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NHS: Hospital Corporation of America that donates to Tories handed huge contract - Mirr... - 0 views

www.mirror.co.uk/...ration-america-donates-2246513
shared by CPAS RECHERCHE on 03 Sep 13 - No Cached
  • By Andy Lines 15 Comments Controversial American health firm that donates to Tories handed huge NHS contract 3 Sep 2013 00:00 It is already at the centre of a massive row after being accused of overcharging the NHS by millions of pounds in a damning report // Vital skill; Brain surgeon at work Getty A contract to treat NHS patients with brain tumours has been awarded to a controversial American healthcare firm that is a donor to the Tory party.
  • Hospital Corporation of America
  • HCA has given the Tories at least £17,000 since they came to power.
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  • Labour MPs are particularly angry because London’s University College Hospital – one of the best NHS brain treatment centres in the country – has been told to stop treating brain cancer patients and send them to HCA.
  • HCA is already at the centre of a massive row after being accused of overcharging the NHS by millions of pounds in a damning report released last week.
  • HCA has a chequered history in the US and has been fined more than $1billion for mis-selling healthcare.
  • A senior hospital source told the Mirror: “The radiotherapy community is very concerned about the way NHS England is handing out contracts for NHS patients.
  • Patients who were being treated there have been told to move to Barts. NHS England have told UCHL that they won’t pay for any more NHS patients to be treated there because they’ve signed a contract with two private hospitals – one of which is HCA
  • HCA, along with two other private hospital groups, was at the centre of a scathing report from the Competition Commission last week which showed that between 2009 and 2011 they overcharged by up to £193million
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Inside Ontario's chemotherapy scandal | Toronto Star - 0 views

www.thestar.com/...rios_chemotherapy_scandal.html privatization drugs
shared by Doug Allan on 15 Jul 13 - No Cached
  • Claudia den Boer Grima, vice-president of cancer services for the hospital and the region, is on the other end of the line. “There is a problem with a chemo drug,” she says. “It looks like the wrong dose has been given. We don’t know how many.”
  • Peterborough Regional Health Centre, where the problem that affected all four hospitals had been discovered exactly seven days earlier.
  • It would be another seven days before she would learn that all her treatments involving this drug had been diluted by as much as 20 per cent.
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  • Since the crisis, all the hospitals involved have stopped outsourcing gemcitabine and cyclophosphamide mixtures and brought it in-house, mixing their own medications.
  • Their trust would be further hit. Within two weeks, the Star reported that health-care companies are allowed to mix drugs for hospitals without federal or provincial oversight, prompting top health officials — Ontario health minister Deb Matthews and federal health minister Leona Aglukkaq — to scramble to close that regulatory grey area.
  • This week Jake Thiessen, the founding director of the University of Waterloo school of pharmacy, submitted a final report of his investigation into the issue. There has been no formal indication when it will be made public. Hospital administrators say they have been told it will be two to three weeks before they or the public see this report.
  • The Ontario College of Pharmacists has passed legislation that allows it to inspect any premises where a pharmacist works — not just licensed pharmacies.
  • All of the changes taken together would have seen Marchese Hospital Solutions still able to supply drugs as it did but subject to inspection by the college.
  • The federal government has new rules defining who can be a drug producer, adding that any facility supervised by a licensed pharmacist can do the job. The province has said that hospitals can only purchase drugs from accredited suppliers.
  • There is very little clinical evidence to indicate what might happen to a cancer patient who receives an underdose of chemotherapy.
  • At the same time, many of the more recent advances in chemotherapy have been in drugs that alleviate side effects like nausea.
  • In an oncology pharmacy, strange is not good. And on March 20, one week before Marley’s last cyclophosphamide treatment, Craig Woudsma, a 28-year-old pharmacy assistant, and a colleague at the Peterborough Regional Health Centre, had a bad feeling.
  • In this case, it was a shipment of new gemcitabine chemotherapy bags that required refrigeration, according to the label. Previous batches, from a different supplier, had not.
  • Woudsma noticed more differences. The bags from Marchese only had a total volume and concentration on the label — 4 grams of gemcitabine in 100 mL of saline — instead of the specific concentration, the amount of drug per single mL of saline, as the old bags indicated.
  • The new bag’s label did not contain enough information for him to accurately mix the patient’s dose. He needed to know the specific concentration.
  • When preparing the solution, staff at Marchese Hospital Solutions, in Mississauga, Ont., dissolved the medication into a pre-filled 100 mL bag of saline. These bags typically contain between 3 to 20 per cent more solution than 100 mL,
  • “I told the pharmacist in the area. And then it kind of went above me at that point ... They came to me saying, this is kind of a big deal; teleconferencing with the minister of health, that kind of stuff,” said recently, sitting on the front steps of his red-brick, semi-detached home in the village of Millbrook, Ont. “It’s kind of a foreign concept, to think that what we do, in our corner of the hospital, is going to get that kind of exposure.”
  • This means that the bag Woudsma was holding contained 4 grams of gemcitabine in more than 100 mL of solution. The concentration of the medication wasn’t what the label would have made him think. It was weaker than advertised.
  • People have asked Woudsma why he was able to catch a problem that went undetected at other hospitals for more than a year. Simple, he says. He had something to compare it to.
  • The company’s pharmacy workers did not remove the known overfill when mixing the medication because they thought each bag was going to a single patient
  • referred to in the industry as overfill, included to account for possible evaporation.
  • The hospital had switched that very day to a new supplier — Marchese Hospital Solutions. A bag of the old supply from Baxter CIVA was still on site.
  • Medbuy, a group purchasing company for hospitals, starting in 2008, had a contract with Baxter Central Intravenous Admixtures to provide drug-mixing services. The two drugs in question, cyclophosphamide and gemcitabine, were outsourced because they come in powder form and are tricky to mix. It takes about four hours to reconstitute them in liquid, and in that time they must be shaken every 20 minutes.
  • As that contract was about to expire, Medbuy issued a request for proposals for drug-mixing services: Baxter CIVA, which wanted its contract renewed, Quebec-based Gentes & Bolduc and Marchese all stepped forward.
  • The details of the new arrangement remain known only to Medbuy. It was founded in 1989 to get better deals for hospitals buying products like scalpels, bed pans and even some medications in bulk. The company’s 28 member hospital organizations in Ontario, New Brunswick and Prince Edward Island spent a combined $626-million on contract purchases in 2012.
  • Marita Zaffiro, president of Marchese, testified at Queen’s Park that the Medbuy contract did not indicate the hospitals wanted the labels on these drugs to cite a specific concentration. The reason she included it that way in the RFP was simply to show what could be done.
