In its abstract on the post-surgery death indicator, CIHI states a similar sentiment, adding that CIHI knows not all deaths recorded are preventable. 

“Although not all deaths are preventable, reporting on and comparing mortality rates for major surgical procedures may increase awareness of surgical safety and act as a signal for hospitals to investigate their processes of care before, during or immediately after the surgical procedure for quality improvement opportunities.”

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