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Govind Rao

Four things needed to make pharmacare work - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|vitc|20150228|215426928

from heather pharmacare drugs

shared by Govind Rao on 04 Mar 15 - No Cached
  • Times Colonist (Victoria) Sat Feb 28 2015
  • A growing number of health professionals, patients, community groups and even politicians are calling for national pharmacare. But many Canadians likely wonder what pharmacare is and whether Canada is ready for it. Let's start at the beginning. Affordable access to safe and properly prescribed prescription medicines is so critical to patient health that the World Health Organization has declared governments are obligated to ensure such access for all of their citizens.
  • Unfortunately, Canada is the only developed country with a universal health-care system that does not include universal coverage of prescription drugs. The negative consequences for our health and economic well-being are significant. Without universal coverage of prescription drugs, one in 10 Canadians cannot afford to fill the prescriptions their doctors prescribe. When patients don't fill prescriptions they need, it hurts them and our economy because they end up needing more health care in the long run.
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  • But pharmacare is about more than just drug coverage. Insurance companies can do that. What national pharmacare must do is to ensure sustainable, equitable and affordable access to medicines that are safe and appropriately prescribed. In the Canadian context, this is a public responsibility. And, to be clear in this election year, it will require federal engagement - and not just in the form of cutting cheques for provincial pharmacare programs, but real leadership. More so than other aspects of health policy in Canada, the federal government has responsibility for matters that affect the safety, availability, use and cost of prescription drugs. Here are four things the federal government could do to make national pharmacare work for Canadians:
  • Commit to a clear and comprehensive pharmacare plan, not a patchwork of private and public insurance and not income-based or "catastrophic" drug coverage. Research has consistently shown those systems don't work well and are unnecessarily costly. Canada needs a universal, public and comprehensive pharmacare system that will meaningfully integrate medicines into medicare in ways that lead to safer, more affordable use of medicines for all Canadians. We've known this since the 1960s. It's time for a government to commit to make it its legacy for Canada. Get on with the task of improving prescribing in Canada. About one in three seniors receives prescriptions known to pose health risks for older adults. The preventable problems of overuse, underuse and misuse of medicines cause one in five hospitalizations in Canada. Cutting these problems in half would save Canadians billions.
  • The federal government should fund the development and implementation of a national strategy to improve prescribing. Done in partnership with patients, professionals and the provinces, this national strategy should aim to establish a culture of safety and appropriateness, to put an end to questionable drug-marketing practices, and to put credible and usable information in the hands of patients, prescribers and policy-makers. Quit applying antiquated drugprice regulations. We live in a world where most comparable health systems have abandoned the blunt instrument of price regulation in favour of more sophisticated tools of price-and-supply contract negotiation. When done well, negotiations with suppliers lead to more competitive prices and more assurances of a secure supply of the medicines the country needs.
  • The federal government should take the $11 million spent enforcing antiquated price regulations and invest it in joint capacity for negotiating, monitoring and enforcing contracts on behalf of public drug plans and hospitals from coast to coast. This would not only level the playing field within Canada, it would also make Canada much stronger on the world market. Sustainability of any system to encourage access to medicines depends to a great extent on timely and vigorous generic competition. Yet Canadian regulations create unnecessary barriers to generic drugs entering our market.
  • The federal government should create a clearer, faster and fairer path to generic entry following required periods of market exclusivity for patented drugs. This would save Canadians millions - and wouldn't cost the federal government a dime. If done right, a pharmacare plan would effectively integrate medicines into Canadian medicare and ensure that the Canadian principles of universal access to highquality, affordable healthcare do not end when doctors give patients prescriptions to fill. It is within reach with the right plan - and leadership.
  • Steve Morgan is a professor in the University of British Columbia's school of population and public health and an expert adviser with EvidenceNetwork.ca.
Govind Rao

Health-care system in need of more transparency, report says | Toronto Star - 0 views

www.thestar.com/...d-in-health-system-report.html

from heather quality privatization

shared by Govind Rao on 16 Nov 15 - No Cached
  • C.D. Howe Institute says there should be more public reporting on patient experience within Canada’s health-care system.
  • Seniors health was a hot issue during the recent federal election. A recent C.D. Howe Institute report argues Canada's whole health care system needs greater transparency.
  • By: Theresa Boyle Health, Published on Thu Nov 12 2015
  • ...3 more annotations...
  • Canada’s health system is not transparent enough, says a new report that calls for more public reporting on patient experience, such as in instances when they are harmed. Consideration should be given to publicly reporting physician-level outcomes, such as death rates for patients of individual cardiac surgeons, states the report published Thursday by the C.D. Howe Institute. More collection and public disclosure are critical to creating better value for the health system, it says, urging the federal and provincial governments to pave the way. “From a democratic perspective, publicizing outcome measures can empower patients, families and communities to engage in the policy debate about which outcomes matter most and at what cost — and in the ways health care should be delivered,” says the report, titled “Canadian Health Care Needs a Checkup, Here’s How.”
  • Health-care outcomes that could be measured and publicly reported include data about death, disease, disability, discomfort and dissatisfaction, it states. As well, there could be more transparency surrounding patient satisfaction and health-system responsiveness.
  • “Public reporting of any individual physician or health-care provider has not shown to improve patient outcomes or satisfaction levels,” a statement from the OMA said. “Our health-care system is made better through the collection and reporting of accurate and meaningful data that physicians use to innovate how they deliver care.”
Govind Rao