  • Sobel ran the calculations in his office. For a single patient to require a 4,000 mg dose of cyclophosphamide, on a common breast cancer treatment regime, that patient would need to be about 7 feet tall and weigh 2,200 lbs.
  • “The chance of 1,200 patients getting 4,000 mg exactly — it’s just impossible.”
  • Four Marchese pharmacists who played a role in the new contract work revealed to the Queen's Park committee in June that they had either limited or no background in oncology.
  • Marchese Hospital Solutions began as Marchese Pharmacy, a Hamilton-area community drugstore that expanded beginning in 1998 when Zaffiro became president. In 1999 the company obtained a contract to supply the Hamilton Niagara Haldimand Brant Community Care Access Centres, business they did until the contract expired in 2011, shortly before it was awarded the Medbuy contract.
  • It lost the CCAC contract in 2011, shortly before the Medbuy deal, and shed employees. Fifty-seven were either laid off or left the company during this troubled time, according to internal newsletters. But then things started looking up.
  • Zaffiro attempted to get accreditation for the site, according to her Queen’s Park testimony, approaching both the Ontario College of Pharmacists and Health Canada, neither of which took steps to regulate the fledgling business because each thought the other had jurisdiction.
  • Medbuy, Marchese and Jake Thiessen have maintained that cost was not a factor in the error. Marchese’s bid on the request for proposal came in at about a quarter of the cost of previous supplier Baxter Corporation. Bags from Marchese cost from $5.60 to $6.60; Baxter charged $21 to $34.
  • CEO David Musyj thinks about what went wrong. The problems, he says, go far beyond Marchese and Medbuy. “All of us are culpable,” he says. “We could have done some things internally that could have prevented this. We could have weighed the bags when they came in.”
  • Doug Allan on 15 Jul 13
     
    Since the crisis, all the hospitals involved have stopped outsourcing gemcitabine and cyclophosphamide mixtures and brought it in-house, mixing their own medications. This week Jake Thiessen, the founding director of the University of Waterloo school of pharmacy, submitted a final report of his investigation into the issue. There has been no formal indication when it will be made public. Four Marchese pharmacists who played a role in the new contract work revealed to the Queen's Park committee in June that they had either limited or no background in oncology."The chance of 1,200 patients getting 4,000 mg exactly - it's just impossible." Marchese lost the CCAC contract in 2011, shortly before the Medbuy deal, and shed employees. Fifty-seven were either laid off or left the company during this troubled time, according to internal newsletters. But then things started looking up. Medbuy, Marchese and Jake Thiessen have maintained that cost was not a factor in the error.
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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.
  • 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).
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  • 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
  • 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. 
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Hospital pest woes blamed on renovations; Official says rodents do not pose imminent he... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|cahr|20150119|212716167 from heather bc privatization food health and safety safety hospital
shared by Govind Rao on 19 Jan 15 - No Cached
  • Calgary Herald Mon Jan 19 2015
  • Rats scurrying down hospital hallways, chewing through wires and nibbling on food scraps near the cafeteria. These are a few of the recent rodent sightings reported by public health inspectors, nurses and staff members at B.C. Women's and Children's Hospital in Vancouver.
  • Inspectors issued verbal and written directives after the Dec. 22 visit, according to the environmental health inspection report, which notes: "Minimal pest proofing has been completed to date which is contributing to the difficulty in controlling and abating the rodent activity with the food services." The report also mentions: "A number of food products have been chewed through resulting in products being discarded," and "wiring of equipment chewed on in the retail side which also raises a safety concern." The most recent inspection report lists a "Target Completion Date" for rodent control recommendations as Jan. 27. Taki said the hospital has an action plan in place with the help of the pest control company. "We've asked them to almost quadruple-up on the service until everything gets under control," said Taki.
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  • A surging rat population in the hospital's cafeteria and food preparation area has prompted management to step up rodent control efforts in recent weeks. Inspectors believe that despite the increase, the rodents do not pose an imminent health risk to the hospital's patients, visitors or staff, said Richard Taki, regional director of health protection for Vancouver Coastal Health. But the results of last month's inspection highlight the hospital's ongoing challenges dealing with vermin, a situation hospital management and health inspectors say has been exacerbated by demolition and construction work in recent months. Inspection reports from 2013 show Vancouver Coastal Health had previously identified issues with rats and mice in the hospital cafeteria and more recently, last month's inspection found signs the problem had worsened.
  • "I don't think it's any different from any restaurant that has a rodent problem. They have rodents, they're under control, they've got a company looking after it. They're working toward resolving a problem, but you know, we live in a city that has rats everywhere." Nurses have seen the pest problem worsen, along with general cleanliness, said Claudette Jut, regional chair of the B.C. Nurses Union council. The Hospital Employees Union has identified the issue of short staffed cleaning and food service in the hospital and raised it "on several occasions" with the private contractor who employs the workers, said HEU spokesman Mike Old. "It's hard for us to tell what exactly has contributed to the rat infestation," said Old. "But it's a problem, I think, that the delivery of services is so badly fragmented because of privatization."
  • Frank Levenheck, director of facilities management for B.C. Women's and Children's Hospital, said demolition and construction on the hospital campus has contributed to the cafeteria's rodent issue. Over the past three weeks, hospital management has increased its efforts, Levenheck said, which includes working to seal holes in the building that act as entry points for vermin, more frequent cleaning and more frequent visits from the pest control company. Demolition for the hospital redevelopment began last May. Excavation began in August and is scheduled to be complete in February. Eight months before demolition began, hospital management had been directed to improve rodent control, records show. A VCH inspection on Sept. 3, 2013 found issues with "Inadequate Insect/Rodent Control," noting: "Areas have not been cleaned and Manager not aware if Pest Control has been in to specifically address these new sightings. Communication between services found to be poor and lacking in followup."
  • A week later, a followup reinspection report dated Sept. 10, 2013, noted: "Rat droppings still to be THOROUGHLY cleaned from underneath the heater vents in the production area. Noted mouse droppings in warehouse areas have not been cleaned up." The next Inspection Report, from July 2014, does not specify whether the rodent situation had improved or worsened since the problems noted in the report from the September before. The July 2014 report was the most recent posted to the Vancouver Coastal Health website until Postmedia News contacted the health authority this month to ask about inspections. Taki acknowledged the Dec. 22 inspection and provided Postmedia with a copy of the report, which was subsequently uploaded to the health authority's website.
