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POLICIES BY REGION

BURNTWOOD REGION

ORGANIZATION >> Burntwood RHA Thompson General Hospital
POLICIES:    
Current DNR Order Placement Policies patient has final say competent patients have rights to determine course of treatment
Patient/Proxy
Knowledge of DNR Order Placement		 patient/proxy knowledge mandatory required
Patient/Proxy
Consent of DNR Order Placement		 patient/proxy consent mandatory required
Ethics Board none - consultation with Health Sciences Centre Ethics Committee as required n/a
Community Representation on Ethics Board n/a n/a
Disagreement between patient - doctor consult can be requested; patient has the final say patient has final say
Representation of persons with disabilities in establishing guidelines identified people in community to provide feedback n/a

BRANDON REGION

ORGANIZATION >> Brandon RHA Brandon General Hospital
POLICIES:    
Current DNR Order Placement Policies as per a prior Advance Health Care directive of patient or determined by doctor in consultation with patient/proxy patient/proxy must agree to placement of DNR Order
Patient/Proxy
Knowledge of DNR Order Placement		 mandatory mandatory
Patient/Proxy
Consent of DNR Order Placement		 mandatory mandatory
Ethics Board yes yes
Community Representation on Ethics Board yes yes
Disagreement between patient - doctor patient has final say patient/proxy has final say
Representation of persons with disabilities in establishing guidelines no - open to input from MLPD no - open to input from MLPD

CENTRAL REGION

ORGANIZATION >> Central RHA Winkler Bethel Hospital Gilbert Plains Health Centre
POLICIES:      
Current DNR Order Placement Policies development underway development underway resuscitate only in exceptional cases
Patient/Proxy
Knowledge of DNR Order Placement		 development underway development underway policy made known at time of admission
Patient/Proxy
Consent of DNR Order Placement		 development underway development underway no; decision made by individual facilities
Ethics Board concept currently in discussion n/a policy made known at time of admission
Community Representation on Ethics Board not applicable to RHA n/a n/a
Disagreement between patient - doctor no policies in place no policies in place patient must express a desire to be resuscitated
Representation of persons with disabilities in establishing guidelines none n/a n/a

DAUPHIN REGION

ORGANIZATION >> Dauphin Regional Health Centre Dauphin General Hospital Dauphin Personal Care Home St. Paul’s Home
POLICIES:        
Current DNR Order Placement Policies competent patient has final say determined by doctor resuscitate only in exceptional cases resuscitate only in exceptional cases
Patient/Proxy
Knowledge of DNR Order Placement		 mandatory yes policy made known at time of admission policy made known at time of admission
Patient/Proxy
Consent of DNR Order Placement		 mandatory yes policy made known at time of admission policy made known at time of admission
Ethics Board no no no n/a
Community Representation on Ethics Board no no no n/a
Disagreement between patient - doctor Competent patient has final say Competent patient has final say discussion with patient/proxy dealt with on case-by-case basis
Representation of persons with disabilities in establishing guidelines supports the idea but not in place now no, supportive of input thru focus groups or committee representation no, but supports idea for RHA n/a

PARKLAND REGION

ORGANIZATION >> Parkland RHA Winnipegosis General Hospital Grandview Personal Care Home Roblin District Health Centre Winnipegosis Mossey River Personal Care Home
POLICIES:          
Current DNR Order Placement Policies none determined by doctor determined by doctor with patient/proxy input if possible determined by doctor determined by doctor
Patient/Proxy
Knowledge of DNR Order Placement		 no, decision made by individual facilities doctor requested to speak to patient/proxy if possible mandatory doctor requested to speak to patient/proxy
Patient/Proxy
Consent of DNR Order Placement		 no, decision made by individual facilities verbal consent required if possible mandatory verbal consent required
Ethics Board none none n/a no, follow guidelines of College of Physicians & Surgeons none
Community Representation on Ethics Board none none n/a n/a none
Disagreement between patient - doctor no, decision made by individual facilities patient/proxy has final say dealt with on case-by-case basis patient has final say patient/proxy has final say
Representation of persons with disabilities in establishing guidelines none yes - is seen as necessary to set protocol for DNR Orders for persons with disabilities n/a supports idea through survey & project team input n/a

WINNIPEG (RHA and Chronic Care Institutions)

ORGANIZATION >> Winnipeg RHA Riverview Health Centre Concordia Personal Care Home Deer Lodge Centre
POLICIES:        
Current DNR Order Placement Policies in process “no CPR” placed upon admission doctor decides in consultation with patient/proxy -resuscitation under patient’s Advance Directive n/a
Patient/Proxy
Knowledge of DNR Order Placement		 practice is encouraged policy information available at time of admission consultation expected n/a
Patient/Proxy
Consent of DNR Order Placement		 practice is encouraged no consultation expected n/a
Ethics Board yes yes ad hoc committee formed for specific situations n/a
Community Representation on Ethics Board yes, through hospital board members yes, through board members n/a n/a
Disagreement between patient - doctor n/a order can be withdrawn by doctor opinion of 2nd doctor sought n/a
Representation of persons with disabilities in establishing guidelines n/a policies are forwarded to Residents’ Committee for comment n/a n/a

Winnipeg Acute Care Hospitals

ORGANIZATION >> Concordia Health Sciences Centre Seven Oaks St. Boniface Victoria
POLICIES:          
Current DNR Order Placement Policies doctor decides in consultation with patient/proxy - resuscitate under advance directive must have patient/proxy consent DNR determined by doctor; can be rescinded by patient/proxy patient primary decision maker under review
Patient/Proxy
Knowledge of DNR Order Placement		 consultation expected mandatory recommended with some exceptions yes consultation expected
Patient/Proxy
Consent of DNR Order Placement		 consultation expected mandatory recommended with some exceptions yes consultation occurs
Ethics Board ad hoc committee for specific situations yes yes yes Bioethics Committee
Community Representation on Ethics Board n/a yes, thru board members yes yes Committee representation
Disagreement between patient - doctor opinion of 2nd doctor sought patient has final say competent patient has final say opinion of 2nd doctor, then mediation by Ethics Board Staff & Bioethics committee assist in resolution
Representation of persons with disabilities in establishing guidelines n/a no - open to input from MLPD no - open to input from MLPD no - open to input from people with disabilities no - open to input from MLPD





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