Health care strike vote - BC News - Castanet.net - 0 views

www.castanet.net/...news-story-112020-3-.htm

from heather bc cupe bargaining strike

shared by Govind Rao on 09 Apr 14 - No Cached
  • Mar 29, 2014
  • Unions representing 47,000 health care workers are seeking a strike mandate from members. (Photo taken during 2004 HEU strike)
  • Health care unions representing 47,000 health care workers are seeking a strike mandate from members to back efforts to reach an agreement with B.C.'s health employers. The 11-union Facilities Bargaining Association says that talks have stalled on a number of issues including health employers' refusal to extend employment security provisions, a move that would open up health care to further privatization and put decent jobs at risk. "Health employers' demands for more contracting out will cause uncertainty and instability in our hospitals, care facilities and in the community," says Bonnie Pearson, the FBA's chief negotiator and secretary-business manager of the Hospital Employees' Union. The current provision in the collective agreement that protects services against contracting out expires on Sunday. It was renegotiated into the agreement in 2012 for the first time since it was removed by legislation 10 years earlier. The Supreme Court of Canada later ruled that law unconstitutional. Pearson says health employers are refusing to take steps to improve health and safety in the province's most dangerous workplaces. And they've rejected proposals to improve health service delivery by expanding roles for B.C.'s paramedics in the community. Negotiations between the FBA and the Health Employers Association of BC (representing most publicly funded health employers) include a wide range of health care jobs in hospitals, care facilities, emergency health services, logistics and supply warehouses, and other shared services.
Govind Rao

Infected & undocumented; Thousands of Canadians dying from hospital-acquired bugs - Inf... - 0 views

www.fpinfomart.ca/...212715615

from heather hai infectious disease hospital health and safety

shared by Govind Rao on 19 Jan 15 - No Cached
  • National Post Mon Jan 19 2015
  • In the second of a two-part series on medical errors, Tom Blackwell reports on the deadly infections Canadians are picking up in hospitals. Kim Smith was no stranger to stress - her job in community corrections often brought her face to face with members of Winnipeg's violent street gangs. But as she lay in a local hospital's gynecology ward more than a year ago, nurses called her brother with an unusual question: Did Kim suffer from any kind of emotional troubles? The woman, her caregivers said, had been telling them she wanted to kill herself.
  • It was a shocking turn of events, coming a week after Ms. Smith entered St. Boniface Hospital for a routine hysterectomy and ovary removal. In the days since the operation, however, she had been complaining of escalating pain in her gut, so intense she began to fear for her life - and then apparently wanted to end it. By the time medical staff took the woman's complaints seriously, an infection inside her belly had developed into necrotizing fasciitis (flesh-eating disease) and devoured large chunks of her abdomen.
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  • Within hours of emergency surgery to drain "brown, foul-smelling liquid" and excise dead tissue, and four days after her 45th birthday, Ms. Smith was dead. "She kept yelling at me, 'I know my body, I know there's something wrong in my stomach and nobody wants to listen to me. And I'm going to end up dying here,' " said Kym Dyck, her sister-in-law. "She died the most horrible, painful death anybody could suffer, and nobody would listen to her and reach out to her." Ms. Smith's tragic demise was more dramatic than many cases of hospitalacquired infection (HAI). Necrotizing fasciitis is a frightening, but rare, complication. Still, about 8,000 Canadians a year die from bugs they contract in facilities meant to make them better, while many more see their hospital stay prolonged by such illness.
  • She likely did not know that most surgical-wound infections arise from bacteria patients carry into hospital on their skin, which can then sneak inside through incisions, especially when infection-control safeguards are not optimum. As early as the day after her operation, the Métis woman began to complain of pain in her abdomen, only to be told by nurses that she simply needed to walk about, Ms. Dyck recalls. Some of that suffering is reflected in her patient charts, obtained by the family and provided to the National Post. On Oct. 1, she complained of gastrointestinal bloating and discomfort; the following day, heartburn, bloating and slight nausea, the records note.
  • Meanwhile, important lessons about how diseases spread inadvertently within health facilities often come to light in fits and starts. Two hospitals in Toronto and one in Quebec, for instance, announced independently in the late 2000s that they had discovered contaminated sinks were the source of separate, deadly outbreaks of infection. Some word of the episodes got out through specialized medical journal articles, academic conferences and sporadic news stories. But there is no systematic way of disseminating such information across the system, said Darrell Horn, a former patient-safety investigator for the Winnipeg Region Health Authority. "It's just totally loosey-goosey," he said.
  • "You could sit and call every hospital in the country, and ask them when was the last time they cleaned the sink in the [neonatal intensive care unit] and how they cleaned it, and you'd get nothing but blank stares." Health care is paying much more attention, at least, to the HAI problem than it did a decade ago, said Dr. Michael Gardam, infection-control director at Toronto's University Health Network. After heavy media coverage of the mostly hospital-based severe acute respiratory syndrome (SARS) outbreak and deadly hospital infestations of Clostridium difficile, said Dr. Michael Gardam, infection-control director at Toronto's University Health Network. As health-care-related infection became a very public affair, hospitals started hiring more experts, encouraging hand-washing and generally striving to prevent infection, rather than just treating it after the fact as an unavoidable cost of doing medical business. Dr. Gardam's hospitals have even begun characterizing hospital-acquired infections as adverse events, akin to more traditional medical error. Whether because of such measures or not, Ms. Smith had few fears when she entered St. Boniface on Sept. 30, 2013, for an operation for uterine fibroids, her family says.
  • Yet after years of well-intentioned work and millions of dollars spent on combating the scourge, the details and extent of the problem remain murky. No national statistics, for instance, document the number of surgicalwound infections like Ms. Smith's, one of the most common types of hospitalacquired pathogens. A federal agency now publishes rates of sepsis, or blood infection, at individual hospitals, but their methodological value is a matter of debate. Government tracking of worrisome, drug-resistant bacteria is patchy and of questionable practical use, say infectious-disease physicians. "There is no question that at a national level, both our surveillance for hospital-acquired infection and our surveillance for anti-microbial resistance is not serving our needs," said Allison McGeer, an infectious-disease specialist at Toronto's Mount Sinai Hospital. "[And] we know, very substantially, that you can't fix what you're not measuring."
  • The program's focus is drug-resistant bacteria, the increasingly familiar methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE) and C. difficile. It is based, though, on a sampling of just 57 teaching hospitals, a fraction of the country's 250 or so acute-care hospitals. The SARS outbreak, for instance, erupted at a community hospital that is not part of that network. Infectious-disease doctors have long complained that it takes too long for the data those hospitals submit to the Agency to be posted. "If I want to know what's happening with MRSA, I call my friends," said Dr. McGeer. More complete, and easier to access, is the system developed by the European Centre for Disease Control, says Lynora Saxinger, an infectiousdisease specialist at the University of Alberta. It not only tracks drug-resistant bugs, but matches those stats with the use - or possible over-use - of antibiotics, considered the main cause of the problem. The latest concern of infectiousdisease specialists is a class of antibiotic-defeating organisms known as carbapenem-resistant Enterobacteriacaeae (CRE), a "game-changer," said Dr. Saxinger. The death rate is as high as 50%. CRE is part of the public health agency's surveillance system, meaning those 57 hospitals submit their numbers, but Dr. McGeer said all acutecare hospitals in Canada should have to report them. Meanwhile, "the last CRE outbreak ... I heard about it on the news," said Dr. Saxinger.
  • There is no evidence Ms. Smith was infected with a drug-resistant organism, but by the time she went in for emergency surgery, it appears little could have saved her. Indeed, once begun, necrotizing fasciitis has a 70% death rate. Early the next morning, her blood pressure had sunk, the telltale black of more dead tissue had spread around her side to her back and she went into cardiac arrest, dying minutes later. The hospital investigated the incident and assured the family that lessons learned from it would be passed on to staff - and help future patients, says Ms. Dyck. Mr. Horn says his experience across Canada suggests it is unlikely those lessons will be shared with anyone else in the health-care system, or the public. Meanwhile, Ms. Dyck says the sight of doctors and nurses fruitlessly attempting to revive her sister-in-law - her abdomen left open as part of the flesh-eating treatment - remains etched in her mind, as is the thought it might all have been prevented. "What I witnessed, I was traumatized by for months and months," she said. "It was just a terrible, terrible, painful death. And she knew she was going to die, that's the worst thing." National Post tblackwell@nationalpost.com
  • To see the first part of the series, Inside Canada's world of medical errors, go to nationalpost.com
Govind Rao