  • Kristy Anderson, a spokeswoman from the provincial Ministry of Health, said if an inspector finds a food service establishment is not responsive to food safety notices or orders, the establishment "could be fined or ultimately be required to shut down until the situation is remedied. To our knowledge this has never occurred in a hospital or health authority-run facility."
  • Eight months before demolition, management at B.C. Women's and Children's Hospital had been directed to improve rodent control, records show.
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Rally draws hundreds; Province called upon to free up money for hospitals - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|nbng|20151201|234859143 from heather Ontario hospital cuts cupe campaign
shared by Govind Rao on 01 Dec 15 - No Cached
  • North Bay Nugget Tue Dec 1 2015
  • The size of your wallet should not determine the quality of health care you receive. That was the message delivered to close to 1,000 protesters calling for the provincial government to free up more money for hospitals in Northern Ontario - particularly the North Bay Regional Health Centre.
  • "In North Bay, and across Northern Ontario, we are seeing the most severe cuts," said Linda Silas, president of the Canadian Federation of Nurses Unions. The rally drew supporters from across the province to protest cuts across the province. This year, the North Bay Regional Health Centre announced it is cutting almost 160 positions and closing more than 30 beds in an attempt to stave off a flood of red ink. "Here you are looking at 100 layoffs every year" if the province does not end a freeze on healthcare spending, Silas said.
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  • Silas was one of a number of speakers who called on the government of Premier Kathleen Wynne to increase spending on health care in the province. North Bay, they said, is particularly hard hit because it is a P3 (public-private partnership) hospital - and because it brought three hospitals - two general and one psychiatric - under one roof. "It is time to raise the alarm," said Natalie Mehra, executive director of the Ontario Health Coalition.
  • "This is devastating to the community, so let's raise the alarm." Mehra said people should not make the mistake of "believing that these hospital services are being replaced in so-called community care. You do not replace medical and surgical beds in community care. It's just not community care. It is acute hospital care services that are being cut. "You do not replace emergency room nurses. You do not replace cleaners in community care. Let's not buy into the nonsense that is just window dressing to cuts, cuts and more cuts to local services that are needed by the community." Michael Taylor, one of the organizers of the rally, said the cuts in North Bay are "the worst and deepest". .. that affect departments throughout the whole hospital.
  • Jamie Nyman was part of a large contingent from Sudbury to travel to North Bay Monday. "This is a very important issue," he said. "The government is cutting services and patient care is declining." Sudbury, he pointed out, has also seen many cuts.
  • "It's leaving us with too much workload," he said. "We are seeing a lot of workload issues because of cuts." Debbie McCrank from Kirkland Lake, the local co-ordinator for the Ontario Nurses Association, said the cuts are "going to impact all the North." She is responsible for the area from Kirkland Lake to North Bay, including Mattawa and West Nipissing.
  • The North Bay Regional Health Centre, she said, is "a major treatment centre," but the province's cuts are putting that designation at risk, and putting extra pressure on all hospitals in the North. "It's just having a huge impact," McCrank said of the health funding cuts.
  • "It comes down to cheaper care versus quality care," she said. "The province is driven by the budget, not by the concern for quality health care." Another supporter was Mike Labelle, a locked-out employee at Ontario Northland. "I'm here to support all the nurses and everyone on down," he said. "Health care has really deteriorated here, and it's time the government wakes up."
  • Labelle said the mass of protesters "is the heart of the hospital." About 100 Ontario Northland employees, he said, turned up for the rally. Canadian Union of Public Employees president Mark Hancock said the province's health care cuts amount to an attack on the local hospital and the community.
  • The funding freeze means hundreds of staffand beds across Northern Ontario," he said, pointing to placards waved by hospital workers from Timmins, New Liskeard and Sudbury pointing out the effects of cuts at those facilities. Hancock said health care needs a 5.8 per cent annual increase just to meet rising costs, but the freeze means hospitals are getting zero per cent. In real terms, he said, that works out to a 20 per cent cut over the life of the spending freeze.
  • Also speaking was North Bay Mayor Al McDonald, who said the situation at the hospital is a major concern in the city. In addition to proper health care for all members of the community, he said, the jobs being cut at the hospital are good-paying jobs, and "if you want to build the city, you need your hospital to provide the same level of care as they have in southern Ontario." Nearby, Stan Zima was waving a large Canadian flag on a 10-foot flagpole.
  • "It's obvious the cuts in Northern Ontario have become excessive, and especially in North Bay," he said. "We are taking big hits in this. Hospital cuts hurt everybody. "Wynne has got to get the message. Northern Ontario is suffering more than any other area." Nipissing MPP Vic Fedeli, speaking at Queen's Park, called on the provincial government to address the funding crisis at the North Bay Regional Health Centre.
  • Health-care professionals and patients alike in my riding are concerned that the quality of care we're getting in Nipissing is in jeopardy. And it's creating turmoil in the community," Fedeli said, asking the government to restore "proper ongoing funding" to the facility.
  • Pj Wilson, The Nugget / Natalie Mehra, executive director of the Ontario Health Coalition, addresses a crowd of close to 1,000 people at Lee Park, Monday. Supporters from across the province were in North Bay to pressure the Kathleen Wynne government into providing more funding for hospitals across the province. • Pj Wilson, The Nugget / Close to 1,000 people called for the provincial government to increase funding to Northern Ontario hospitals and, in particular North Bay Regional Health Centre, at a rally at Lee Park, Monday. Busloads of supporters came from as far as Toronto, Hamilton and Stratford to support North Bay.
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Closing hospital cafeterias won't accomplish much - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|frdg|20151127|234591166 from heather NB hospital food cuts
shared by Govind Rao on 27 Nov 15 - No Cached
  • The Daily Gleaner (Fredericton) Fri Nov 27 2015
  • Last week, the Horizon Health Network announced that it was closing some hospital cafeterias and substantially reducing the hours of others. This change is meant to save the health network some of the money that it currently spends on the cafeterias, but it will only save the health network a tiny amount of money, while imposing a real cost on vulnerable New Brunswickers, most notably those who are ill in hospital and their families, as well as the staff that makes hospitals run efficiently and provides the public services that are delivered in hospitals. In the greater scheme of things, this decision will have no real impact on New Brunswick's fiscal health but it will hurt those New Brunswickers who need the service in a very tangible way.
