Alexis Shackleton has been named Kateri Memorial Hospital Centre (KMHC)’s first-ever ombudsperson, a role created specifically to respond to complaints, conduct investigations, and make recommendations for recourse.
“On the one hand, it’s a negative that a person’s making a complaint, but on the other hand, it strengthens the community orientation of the hospital,” said Shackleton. “Every complaint will assist in the hospital focusing on improvements.”
Shackleton, who will continue her work as director of Client-Based Services (CBS) for the Mohawk Council of Kahnawake (MCK), was selected for the ombudsperson role in November, beginning her role at KMHC later that month. The role is structured so that Shackleton works on an on-demand basis when complaints arise.
When asked why the complaints process was only announced on Wednesday, given that Shackleton has been working in the role since last year, Valerie Diabo, who was announced as the new executive director of KMHC earlier this month, explained that it took time to identify the ombudsperson role, develop the hospital’s policies and procedures, and onboard Shackleton to the new position. KMHC has been working with Monteregie-Ouest Integrated Health and Social Services Center (CISSSMO) and other hospitals to further develop complaints processes at KMHC.
“The ombudsperson assists in the resolution of complaints in an impartial, confidential, and independent manner,” reads a press release published by KMHC this week, announcing the new complaints process.
Shackleton will be handling complaints previously made to the executive director. When a complaint comes in, she will investigate and make recommendations to the pertinent departments, so that those who have the power to address the problem, can. In this way, complaints prompt further development, said Shackleton.
“I think (Shackleton) is going to be a real asset to our community in helping KMHC to deal with the complaints process,” said Diabo.
“There weren’t any problems,” said Diabo about the previous complaints process, noting that in the past, if a complainant was dissatisfied with the investigation, there would be an opportunity for further investigation, which would still be carried out by hospital staff. According to Diabo, the hospital sees the new role as an opportunity to bolster their responsibility to their patients.
The addition of an ombudsperson to KMHC’s team is welcome for many, such as Tracey Snow, who spoke with The Eastern Door in July 2022 for an investigation into the neglect of elders and other vulnerable patients at the hospital. Snow’s mother, Ruth, has been in long-term care at KMHC since 2018 and has dementia. Last year’s investigation exposed the struggles Snow has faced in advocating for her mother at the hospital.
Ruth was not being bathed properly or regularly. Her bedding was not being changed routinely. Sometimes she was over-medicated, prescribed drugs that she did not need without her family’s knowledge or consent; often she was under-medicated, and Snow would find her mother shaking with anxiety. Ruth had osteoporosis fractures in her spine, which left her with a lot of pain and increased the likelihood of her falling and incurring other injuries. Snow recalls telling the then-manager of long-term care, Robin Guyer, “We need to do something right now. We need to catch this.”
Snow was told that the hospital staff were aware of her mother’s condition, and that they were going to get someone in to help her mother the next day. “That night she fell. That night, she broke her hip,” said Snow.
Ruth had to be rushed to Anna Laberge Hospital, an experience that Snow described as “hell on earth,” especially given the heightened anxiety her mother experienced as a result of her dementia. Anna Laberge is also known for having the longest wait times of any emergency room in Quebec, according to a public report from last year.
The quality of Ruth’s care lapsed during the height of the pandemic, a time where the hospital was grappling with province-wide staffing shortages. Snow is quick to acknowledge that nursing is arduous work, especially when caring for patients like her mother with concurrent physical and mental ailments. However, the lack of accountability in the complaints process made the experience all the more difficult, she said.
“I don’t even know if you want to call the last complaints process effective, because my personal experience was that nothing was done,” said Snow. She said that she would submit complaints and nothing would come of them. Even when she approached a member of the oversight committee in person and was told that they were looking into it and would follow up with her, no one did. “Nobody ever gets back to you,” said Snow.
“I know that there were a lot of people that were working that were really afraid to say things because they were going to be reprimanded,” said Snow.
She said that creating a role meant to handle complaints that is external to and independent from KMHC was “the best thing (KMHC) could have done.”
Since The Eastern Door’s investigation, Snow has seen a shift in the hospital’s response. “We’re seeing consistency now,” said Snow.
Ruth has been moved to a room beside the nursing station. An alarm system has been installed to notify nurses when she leaves her bed to reduce the chances of her falling, and rubber mats have been installed to cushion the blow in the event that she does. Her bedding is changed on a regular basis and she is being given the right medication. Staff respond more quickly and effectively to the patient advocacy that Snow and her sisters do for their mother.
Despite these improvements, Snow identified a need for more consistent communication around complaints processes. “Get back to the families, whether it’s through email or a phone call to say, ‘We heard you, we got your letter, we got your email. We looked into it and these are things we’re going to change.’ People would feel so much better about that,” said Snow.
“If I have to make a complaint tomorrow, who is going to take my complaint? And where is it going to go? And how is it going to be rectified? And how’s it going to get back to me? How am I going to be told?”
She also expressed concern for patients without loved ones to advocate on their behalf.
“There should be a communication tool for the patients that don’t have family members, or a social worker,” said Snow.
She also called for efforts to find solutions to be made more measurable, with ongoing updates and reports provided to families that include descriptions of what has been done to rectify the issues that led to the complaint.
Shackleton said that she sees the hospital working hard towards increasing accountability, and the development of this role is a key step in their strides towards that goal. She feels prepared to take it on given her experience at the MCK, her familiarity with the Community Decision Making and Review Process, as well as her comfort working with policy.
“I am a person who uses the hospital,” said Shackleton. “I am a person who has worked with policies in the past, but I also see it as providing that support to the community to be able to have complaints turned into something positive for future users.”
Currently, Shackleton can be reached by phone at 450-638-3930 ext. 2311, though KMHC is in the process of developing a form for complaints to be made digitally through their website.
Calls made to the ombudsperson line will likely be met by a voicemail, as much of Shackleton’s work will take place after hours, but complainants are encouraged to leave their contact information and their call will be returned.
Diabo confirmed that in her role as ombudsperson, Shackleton has already responded to a complaint.