Ebola whistleblower given provincial health and safety award - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|hbsp|20150529|221514848

from heather infectious disease hospital cupe Ontario

shared by Govind Rao on 29 May 15 - No Cached
  • The Hamilton Spectator Fri May 29 2015
  • Blowing the whistle on McMaster Children's' Hospital's failure to properly prepare staff to handle the deadly Ebola virus last year has earned a provincial honour for Hamilton labour activist Kathy MacKinnon. She received the Ontario Health and Safety Award from the Canadian Union of Public Employees this week for exposing the facility's lack of worker training and protective equipment.
  • "Kathy has been on their case quite often over the last 25 years," said Dave Murphy, president of CUPE Local 7800, representing 3,800 Hamilton Health Sciences workers. "She was instrumental in the Ebola case after the hospital said they were ready for it and we found out they weren't." A spokesperson for Hamilton Health Sciences did not respond by deadline.
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  • At the end of August last year, MacKinnon cut short a vacation to rush to the hospital after at least three union members refused to clean a room where a child suspected of being infected with the deadly Ebola virus was treated. The workers said they lacked the proper training or equipment to face such a threat. "We gave them several weeks, but they didn't seem to be doing what they said they would do, so I called the Ministry of Labour," MacKinnon said. "They just didn't seem to care about the employees."
  • The Ministry of Labour investigated MacKinnon's complaints and issued five orders requiring the hospital to train workers and ensure proper equipment was available. The child eventually tested negative for the virus. MacKinnon is worker co-chair of the McMaster Children's Hospital health and safety committee as well as health and safety chair for the local. "I do this because I want to look out for the health and safety of all the employees here, even if they're management," she said. "Workers need an advocate to fight the fight."
  • Murphy said bringing the hospital's actions during the Ebola scare to public attention was an important move, especially as the Pan Am Games move closer, bringing people from around the world into Hamilton and Ontario. MacKinnon was nominated for the award by members of Local 7800, who pointed to her work ensuring workers and contractors were properly protected from exposure to asbestos in the McMaster hospital. Her efforts on that front eventually led to charges and fines of $19,000 against the facility.
  • "Kathy is absolutely tireless about these issues," Murphy said. "Even if her nose gets bloodied she gets up, dusts herself off and gets right back into the fight." The award, he added, isn't something MacKinnon would have sought for herself, but he and the members nominated her for years of effort. "She would never want this for herself but I thought she deserved it," he said. "For years she has been fighting for us so that when people go to work, they can come home again healthy." CUPE Ontario represents 250,000 members in social services, health care, municipalities, school boards, universities and airlines. sarnold@thespec.com
Govind Rao

Colonoscopy clinics kept hep C outbreaks secret; Eleven patients infected, tainted seda... - 1 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|243387|tost|20140927|204928571

from heather privatization private clinics ontario safety health and safety quality infectious disease

shared by Govind Rao on 29 Sep 14 - No Cached
  • Toronto Star Sat Sep 27 2014
  • Three Toronto colonoscopy clinics have had hepatitis C outbreaks since 2011, the Star has learned. Toronto Public Health, which revealed the outbreaks when pressed by the Star, says 11 patients were infected and that tainted sedative injections were the "possible" cause in all cases. The authorities responsible for investigating the spread of infection and inspecting the clinics - TPH and the College of Physicians and Surgeons of Ontario, respectively - kept the outbreaks secret. NDP health critic France Gélinas said public awareness of the first outbreak might have prevented the next two. "It has gone beyond appalling that the same mistakes are being repeated and are not being reported," she said.
  • Gélinas is calling on the province to remove the CPSO as the regulator of such clinics - known as "out-of-hospital premises" - charging that the outbreaks show the organization is failing in its duties to uphold quality of care and to be transparent, and is placing patients at risk. The MPP for Nickel Belt also wants the province to suspend the downloading of hospital services into the community and place a moratorium on the creation of any new clinics until a new oversight body is created to ensure public safety. "The minister of health has to realize that this push into the community is not safe. It won't be safe until we have in place much more robust oversight," she said. Health Minister Eric Hoskins said he is seeking advice on ways to strengthen outbreak protocols and inspection programs to ensure patient safety in clinics outside of hospitals.
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  • "We will work to identify new tools that can help us continue to protect patient safety no matter where (patients) are receiving treatment. Ontarians have my commitment as minister that we will do whatever is necessary to protect the safety of patients," he said. TPH told the Star 11 patients contracted the liver-damaging virus during three outbreaks over the last three years; three were infected at the Downsview Endoscopy Clinic on Dec. 7, 2011, three at the North Scarborough Endoscopy Clinic on Oct. 17, 2012, and five at the Finch Ave. W. site of the Ontario Endoscopy Clinic on March 15, 2013. Nine of the 11 infected patients have gone on to develop chronic hepatitis C, meaning the virus has remained in their bodies, placing them at risk of serious, long-term problems, including cirrhosis of the liver and liver cancer. None of the clinics offered up anyone to be interviewed, but all three provided written statements. They all expressed concern for the health and recovery of the patients, said they co-operated fully with investigations and emphasized that they are committed to ensuring outbreaks never occur again. The Downsview Endoscopy Clinic also said it no longer uses multi-dose vials.
Govind Rao