  • If Horizon Health is going to treat food service as a commercial operation and not treat it as a public service, then it should go all the way and privatize food service operations in New Brunswick's hospitals. In doing so, though, the health network needs to realize that food service in hospitals has to be accessible for a wide range of hours; it should be a requirement of any contracts signed with private food service providers that the privatized cafeterias remain open and serve food, at a minimum, from 8 a.m. to 8 p.m., or maybe even require them to remain open 24 hours a day. As well, privatizing the food service operations in our hospitals risks having our workforce lose good, unionized jobs, at a time when good jobs are hard to find in New Brunswick; doing so should thus only happen after a serious public debate
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  • The reality is that, when a loved one is in hospital, you cannot schedule your meals at normal hours. You need access to nutritious food, not to mention to the relief from the stress of sitting by the bedside of a loved one who is ill, whenever it is convenient, for example when your ill loved one is being looked after by the medical staff or when they drift off to sleep. It is therefore an important public service to provide the members of the public who have to make use of the hospital with access to good, nutritious food beyond the normal hours when the rest of us have breakfast, lunch, and dinner. These cafeterias are not really "commercial operations" but part of the public service of a hospital; as CUPE local President Norma Robinson pointed out, nutritious food is a necessary part of a patient's recovery. It is also a necessary part of a patient's family members' continuing health.
  • Alternatively, maybe the smart thing for Horizon Health to do is to accept that food service is part of the public service that our hospitals provide and therefore get on with providing food services to those who use our hospitals as a public service, not as "commercial operations." This means that the health network needs to accept that providing adequate food services, including by investing in new equipment and putting the cafeterias in better locations to increase visitorship, will cost the health network money. The harsh truth is that trying to balance Horizon Health's and the provincial government's books by reducing the hours of cafeterias that, in total, are losing $350,000 a year is the public finance equivalent of trying to get rich by looking for loose change behind your couch cushions.
  • If the government of New Brunswick wants to have the health care system contribute to reduced government expenditures and a balanced provincial budget, reducing the hours of hospital cafeterias is simply a side-show; it will have no meaningful effect on the provincial budget. If the provincial government wants to reduce expenditures on the health care system in a meaningful way, it and the health networks should engage in real health care reform.
  • As part of these reforms, they should either close or downgrade a number of hospitals to basic health care and triage centres and build the health-care system around a few full-service, high-quality regional hospitals. If the evidence of other provinces that had a plethora of small rural hospitals but rationalized their health care service delivery as part of a health care reform agenda is anything to go by, these reforms will also have valuable side-effect of providing New Brunswickers with better health care and making them healthier. As well as not saving any significant amount of public money, closing cafeterias in hospitals or substantially reducing their hours, on the other hand, will not do anything to make people healthier, either. If it cannot make a serious contribution to either public sector cost containment or health reform and will harm people in the process, why do it?
  • an Peach has worked in senior positions in federal, provincial, and territorial governments and at universities across Canada; he also served as vice-president, Policy for the New Brunswick NDP between 2012-15. His expertise is in constitutional law, federalism and intergovernmental relations, Aboriginal law and policy, and the policy-making process.
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Food in hospitals and prisons is terrible - but it doesn't have to be that way - The Gl... - 0 views

www.theglobeandmail.com/...article29951216 food hospital
shared by Heather Farrow on 11 May 16 - No Cached
  • Each Ontario hospital sets its own food budget, since the Ministry of Health and Long Term Care doesn’t give hospitals a cost guideline. North York General Hospital in uptown Toronto spends $4.46-million a year on food service: $1.66-million for food, plus $2.8-million for labour. The hospital says it had 144,165 “inpatient days” in 2014-15, which works out to $11.51 for food and $19.42 for labour, each day, per patient.
  • The hospital uses Steamplicity, a meal program by Compass, a global food service provider with annual sales of $31-billion. It’s one of the main providers of large-scale food service in Canada; its competitors include Sysco, Gordon Food Service, Aramark and Sodexo.Steamplicity meals are made in a production facility in Mississauga: food and water are put in “bespoke packaging” (it appears to be a plastic container) that has a valve designed to pop open when the internal temperature reaches 120 Celsius in a microwave. “The result is hot, delicious food, which retains its essential nutrients, where the flavour and texture of the food are preserved,” says Saira Husain, a spokeswoman for Compass.
  • “It sounds good, but is almost all frozen and quite highly processed,” says Joshna Maharaj, a chef and food advocate who has led changes in the kitchens at The Stop Community Food Centre, Ryerson University and the Hospital for Sick Children. “The biggest problem with frozen food is that it ends up quite watery, and everything is soft, one texture. Clinical.”From 2011 to 2012, Maharaj attempted to revolutionize the food at Scarborough General Hospital in east Toronto. Using grants from the province and the Greenbelt Fund, she bought ingredients from local farmers, changed the menu to reflect the community’s food culture (congee, jerk chicken) and trained the kitchen staff to cook from scratch.Sadly, the changes were all temporary. Scarborough General declined to say why it abandoned Maharaj’s program – she says the lunch tray, for example, cost just 33 cents more using her preferred ingredients – but the hospital no longer cooks food on site.
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  • She says she had greater success at Ryerson University, where she was hired to overhaul the food service from 2013 to 2015. “Ryerson was tremendous. We created a beautiful model and the students responded to it,” she says.Under her direction, staff stopped reheating soup from a bag and learned to cook from scratch with raw ingredients. “Soup easily became one of the most popular things on the campus,” she says. “Because it was good and made with thoughtfulness and not that much more work.”The big take-away for Maharaj was learning to negotiate with the companies that provide the food. “Working with a third-party operator is the undeniable piece you have to address when you’re talking about institutional food,” she says. “And these operators are the people we need to start talking to when we want change.”
  • “The vegetables are almost non-existent. They’ll throw a couple on the plate. You’ll have a spoonful of some nasty peas. And they’re not even green no more. They’re grey,” says Tom, who also says powdered mashed potatoes are served multiple times a week (“Both dehydrated and fresh potatoes are used in both the cook-chill and institutional kitchens,” Ross says.)Tom avoided eating chicken entirely when he was in jail. Another woman I spoke with, who spent a year at Vanier from 2010 to 2011, says the poultry was routinely served undercooked and pink. She says she relied on food purchased at the canteen, mostly ramen noodles. When dinner was “fish slop” – a dish she describes as “garbage with fish parts in it” – inmates would run to their stashes, softening the noodles with hot water from the sink over the toilet.
  • In 2012, Paulette Padanyi, a now-retired faculty member of the University of Guelph, co-wrote a research paper called Food Provision in Ontario Hospitals and Long Term Care Facilities. Of the 55 hospitals studied, 19 hospital administrators agreed to discuss their food budgets. All of them outsourced the food production. Most told Padanyi that they took their cue from long-term-care facilities, which have a prescribed Ministry of Health and Long Term Care rate of $8.03 per day per patient to spend on food.In 2012, the average amount spent per patient in the hospitals Padanyi looked at was $7.91 a day. “They say to the contractors, ‘You’ve got x number of dollars, eight bucks a day per patient or whatever,’ effectively downloading the responsibility of meeting that budget,” she says.Often, these contracts are not just for patient meals, but the staffing and operation of food franchises within the hospital, plus housekeeping and custodial. The main conclusion of Padyani’s report was that food service is considered unimportant relative to the entire hospital.
  • Tom, a former prisoner introduced to me through the John Howard Society (which asked that I not use his last name), has served time at various correctional facilities around Ontario and suffers from diabetes and Crohn’s disease. He challenges Ross’s statement. “They don’t follow diets,” says Tom, who is in his 30s, was first locked up at the age of 12 and has spent more than 10 years behind bars. “Any jail food, you’re going to be on the toilet six times a day because what they’re giving you is running though you.”
  • Compass employs half a million people around the world (including 30,000 in Canada), and supplies food to schools, offices, stadiums, museums, mining camps and offshore drilling platforms, as well as hospitals and correctional centres. Of the company’s many customers, patients and inmates have two things in common: First, they are unable to go buy themselves something more healthy, or at least more tasty; and second, we, the taxpayer, are responsible for feeding them.Last November, Compass took over food services at the Regina Correctional Centre, a move that saved the Saskatchewan government $2.4-million a year. Lacking a Yelp page, inmates went on a hunger strike in January to protest against the quality of the food. “If you don’t like the prison food, don’t go to prison,” Premier Brad Wall responded. In March, inmates refused food again, in part because Compass had raised prices at the canteen.Ontario spends $14.54 a day per inmate to feed about 8,000 prisoners in 26 correctional facilities, for a total of $41.3-million a year, including labour and transportation. The food cost is $9.17 for three meals. Perhaps inmates should not, per our punitive view of criminal justice, be dining on lamb racks and truffles. But it’s hard to imagine eating healthy on $9.17 a day.
  • May 10, 2016
  • For my entire life, my doctors, my parents and my government have sent me one clear message about food: Nutrition is a key component of physical and mental health. So I had assumed (and hoped) that if MDs or MPPs were choosing menus for those in their care, the result would be a 3-D version of the Canada’s Food Guide chart I coloured in elementary school.
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Supervisor at city hospital a 'distraction': Union - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|brrt|20160924|256862233 cupe Ontario hospital
shared by Heather Farrow on 26 Sep 16 - No Cached
  • The Brockville Recorder & Times Sat Sep 24 2016
  • Brockville General Hospital needs more provincial funding, not a provincial supervisor, an Ontario hospital workers' union argues. The Canadian Union of Public Employees (CUPE) said in a media statement the appointment of the supervisor at BGH is a "surface distraction from the real problem: Provincial underfunding of our hospitals, including BGH, that is causing deficits." "This is being characterized as a problem of management, but we would say, actually, this is a systemic problem of underfunding, chronic underfunding," Michael Hurley, president of CUPE's Ontario Council of Hospital Unions, added in a telephone interview Friday. Officials at the Ontario Ministry of Health and Long-Term Care on Friday reiterated that the appointment of a supervisor stems from a local recommendation.
  • BGH officials this week confirmed the Ontario government will appoint a supervisor who will have full control of the organization's affairs. The move, initiated by the hospital's board of governors, follows news the hospital has borrowed $5.3 million from the South East Local Health Integration Network (LHIN) to cover its bills. The hospital faces an additional $4.2-million deficit for 2016. BGH interim president and chief executive officer Wayne Blackwell this week said a provinciallyappointed supervisor will help develop the plan for putting BGH back on track.
  • ...4 more annotations...
  • The provincial government has only exercised the right to appoint a supervisor to Ontario hospitals 21 times since 1981. But CUPE, which represents more than 300 BGH front line staff, called the move "an optics exercise to distract from the significant provincial funding shortfall." The union said it relied on the latest figures from the Canadian Institute for Health Information (CIHI), to conclude the Ontario government's funding for hospitals is $1,395.73 per capita. The rest of Canada, excluding Ontario, spends $1,749.69 per capita, the union added. CUPE's own research shows that average Ontario hospital funding for a population the size of Brockville in 2005-06 would have been about $1.04 million less than average funding for the same population outside of Ontario. By 2015-16, the union adds, the funding difference would have reached $7.74 million.
  • That much more money every year would put an end to BGH's financial distress, added Hurley. "We're advocating for the hospital to receive an infusion of funding," he said. Leeds-Grenville MPP Steve Clark has also pointed to the provincial funding model as a "primary factor" behind BGH's fiscal woes. Staffat the Ministry of Health and Long-Term Care did not immediately respond on Friday to a question about CUPE's funding figures, but defended the appointment of a supervisor.
  • In an email to The Recorder and Times, spokesman David Jensen said the supervisor's appointment is based on a recommendation by the South East LHIN, which cited "ongoing concerns about the hospital's financial situation and organizational challenges." Jensen cited local media coverage "regarding the organization's financial challenges as well as other organizational issues facing BGH. "The appointment of a supervisor will help to move the hospital forward to achieve its goals and foster the development of more positive relationships," wrote Jensen. At this stage, added Jensen, the supervisor appointment is still a recommendation to be made by Health Minister Dr. Eric Hoskins.
  • "If appointed, a hospital supervisor would work with the hospital and government to support robust governance and management at the facility," wrote Jensen. The minister has notified BGH of his intention to recommend to the Lieutenant Governor in Council that a hospital supervisor be appointed, added Jensen. The Public Hospitals Act provides for a 14-day notice period, after which the supervisor can be appointed.
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Capacity of Ontario hospitals being stretched | Ontario | News | Toronto Sun - 0 views

www.torontosun.com/...ario-hospitals-being-stretched hospital ontario funding
shared by Cheryl Stadnichuk on 25 May 16 - No Cached
  • Deep cuts to funding are causing dangerous over-crowding and have put the province’s hospitals — including the country’s most important children’s hospital — on life support. Opposition critics say cuts mean emergency rooms across the province are struggling to cope with new patients — and there’s no room in the hospitals for patients that need admitting. Documents released by the New Democrats last week show many hospitals are over capacity. Toronto’s world-renowned Hospital for Sick Children is at 100% capacity, say the figures obtained by the NDP under a freedom of information request
  • A spokesman for the hospital confirmed they’ve been experiencing a surge in patients. “SickKids has been experiencing high volumes of patients and the complexity of these patients appears to be increasing,” said Matet Nebres. “For example, the volumes in our emergency department in February were up 50% over the same month last year and our critical care units have been operating at or above physical capacity for a number of months now.” That creates challenges in terms of dealing with unexpected or unplanned surges in clinical demand, she said. Workers at the hospital are doing their best to care for the children, she said.