Health Council Canada - 0 views

www.healthcouncilcanada.ca/rpt_det.php

shared by Govind Rao on 11 Mar 14 - No Cached
  • Progress timeline 2003-2013:Highlights of health care reform
  • February 2014
  • Govind Rao on 11 Mar 14
     
    With almost $2 trillion spent, from both public and private sources, on health care in Canada over this period, Canadians should demand accountability for their investments in the health care system. This report outlines key national, provincial and territorial policy reforms since 2003, in addition to the Health Council's contributions over this period. This report covers several areas where positive changes have occurred, including: a growing focus on seniors' issues, new partnerships with First Nations, Inuit and Métis in a number of provincial health systems, an increased focus on quality of care, government actions to improve access and patient safety, and the creation of national organizations for mental health and cancer control.
Doug Allan

Your Health System website reveals Canadian health care statistics by hospital, region,... - 0 views

www.cihi.ca/...RELEASE_18SEP14

CIHI

shared by Doug Allan on 23 Sep 14 - No Cached
  • A unique website from the Canadian Institute for Health Information (CIHI) will allow Canadian hospitals, health regions, provinces and territories to compare how they measure up on 37 indicators related to access, quality of care, patient safety and emerging health trends across the country.
  • “This website and its data should help health sector leaders make decisions about the delivery of health services based on comparisons with leading practices. Our experiences and those in other jurisdictions show that public reporting like this makes our health system function more effectively. In spring 2015, we will release similar comparative data for long-term care facilities across the country.”
  • Using data provided to CIHI over several years from Canadian hospitals, as well as other data sources, the website can measure a broad range of topics, including hospital readmission rates, rates of in-hospital infection from sepsis, avoidable deaths from treatable causes and hospital deaths following major surgery. Indicators of the health status of Canadians by province and region are also available, including average life expectancy at birth and at age 65, and the number of hospitalizations due to heart attacks and strokes.
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  • “Your Health System is a new resource health care managers can use to look at their own data and then compare outcomes with those of peer hospitals, regions, and other provinces and territories across the country,” says Jeremy Veillard, vice president of Research and Analysis at CIHI.
  • CIHI intends to expand the site in 2015 by adding comparable data for long-term care facilities. Indicators will be updated on an ongoing basis.
Govind Rao

Canada's head bureaucrat makes mental health in the workplace a top priority | National... - 0 views

news.nationalpost.com/...n-the-workplace-a-top-priority

from heather mental health health and safety

shared by Govind Rao on 11 Apr 16 - No Cached
  • April 4, 2016
  • Canada’s top bureaucrat is making mental health in the workplace a top management priority in this year’s performance contracts for all deputy ministers. Privy Council Clerk Michael Wernick has notified deputy ministers that they will be assessed on the health and well-being of their departments. That means a portion of their performance pay will be tied to how well their departments are faring in building a “respectful” workplace.
  • Govind Rao on 11 Apr 16
     
    Improving mental health in the workplace is a top priority for the public service, and deputy ministers will be assessed on the "health and well-being" of their departments, reports Postmedia News. Almost half of health claims among public servants are for anxiety, depression or other mental health issues.
Irene Jansen

CBC.ca | White Coat, Black Art | Unfinished Business Show - 0 views

www.cbc.ca/...unfinished-business-show-1

care aide retirement homes regulation ltc ontario

shared by Irene Jansen on 23 Jan 12 - No Cached
  • we have reaction from Ontario's Minister of Health and Long Term Care to our season debut episode on personal support workers and the work they do at retirement homes in the Province of Ontario
  • personal support workers or PSWs, the subject of our full edition season debut episode back in September
  • unlike nursing homes, retirement homes operate in a regulatory grey zone.  And it's at these retirement homes where we found PSWs who say they're expected to perform duties they aren't qualified to do, like injecting insulin or administering narcotics.
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  • We played some of Jen's interview to Deb Mathews, Ontario Minister of Health and Long Term Care. 
  • "That is a very troubling clip you just played for me," Mathews told WCBA.  "No health care worker should ever be put into a position where they feel that they're compromising the health and safety of their patients or their own personal safety."
  • As for the operators of retirement homes that compel PSWs to perform nursing duties that they may not be qualified to perform? "Well, I would say that they're taking a very big risk," she added.  "They really should not be supporting a practice that isn't safe."
  • But if retirement homes are taking a big risk, as the Minister puts it, it's a risk that exists in part because retirement homes aren't regulated nearly as strictly as long term care facilities.  And that won't be changing any time soon.  In terms of regulations, a retirement home is little different from your own home.  
  • Irene Jansen on 23 Jan 12
     
    The story on PSWs and interview with Deb Mathews runs from minute 1:34 to minute 9:28. Mathews: I would say to the operators "they are taking a very big risk and they really should not be supporting a practice that isn't safe - they have to take that responsibility very seriously" I'm asking PSWs to "please stand up and report this". The scope of practice for PSWs is not as clear as it ought to be ... this is why we're establishing the PSW registry. It will allow us to see the training and experience of PSW - this information will be available to the public. My expertise is long-term care homes. Very high standards there. Retirement homes in Ontario are different - wide range of people. They do not fall under the Ministry of Health. Dr. Goldman: Why not regulate retirement homes? Mathews: Because they serve a very different function - e.g. for people who are very healthy but would like to have for example their meals prepared for them. They are not health care facilities the way long term care homes are. A retirement home is a home. We really do want to offer choice to people. The retirement homes determine when a person needs care they can't provide. Dr. Goldman: Regulation of PSWs?  Mathews: I don't see it any time soon. We are working with our training colleges and universities on a common curriculum. Until we have that standard training and established scope of practice, we can't take them the next step to make them a regulated health care professional.
Govind Rao