  • “We’re also looking at ways in which we can work more closely with our partners across the healthcare system to ensure that children get high-quality care as close to home as possible,” she said. Deputy Premier and Treasury Board Chair Deb Matthews defended the hospital cuts, saying the plan is to have patients stay a shorter time in hospital and go home faster. Overall healthcare funding increased $1 billion this year, she said. “There are too many people in hospitals who actually would be better served outside hospitals,” Matthews said. “As length of stay after procedures comes down, people get home more quickly, we need to provide the support for them outside the hospital.”
  • ...1 more annotation...
  • Brown said there were 33 beds in hallways when he visited Brampton Civic Hospital recently and the ER has 50,000 more visits than they can handle. In Timmins, he was told the 1% funding increase the hospital got barely covers the increased cost of electricity, let alone the collective bargaining increases and the inflationary healthcare costs. Cuts are a reason why doctors and nurses are at loggerheads with the government, he said.
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Factory Efficiency Comes to the Hospital - NYTimes.com - 0 views

www.nytimes.com/...11seattle.html us lean tqm waits hospitals
shared by Irene Jansen on 07 Feb 12 - Cached
    • Irene Jansen
      Irene Jansen on 07 Feb 12
       
      sounds similar to what was done in a Vancouver hospital to improve efficiency of surgeries, cited in a CCPA report on public solutions to reduce waits
  • Using C.P.I., the hospital has reduced the waiting time for many surgeries from three months to less than one.
  • Lack of space in the recovery room was another logjam, and the hospital planned a $500,000 renovation to enlarge it. But a C.P.I. team saw that if a child’s parents went to a common waiting room during surgery, instead of an individual recovery room, more surgeries could be scheduled. Parents were given beepers to alert them when their child would arrive in the recovery room — and maps and colored lines on the walls helped point the way. Plans for the expensive renovation have been scrapped.
  • ...17 more annotations...
  • Medical buildings often have standard benchmarks — basing the number of examination rooms, for example, on the expected volume of patients. Ms. Brandenberg and her team instead used C.P.I. to map out common paths that patients, staff members, supplies and information would flow through. They worked in an empty office building, using cardboard mock-ups of surgical sites, recovery rooms, anesthesia areas and waiting rooms. Fifty staff members then play-acted various scenarios to test the design’s effectiveness. The final design reduces walking distances and waiting times for patients by grouping related facilities together and creating rooms that can be used for more than one purpose. The hospital was able to shave 30,000 square feet and $20 million off of the new building
  • Last year, amid rising health care expenses nationally, C.P.I. helped cut Seattle Children’s costs per patient by 3.7 percent, for a total savings of $23 million, Mr. Hagan says. And as patient demand has grown in the last six years, he estimates that the hospital avoided spending $180 million on capital projects by using its facilities more efficiently. It served 38,000 patients last year, up from 27,000 in 2004, without expansion or adding beds.
  • checklists, standardization and nonstop brainstorming with front-line staff
  • The program, called “continuous performance improvement,” or C.P.I., examines every aspect of patients’ stays at the hospital
  • The system is just one example of how Seattle Children’s Hospital says it has improved patient care, and its bottom line, by using practices made famous by Toyota and others. The main goals of the approach, known as kaizen, are to reduce waste and to increase value for customers through continuous small improvements.
  • “The health care industry could be on the verge of an efficiency revolution, because it is currently so far behind in applying operations management methodologies,” says Professor Litvak.
  • All medical centers, especially larger ones, would have significant return on investment by using operations management techniques like C.P.I., says Eugene Litvak, president and chief executive of the Institute for Healthcare Optimization and an adjunct professor of operations management at the Harvard School of Public Health.
  • Similar methods are now in place at other hospitals and health systems, including Beth Israel Deaconess Medical Center in Boston, Park Nicollet Health Services in Minneapolis and Virginia Mason Medical Center, also in Seattle.
  • TO be sure, not everyone believes that factory-floor methods belong in a hospital ward. Nellie Munn, a registered nurse at the Minneapolis campus of Children’s Hospitals and Clinics of Minnesota, thinks that many of the changes instituted by her hospital are inappropriate. She says that in an effort to reduce waste, consultants observed her and her colleagues and tried to determine the amount of time each of their tasks should take. But procedure times can’t always be standardized, she says. For example, some children need to be calmed before IV’s are inserted into their arms, or parents may need more information. “The essence of nursing,” she says, “is much more than a sum of the parts you can observe and write down on a wall full of sticky notes.”
  • one-day strike by the Minnesota Nurses Association against six local health care corporations, including her employer, partly in protest of lower staffing levels her union thinks have resulted from hospitals’ “lean” methods
  • the Lean Enterprise Institute
  • George Labovitz, a management professor at Boston University, says there are limits to performance-improvement methods in hospitals. “Human health is much more variable and complex than making a car,” he said, “so even if you do everything ‘right,’ you can still have a bad outcome.”
  • Joan Wellman & Associates, a process improvement consulting firm in Seattle
  • examine the “flow” of medicines, patients and information in the same way that plant managers study the flow of parts through a factory
  • In a typical workshop at Seattle Children’s, a group of doctors, nurses, administrators and representatives of patients’ families set aside a 40-hour week to work through C.P.I. methods. They plot each “event” a patient might encounter — like filling out forms, interacting with certain staff members, having to walk various distances or having to wait for assistance — and brainstorm about how each could be improved, or even eliminated.
  • it never ends
  • Standardization is also a C.P.I. cornerstone. Last year, 10 surgeons at Seattle Children’s performed appendectomies, and each doctor wanted the instrument cart set up differently. The surgeons and other medical staff members used C.P.I. to come up with a cart they all could use, reducing instrument preparation errors as well as inventory costs.
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ADF: Hospital Bed Occupancy - 0 views

www.adf.com.au/archive.php occupancy hospitals
shared by Irene Jansen on 21 Feb 12 - No Cached
  • The Australian Medical Association and the Australasian College of Emergency Medicine have acknowledged that bed occupancy rates above 85% negatively impact on the safe and efficient operation of a hospital. In its Position Statement on "Acute Hospital Bed Capacity" (March 2005), the Irish Medical Organisation has also acknowledged an average bed occupancy of 85% as an "internationally recognised measure" that should not be exceeded.
  • In 2005 the average hospital bed occupancy in the 30 OECD countries was 75%.
  • the risk of cross-infection between inpatients in crowded wards and timely admission to an appropriate ward of patients presenting to emergency departments (ED) or for booked surgery
  • ...12 more annotations...
  • the Department of Health in the United Kingdom (UK)1 has found that bed occupancy rates exceeding 85% in acute hospitals are associated with problems dealing with both emergency and elective admissions. That county has instituted a target bed occupancy of 82% as one of its hospitals' quality measures.
  • considering the nature of hospital system, "spare (bed) capacity is essential if an emergency admissions service is to operate efficiently and at a level of risk acceptable to patients".
  • The association between nosocomal infection and bed occupancy rate was also highlighted in another UK Department of Health report5 . That report revealed that hospitals with occupancy rates of more than 90% had a 10.3% greater incidence of MRSA infection than those with occupancies below 85%. Furthermore, the UK House of Commons Committee of Public Accounts has "repeatedly noted that high levels of bed occupancy are not consistent with good control of infections" 6 .
  • This model suggests that there is a discernable risk of a hospital failing to provide sufficient beds, and thereby safe efficient care, when average bed occupancies exceed 85%.
  • Borg3 also found a significant correlation between bed occupancy and MRSA infection rates.
  • Orendi6 has recently compared the circumstances in the UK with those in the Netherlands where the average hospital bed occupancy rate was 64%, as opposed to 84% in the UK (2005), with the same number of beds per head of population.
  • The lesser pressure on hospital beds may in part have been the result of the special level of care provided to nursing home patients
  • Canadian data also show that hospital bed availability has a significant influence on ED length of stay for admitted patients10 (access block) and thus a delay in patients reaching an appropriate inpatient bed. This was most marked when "hospital occupancy exceeded a threshold of 90%", as also found by Sprivulis et al11.
  • analysis of emergency presentations to an Australian hospital has shown that access block may increase a patient's overall hospital length of stay12
  • increased in-hospital mortality11,13
  • increase in the mortality of patients presenting to EDs in Western Australia11 independent age, season, diagnosis or urgency.
  • there appears to be sufficient evidence to support the contention that bed occupancy rates provide a useful measure of a hospital's ability to provide high quality patient care and that 85% is a reasonable target.
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Fewer hospital staff on weekends put patients at risk Healthy Debate August 1 2013 - 0 views

healthydebate.ca/...nds-puts-some-patients-at-risk from heather hospital staffing safety
shared by Govind Rao on 01 Aug 13 - No Cached
  • Govind Rao on 01 Aug 13
     
    by Jeremy Petch, Christopher Doig & Irfan Dhalla AUGUST 1, 2013 In the modern economy, many industries, such as aviation, retail and manufacturing, no longer slow down over weekends. Yet hospitals have mostly resisted this trend, even though demand for many forms of health care is no less on weekends than on weekdays. While most hospitals are open every day of the week, many operate with substantially reduced staffing levels on holidays and weekends. A typical internal medicine ward at a teaching hospital in Ontario, for example, might function with only one-third of the doctors on the weekend that it would have on a weekday. And the most senior of these doctors will have left the hospital by early afternoon. Allied health professionals (such as physiotherapists and dieticians) are often also absent on weekends, with only nurses staffed in numbers that are comparable to weekday staffing levels. It is understandable that health care professionals do not wish work over the weekend, but evidence points to a concerning "weekend effect" at hospitals: a small but meaningful increased risk of death associated with a hospital stay on a weekend versus a weekday. Is it time for hospitals to start staffing at the same level all week?
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Ontario hospitals unprepared for aging population - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150423|219020120 from heather Ontario hospital ageing seniors
shared by Govind Rao on 23 Apr 15 - No Cached
  • Toronto Star Thu Apr 23 2015
  • With the provincial government set to table its budget today, much of the public discussion to date has focused on the future of alcohol sales and power generation in the province. While these issues are important, we must not lose sight of other priorities - particularly how best to care for our aging population. While Ontario hospitals have not received an inflationary funding increase over the last three years, the province's 149 public hospitals have been working very hard to adapt to meet the needs of patients. Hospitals have worked hard to help the government meet its financial objectives by improving operating efficiencies and reducing costs while also enhancing patient care. Over the past decade, Ontario hospitals have become the most efficient in Canada. Despite serving a record number of patients, wait times have gone down and more people are getting the care they need faster in areas such as cancer surgery, cardiac procedures, cataract surgery, and hip and knee replacement. And they're doing so with the fewest hospital beds, per citizen, of any Canadian province.
  • However, hospital leaders are now facing some very challenging budget decisions to contain costs and meet the ever-increasing service needs of Ontarians.
  • ...6 more annotations...
  • When we established our universal health care system more than 50 years ago, the average Ontarian was 27 years of age and less likely to be living with chronic and complex health issues. In contrast, 60 per cent of our total hospital days last year were amongst older Ontarians, particularly those living with multiple health issues, and with minimal social supports.
  • When these patients end up in hospitals, it becomes a particular challenge to get them back in their own homes. In fact, more than 14 per cent of Ontario's hospital beds are currently occupied by patients like these who cannot be discharged because we don't have the right types of services available in the community. By having to stay in hospital, these patients aren't getting the kind of care that they should. And by remaining in hospital, the cost of their care and cost to their overall health is much higher than it actually needs to be. The majority of these patients are waiting for less costly at-home care services through home and community care agencies, or care in more supervised or assisted living environments, such as nursing homes. We also know that too many older Ontarians are still sent to nursing homes when there isn't enough home care, which is less expensive, available. With these growing pressures coming to a head, now is the time to act and make sure that our province can continue to provide the high-quality care that Ontarians want, need and deserve.
  • It is time to invest aggressively in home and community care, nursing home and assisted living services, and other vital areas so that patients can stay healthy and independent in their communities for as long as possible and when hospitalized, be discharged quickly and safely to get quality care in their community.
  • We need to identify the right mix of services to ensure all Ontarians can get the right kinds of care where and when they need it. That means knowing the right number of beds needed in hospitals or long-term care homes, as well as the number of assisted living spaces, home care hours, and primary care and mental health services required to meet the needs of our aging population. Given the exploding need for different kinds of services, it also means we need to be innovative by creating new models of care.
  • While the government has recently acknowledged the importance of robust health-service capacity planning, neither we nor any other Canadian jurisdiction currently has such a plan. This is worrisome because what we do know with absolute certainty is that the number of older Ontarians will double over the next two decades. With service demands growing rapidly at the same time that the system moves to further contain cost growth, we owe it to patients and clients to meet their changing health care needs not only for today but for the decades still to come.