Targeted ads to be shown at health-care facilities - Infomart - 0 views

www.fpinfomart.ca/...214732519

from heather health and safety hospital

shared by Govind Rao on 18 Feb 15 - No Cached
  • The Globe and Mail Wed Feb 18 2015
  • People turning to their phones to kill time in waiting rooms at health-care facilities may soon see an unexpected image: a person in blue scrubs, with dark purple bruises on her arm. It is one of the ads in a targeted mobile campaign launching Wednesday, designed to raise awareness about the pervasive problem of abuse against health care workers. It is using new advertising technology - targeting people with mobile ads based on the GPS location of their phones - to get the message out.
  • The campaign, launched by Ontario's Public Services Health & Safety Association (PSH&SA), will show ads to people in more than 100,000 health-care facilities in the province, including hospitals and rehabilitation centres. Ads will appear in mobile apps people use to play games, read the news, or map their routes home, for example, as long as those people have agreed to allow those apps to gather information about their whereabouts. "The issue of violence against health-care workers is growing," said Henrietta Van hulle, executive director of the PSH&SA, a non-profit funded by the Ministry of Labour.
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  • The campaign is the beginning of a multiyear process to push for better tools to protect these workers. That will include more awareness among families of patients, who need to inform doctors and nurses if the patient has certain triggers or warning signs of a violent outburst. It could also involve tools such as personal alarms workers can wear to call for help when a situation arises. More generally, it also means informing workers of their rights, and encouraging workplaces to do better risk assessments and even flag patients who may become violent. For people working in home care, who do not have security nearby, risk assessment is even more important.
  • Last year, 639 health-care workers in Ontario were injured in a violent incident, badly enough that they were unable to work their next shift. That statistic does not account for incidents where workers are pushed, hit, or scratched, for example, and do not report them or take time away from work. "They're seeing [these incidents] as part of the job," Ms. Van hulle said. According to a decade-old Statistics Canada study, 33.8 per cent of nurses surveyed in hospitals and long-term care facilities reported being physically assaulted by a patient in the past 12 months. Nearly half reported emotional abuse on the job. More recent national statistics are hard to come by, but industry associations and unions say the problem is growing.
  • This is due to a couple of factors. First, there has been a move to deinstitutionalize people with mental health issues. While it is seen as positive to put fewer people with mental-health issues into institutions, protections for workers dealing with these patients have not kept pace with the changes. Another major issue is Canada's aging population, and rising cases of dementia. Although not everyone with dementia is violent, people who are cognitively impaired can easily become frightened and lash out, Ms. Van hulle explained. The campaign uses technology that identifies health-care facilities in Ontario - and through "geofencing," can serve ads to mobile devices inside those facilities.
  • "When someone is in a hospital and they see a message targeting people in a hospital, the context makes it relevant," said David Katz, executive vice-president of EQ Works, the digital media buying company for the campaign. This kind of technology is attractive to advertisers because the more relevant an ad is, the less likely a person is to ignore it - known as "banner blindness" for digital ads.
  • The trouble is that locationbased ads can seem creepy. Because this is dealing with a serious issue - and not selling something - it is less likely to trigger that reaction, said Robert Wise, partner at Scratch Marketing, PSH&SA's ad agency. The campaign will not involve storing information about people it targets. "We're targeting generically, people who are visiting facilities," Mr. Wise said.
Govind Rao

CEO refutes safety concerns - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nbng|20160402|243865534

from heather cupe Ontario hospital violence nursing nurses lpn pn

shared by Govind Rao on 04 Apr 16 - No Cached
  • North Bay Nugget Sat Apr 2 2016
  • The president and CEO of the North Bay Regional Health Centre disputes the results of a poll about employee safety released Friday. In a prepared statement, Paul Heinrich said he is "disappointed in the relentless nature of the Canadian Union of Public Employees/Ontario Council of Health Union's efforts to position our organization and our staff negatively." Heinrich said the campaign "is not based on fact and is harmful to our staff and their care of our patients."
  • The CUPE/OCHU poll indicated that 67 per cent of hospital staff who took part in the Union Calling poll this week do not believe the hospital is doing enough to protect employees from violence in the workplace, and that 72 per cent have experienced physical violence in the past year. Heinrich said the health centre conducts an "organizationwide staff survey" annually, with 75.5 per cent of staff reporting "my organization takes effective action to prevent violence in the workplace," while "73.7 per cent of staff report my workplace is safe."
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  • He said 555 employees participated in the most recent survey. "The health centre is committed to ensuring the safety of staff and patients and has numerous programs and processes in place in order to ensure a safe workplace and to deal with any safety issues, including workplace violence that might arise," Heinrich said.
  • "Further, the North Bay Regional Health Centre supports a blame-free culture of reporting of safety issues, including issues of workplace violence. As per the Occupational Health and Safety Act (OHSA) under no circumstances will any person who in good faith reports an incident of workplace violence /harassment or assists in its investigation be subject to any form of retribution or reprisal as a result of this action."
Irene Jansen

HCA, Giant Hospital Chain, Creates a Windfall for Private Equity - NYTimes.com - 0 views

www.nytimes.com/...ndfall-for-private-equity.html

us hospital hca fraud staffing quality corporation

shared by Irene Jansen on 22 Aug 12 - No Cached
  • profits at the health care industry giant HCA, which controls 163 hospitals from New Hampshire to California, have soared
  • The big winners have been three private equity firms — including Bain Capital, co-founded by Mitt Romney, the Republican presidential candidate — that bought HCA in late 2006.
  • only a decade ago the company was badly shaken by a wide-ranging Medicare fraud investigation that it eventually settled for more than $1.7 billion
  • ...24 more annotations...
  • 35 buyouts of hospitals or chains of facilities in the last two and a half years by private equity firms
  • Among the secrets to HCA’s success: It figured out how to get more revenue from private insurance companies, patients and Medicare by billing much more aggressively for its services than ever before; it found ways to reduce emergency room overcrowding and expenses; and it experimented with new ways to reduce the cost of its medical staff
  • HCA decided not to treat patients who came in with nonurgent conditions, like a cold or the flu or even a sprained wrist, unless those patients paid in advance.
  • In one measure of adequate staffing — the prevalence of bedsores in patients bedridden for long periods of time — HCA clearly struggled. Some of its hospitals fended off lawsuits over the problem in recent years, and were admonished by regulators over staffing issues more than once.
  • inadequate staffing in important areas like critical care
  • Many doctors interviewed at various HCA facilities said they had felt increased pressure to focus on profits under the private equity ownership. “Their profits are going through the roof, but, unfortunately, it’s occurring at the expense of patients,” said Dr. Abraham Awwad, a kidney specialist in St. Petersburg, Fla., whose complaints over the safety of the dialysis programs at two HCA-owned hospitals prompted state investigations.
  • One facility was fined $8,000 in 2008 and $14,000 last year for delaying the start of dialysis in patients, not administering physician-prescribed drugs and not documenting whether ordered tests had been performed.
  • Claiming he provided poor care, the other hospital did not renew Dr. Awwad’s privileges. Dr. Awwad is suing to have them reinstated.
  • “If you were a for-profit hospital with investors and shareholders,” said Paul Levy, a former nonprofit hospital executive in Boston unaffiliated with HCA, “there would be a natural tendency to be more aggressive and to seek more revenues.” Executives at profit-making hospitals are “judged in greater measure by profitability” than the administrators of nonprofit hospitals, he said.
  • some of HCA’s tactics are now under scrutiny by the Justice Department. Last week, HCA disclosed that the United States attorney’s office in Miami has requested information about cardiac procedures at 10 of its hospitals in Florida and elsewhere.
  • HCA’s cardiac business is extremely lucrative, and the Justice Department has requested reviews that HCA conducted that indicate some of the heart procedures at some of its hospitals might not have been necessary and resulted in unjustified reimbursements from Medicare and other insurers.
  • Small and nonprofit hospitals are closing or being gobbled up by medical conglomerates, many of which operate for a profit and therefore try to increase revenue and reduce costs even as they improve patient care. The trend toward consolidation is likely to accelerate under the Obama administration’s health care law as hospitals grapple with what are expected to be lower reimbursements from the federal and state governments and private insurers.
  • Columbia/HCA became the target of a widespread fraud investigation in the late 1990s, which led to one of the largest Medicare settlements ever.
  • HCA wanted to attract more patients to its emergency rooms, and it did. Annual visits climbed 20 percent from 2007 to 2011. But while emergency departments are often a critical source of patient admissions, they are frequently money-losers because many patients do not have insurance. HCA found a solution: it figured out how to be paid more for the patients it was seeing.
  • Nearly overnight, HCA’s patients appeared to be much, much sicker.
  • No one has accused HCA of up-coding, or billing for more expensive services that were not needed — one of the complaints made against it a decade ago.
  • The acting head of Medicare is Marilyn B. Tavenner, a former HCA executive who left there in 2005 to become the secretary of Health and Human Resources in Virginia.
  • Several former emergency department doctors at Lawnwood Regional Medical Center in Fort Pierce, Fla., said they frequently had felt compelled to override the screening system in order to treat patients.
  • When the doctors failed to meet the hospital’s goals for how many patients should be considered emergencies, “they really started putting pressure on.”
  • Regulators in several states have taken HCA hospitals to task over screening out patients too aggressively, including situations where the screening missed serious conditions.
  • “Staffing is critical,” said Courtney H. Lyder, the dean at the UCLA School of Nursing and an expert on wound care. “When you see high levels of wounds, you usually see a high level of dysfunctional staff,” he said.
  • HCA owned eight of the 15 worst hospitals for bedsores among 545 profit-making hospitals nationwide, each with more than 1,000 patient discharges, tracked by the Sunlight Foundation using Medicare data from October 2008 to June 2010.
  • an examination of lawsuits shows bedsore problems have been persistent at several HCA facilities
  • The hospital was cited twice by Florida regulators, in 2008 and 2010, for having inadequate numbers of nurses on its staff to oversee wound care for patients.
Govind Rao

Let Blood Services lead the way - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|ntnp|20150414|218428860

from heather pharmacare cbs drugs

shared by Govind Rao on 14 Apr 15 - No Cached
  • National Post Tue Apr 14 2015
  • I magine having to choose between putting food on the table or buying necessary medication. Research suggests this is the case for one in 10 Canadians who can't afford to fill their prescriptions. Canada is the only country with universal health care that does not also have universal drug coverage. Even for those who do have private or public drug coverage, there are discrepancies in what and who is covered from province to province. Canadians also pay more for drugs than citizens in almost any other Western nation. These are just a few of the arguments that have reignited calls for a national pharmacare program. It is not a new concept, but one that is gaining traction as leaders are turning over every stone to "bend the cost curve" in health care downward. In a recently published study in the Canadian Medical Association Journal (CMAJ), health economists and researchers concluded a universal drug program could actually save Canadians billions of dollars. Great savings are achieved by pooling provincial and territorial needs and resources to increase buying power, eliminate duplication and establish a platform for collaboration and cost-sharing. If health-care leaders are looking for proof that provinces and territories can do more together than they can on their own when it comes to the provision of life-saving and enhancing drug therapies, they need look no further than the blood system they created close to 20 years ago.
  • Many are aware that since its creation in 1998, Canadian Blood Services has been in the business of collecting, processing and distributing blood components in all provinces and territories outside Quebec. But few realize we have also been running a national formulary of biological drugs, providing universal and equitable access to plasma-derived medicine at no cost to patients for nearly two decades. Our organization has sole responsibility for managing a national portfolio of plasma-derived products and their synthetic alternatives worth about $500 million a year. These life-saving pharmaceuticals are used to treat people with hemophilia and other bleeding disorders, patients with inherited and acquired immune disorders, burn and trauma victims, and many others. A national, scalable, cost-shared infrastructure and logistics network ensures the right product gets to the right patient, at the right time.
  • ...3 more annotations...
  • Our approach to managing this drug portfolio is based on best practices in public tendering. This means we provide a competitive, transparent mechanism to achieve best pricing. In fact, governments are benefiting from Canadian Blood Services' success in negotiating an estimated $600 million in savings over five years through 2018 - a testament to the value of pan-Canadian buying power and proof of concept of one of the arguments in the CMAJ study. Some detractors of tendering suggest it can put supply at risk by placing all the purchaser's eggs in that one proverbial basket. However, in our process, we avoid single-sourcing whenever possible, not only to encourage competitive pricing, but to ensure security of supply. Carrying multiple brands of a product, purchasing them in smaller, diverse lots, and negotiating a dedicated and guaranteed "safety stock" are all measures we take to mitigate risks to supply disruption.
  • We have also focused on product choice by incorporating stakeholder (physician and patient) input where appropriate in our tendering processes. Through our medical directors, we provide expert advice when a physician has a patient-based issue that could benefit from an additional specialist perspective - added value for patients and health systems. We also independently qualify new suppliers and audit them periodically, adding another layer of vigilance and product safety for patients. We are often aware early on of supplier issues in bringing products to market or maintaining adequate Canadian supplies, which helps to mitigate the risk of shortages. Because of our governance structure, once a plasma-derived drug is accepted in our portfolio, it becomes available in all jurisdictions. This practice effectively reduces geographic or financial barriers to care, and is consistent with the principles of universal access informing the Canada Health Act and medicare. Equitable access also encourages consistency of practice, and fosters pan-Canadian dialogue on best practices for optimal product utilization. Canadian Blood Services collaborates with health-system leaders, including governments, transfusion medicine physicians and others, to help ensure appropriate utilization and to further control costs.
  • By offering our experience, we are not proposing Canadian Blood Services should bulk-purchase other drugs or that our model is a "cookie cutter" solution to apply to national pharmacare, in part or in whole. Rather, we are suggesting there are important lessons from our 17 years' experience that can be leveraged, and that a national drug program is not only possible - it is already being done, with significant benefits to patients and health system funders. A system that ensures no Canadian patient is left unable to afford life-saving medication, while at the same time driving down system costs, is not only good politics, it's good policy. National Post Dr. Graham Sher is CEO of Canadian Blood Services.
Govind Rao

CFNU rejects Innovation Report's recommendation to eliminate the Canadian Patient Safet... - 0 views

nursesunions.ca/...adian-patient-safety-institute

from heather nursing union innovation federal government

shared by Govind Rao on 24 Jul 15 - No Cached
  • Publication date: Fri, 2015-07-24
  • Canada’s nurses, as represented by the Canadian Federation of Nurses Unions (CFNU), are questioning the recommendation that the Canadian Patient Safety Institute (CPSI) be merged into the proposed Healthcare Innovation Agency of Canada as recommended by the Advisory Panel on Healthcare Innovation in its report, Unleashing Innovation: Excellent Healthcare for Canada. “Since 2003, the CPSI has given patients and families a voice in our healthcare system. It has ensured that the issue of patient safety is a national priority, central to any discussion about the future of our health care system,” said Linda Silas, President of the Canadian Federation of Nurses Unions. “We are concerned that the original mission of the CPSI will be diluted in the proposed Innovation Agency. We must maintain an organization whose fundamental mission is the improvement of patient safety and the quality of patient care.” Last year, CFNU published a report by Dr. Maura MacPhee entitled Valuing Patient Safety: Responsible Workforce Design which vividly documents the effects of the UK’s failure to focus on patient safety in the Mid-Staffordshire NHS Foundation Trust. The report noted that the NHS has taken steps towards making patient safety a priority and improving transparency and public accountability. It recommended that we implement similar measures in Canada. Silas commended the Advisory Panel for its acknowledgement that “federal action and investment” are needed if we are to prevent the decline in Canada’s health care performance relative to our peers.  She added, “Both the CFNU and the Premiers have called on the federal government to cover at least 25% of total health care spending by the provinces and territories.”
Govind Rao

Ontario Council of Hospital Unions - defending healthcare in every community - 0 views

www.ochu.on.ca

from heather cupe Ontario private clinics privatization

shared by Govind Rao on 17 Sep 13 - No Cached
  • Request for an inquest was denied; Family sues hospital for son's death, Sept. 12 Toronto Star - Mon Sep 16 2013 Family sues hospital for son's death, Sept. 12
  • the Ontario Council of Hospital Unions (OCHU), which represents front-line staff at St. Joseph's in Hamilton where the death occurred, publicly called for an inquest.
  • Mandatory flu shot for health staff misdirected November 2, 2012To save lives, prevent thousands of needless deaths stop provincial policies that cause medical errors, bed sores and superbug ... [Read More]infections
  • ...2 more annotations...
  • To target health care workers and take away their right to choose by making the flu shot mandatory, is misdirected in the face of recent evidence that 41 per cent of people who get a flu vaccine receive no protection against the flu,” says Michael Hurley the president of the Ontario Council of Hospital Unions (OCHU).
  • Mandatory Flu Vaccinations for Health Care Workers CUPE encourages health care workers to get an influenza vaccination if they can safely do so. But making flu shots mandatory for health care workers is a serious intrusion on the freedom and personal autonomy of health care workers that may sometimes have detrimental effects on their own health.Forcing people to take flu shots against their will may well undermine public confidence in vaccination programs, even vaccination programs with an excellent results and high safety standards.
  • Govind Rao on 16 Oct 13
     
    Union calls for halt to move procedures from hospitals to private clinics Submission by the Ontario Council of Hospital Unions / CUPE on the Proposed amendment to O. Reg. 264/07 made under the Local Health System Integration Act, 2006 and A Regulation under the Independent Health Facilities Act - Prescribed Persons .  The Ontario Council of Hospital Unions / CUPE represents 30,000 workers in hospitals across the province, including Registered Practical Nurses, service workers, and administrative workers. We are opposed to the government’s plan to move surgical, diagnostic, and other work from public hospitals to private clinics. Our objections can be summarized as falling within seven distinct areas: 1] Quality • Even minor operations can go wrong. We believe that, in contrast with hospitals, it is unlikely private clinics will be able to handle emergencies and that they will likely simply call EMS. Will ambulances be able to move patients to hospitals when things go wrong? (We say “when” advisably, as sooner or later there will be problems.) Indeed, private surgical clinics first came to public attention when a patient died and the paramedics arrived to find a patient with no vital signs. Is it appropriate to establish a system that inherently requires extra time to effectively treat patients who fall into emergency situations? This is particularly troubling as underfunding and restructuring have challenged EMS response times. The government and government officials must be prepared to accept responsibility for such deaths if this plan is approved. 
Govind Rao

Health workplace safety a 'huge challenge,' B.C. health minister says - 0 views

www.vancouversun.com/...story.html

from heather violence wcb bc

shared by Govind Rao on 08 Apr 15 - No Cached
  • Terry Lake says provincial government is open to ideas to stop attacks on nurses, doctors, health professionals  By Pamela Fayerman, Vancouver Sun April 7, 2015
  • Health minister Terry Lake said Tuesday that violence against health professionals should not be deemed “just part of the job” and the government is willing to listen to all suggestions on ways to make hospitals and other facilities safer for those who work in them.Lake made the comments in an interview after giving a short speech at the Summit to Prevent Workplace Violence in Health Care, held in Richmond and closed to the media and public. Among others, it was attended by those working in the health field, employers, government representatives, and health unions.
  • “We can’t accept that violence is part of the job,” he said. “It’s a huge challenge and we’ve got lots of work to do. So we’re listening to unions and all others.”
Irene Jansen

Health Canada not giving timely warnings about pharmaceutical drugs: Auditor General | ... - 0 views

news.nationalpost.com/...ceutical-drugs-auditor-general

drugs safety

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Consumers aren’t receiving safety warnings about pharmaceutical drugs fast enough because Health Canada is slow to act on potential issues that it identifies, Canada’s auditor general has found.
  • people sometimes have to wait more than two years before Health Canada completes a drug safety review of a product already on the market and provides updated information about their risks
  • the audit also found gaps in transparency that are keeping Canadians in the dark about Health Canada’s drug-safety work
  • ...7 more annotations...
  • Health Canada does not disclose information on drug submissions that it has rejected, or information on the status of the drugs it has approved with conditions attached
  • Health Canada has not acted on its “long-standing” commitment to disclose more information about clinical trials
  • consumers should have access to an electronic database of trials authorized by Health Canada
  • adverse reaction reports submitted by drug companies
  • has “increased dramatically” over the last few years, from 43,000 in 2007 to 115,000 last year
  • unlike its European counterpart, Health Canada has failed to address the potential for conflicts of interest in its reviews of drug submissions
  • recent doubling of fees from the drug industry — to $70 million
Govind Rao

International Health Policy Expert Finds Plan to Close Five Hospitals in Niagara Threat... - 0 views

www.ontariohealthcoalition.ca/...and-contains-glaring-omissions

from heather Ontario coalition hospital cuts

shared by Govind Rao on 30 Mar 15 - No Cached
  • March 30, 2015
  • International Health Policy Expert Finds Plan to Close Five Hospitals in Niagara Threatens Patient Safety and Contains “Glaring Omissions” (Welland/Niagara Falls) An international health policy expert warned that the plan to close five hospitals in Niagara risks patient safety, “lacks any rational justification” and contains “glaring omissions”. In two press conferences today in Welland and Niagara-on-the-Lake, Dr. John Lister, author of two books on global health reform and professor at Coventry University, joined from the U.K. by video conference and reviewed his analysis of the documents and reports used by the Minister and the LHIN to approve the closures of five communities’ hospitals across Niagara. Dr. Lister outlined his concerns about the plans based on his decades of experience reviewing hospital planning and restructuring documents. His findings are contained in a report released by the Ontario Health Coalition today.
Govind Rao

NDP appeals to province for action on nurse assaults; Critics want Queen's Park to do m... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150703|224088626

from heather Ontario nursing nurses violence health and safety

shared by Govind Rao on 06 Jul 15 - No Cached
  • Toronto Star Fri Jul 3 2015
  • Ontario's NDP health and labour critics are calling on the government to take action following a Star report detailing the rising number of nurses reporting assaults by patients. In an open letter, labour critic Cindy Forster and health critic France Gélinas urged Health Minister Eric Hoskins and Labour Minister Kevin Flynn to improve the safety of patients and staff in Ontario's health-care system. "It is deeply disturbing that nurses and health-care professionals are facing increasing levels of workplace violence in our province," wrote Gélinas and Forster.
  • In an emailed statement to the Star, a spokesperson for the health minister wrote that Hoskins and Flynn are committed to ensuring Ontario's nurses have safe workplaces, but acknowledged there is room for improvement. "We recognize that there is more work to be done, which is why Minister of Labour Kevin Flynn met with the (Ontario Nurses' Association) earlier this year to discuss these very issues, and meets regularly to keep an open dialogue so we can continue working together to protect health-care workers," read the statement. On Thursday, the Star reported on the dramatic increases of reports of assaults on nurses at several Toronto-area hospitals over the past three years.
  • ...2 more annotations...
  • At the University Health Network, the number of reported violent incidents against staff by patients doubled in two years. Reported assaults included incidents of verbal abuse, as well as patients kicking, punching and throwing urine at staff, according to reports obtained by the Star through an access to information request. UHN said the increase is likely due to a change in the method of reporting incidents and to a push from unions encouraging staff to increase reporting.
  • "Sadly, I'm not surprised (by the increase in assault reports)," said Doris Grinspun, CEO of the Registered Nurses' Association of Ontario, who called on the government to hire more nurses. "When you do not address staffing, the temperature only raises more and more." ONA president Linda Haslam-Stroud told the Star Thursday that she is in discussions with Hoskins and Flynn about addressing workplace violence for nurses but is waiting for confirmation of how they plan to tackle the issue. She added that talking is not enough. The ONA wants to see increased hospital staffing levels, better trained security guards and more accountability from CEOs.
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