  • Ontario needs clear-eyed and effective long-term planning to ensure its health care system has the ability meet the evolving health care needs of Ontarians. Until we know exactly what services the people of Ontario need, our system won't have the long-term plan required to meet them. Dr. Samir Sinha is director of geriatrics at Mount Sinai and the University Health Network Hospitals and provincial lead of Ontario's Seniors Strategy. Anthony Dale is president and CEO of the Ontario Hospital Association.
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Hospitals need money: Unions - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|sust|20150728|225807253 from heather cupe Ontario hospital campaign cuts
shared by Govind Rao on 28 Jul 15 - No Cached
  • The Sudbury Star Tue Jul 28 2015
  • The Ontario Council of Hospital Unions is calling on the Ontario government to end what it calls a five-year funding freeze for Health Sciences North that is now in its fourth year. During a press conference in Sudbury on Monday, officials with the council said the freeze has hit Northern Ontario patients hard, and that it's time for Sudbury MPP Glenn Thibeault to speak out on the issue.
  • "Sudbury and Northern Ontario overall are more affected by hospital cutbacks, which are exacerbated by the challenges of geography and by poverty and health status. As one of only four Liberal MPPs from northern Ontario, Mr. Thibeault has a responsibility to advocate for increased funding for hospitals and to stand up for the patients and their families," the OCHU's Michael Hurley said in a release. The hospital union council recently updated a report to include information specifically on Northern Ontario, entitled Pushed Out of Northern Hospitals, Abandoned at Home: After Twenty Years of Budget Cuts, Ontario's Health System is Failing Patients. "The hospital is in year four of a five-year funding freeze, so to bring the hospitals up to where they would be able to function -it's a 5.8% increase," said said OCHU northeast Ontario vice-president Sharon Richer. "Pharmaceuticals is an issue where their price go up year after year, equipment costs for the hospital goes up, doctors' wages go up, so it does add a pressure to northern hospitals.
  • ...7 more annotations...
  • "We are asking for the reopening of the chronic beds and alternative level of care beds which have been closed because of the funding freeze. We are asking that the provincial government stop the closure of acute care beds and to put funding back into the public sector and not the private sector," said Richer. According to Sudbury District Health Unit data, Sudbury/ Manitoulin has greater rates for obesity, arthritis, and high blood pressure and death than the Ontario average.
  • "They are decreasing the funding to the hospital and they are increasing the amount of funding they are putting into home care, but we have yet to see that," Richer said. "Many patients who are in hospital who need home care, their family is asked if they are able to perform any type of care for them and as soon as the family says yes, then that is when home care is very much decreased. "The patients in Northern Ontario, that need cleaning of wounds or changing of dressing, many of them have to go into a clinic, nobody is able to go into their homes so that definitely is an issue for the rest of the family members who have to book off time to get their loved ones into a clinic. "We are currently seeing no extra funding put into home care for these individuals and when they are on a list, the list is very significant, so when they are actually able to receive care it's sometimes too late."
  • Hurley said patients are suffering as hospital's try to balance their books. "What families experience when they are sent home is that they are asked 'is there anybody who can help with the patient,' and if you answer yes to that, then you don't actually get to access care because you don't need it, but if you need it, then you are put on a triage system and only the most urgent cases actually get access to home care -that's the sad reality," said Hurley "What people experience ... is that they are sent home by themselves, and often they are sent home when they are still acutely ill. They are sent home when they have needs like IVs, complex mobility issues which are far beyond the abilities of their aged spouses to deal with -that's what we do we just send them home and this then becomes individualized and becomes an individual problem of care."
  • Dan Lessard, media and public relations officer for Health Sciences North, said the freeze on the hospital's budget has had little to no effect on the organizations ability to treat patients. "One of the things that we have done, recognizing that hospital base budgets have been relatively static for the past four years, is we have really launched into an exercise of trying to find as many efficiencies as we can so that we get more use out of the dollars that we already have," said Lessard.
  • Lessard said that creating efficiencies means anything from eliminating vacancies for positions that have had little to no applicants, reducing overtime through better scheduling, and reorganizing the way supplies are ordered and managed. "I think we have been pretty good at maintaining our services so what we have really tried to do is look at areas where we can be more efficient and smarter in the way we do things so that we are not causing patient services to suffer," Lessard said.
  • "That's the last thing we want to do, that's the last thing our patients want us to do, certainly the last thing the community wants us to do is to put in place measures that is going to impact patient care. "I think we have done a pretty good job at maintaining our services and maintaining the quality of care that we are giving patients -it's not easy, it is challenging and demanding but we have very very smart people here working very hard to make that happen." Thibeault, the Sudbury MPP, did not return phone calls asking for comment.
  • • Sharon Richer, left, northeast Ontario vice-president of the Ontario Council of Hospital Unions (OCHU), and Michael Hurley, president of OCHU, hold a press conference in Sudbury on Monday.
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C. difficile infection rates drop sharply; The Ottawa Hospital reports just 74 infectio... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=ln|otct|20150206|213961273 from heather hai Ontario
shared by Govind Rao on 09 Feb 15 - No Cached
  • C. difficile infection rates drop sharply; The Ottawa Hospital reports just 74 infections, down from 112 in 2013
  • Ottawa Citizen Fri Feb 6 2015
  • The Ottawa Hospital appears to be winning its struggle against persistently high rates of Clostridium difficile. In 2014, the hospital's General campus reported 74 new C. difficile infections, a sharp reduction from the 112 it reported in 2013 and 134 in 2012. The Civic campus had just 45 new cases last year, barely half as many as in 2013. In 2012 and 2013, the General campus reported more new C. difficile infections than any hospital in Ontario. But last year, it ceded that dubious distinction to London's Victoria Hospital, which reported 112 cases.
  • ...7 more annotations...
  • The General now sits in the middle of the pack among large teaching hospitals, with infection numbers similar to several comparable hospitals in Toronto, Hamilton and London. The Civic is at the low end among comparable hospitals, with C. difficile infection numbers almost identical to those of three Toronto hospitals: St. Michael's, Princess Margaret and Toronto Western. Moreover, the General campus beat the hospital's target of 0.45 infections per 1,000 patient days seven out of 12 months last year.
  • In 2013, it did that only twice. The Civic was below target 10 out of 12 months in 2014 after doing so only four times the previous year. "We're very pleased to see the rates come down," said Dr. Kathy Suh, the hospital's medical director of infection prevention and control. "It's been a long time coming for us.
  • "We've had our challenges, which have been quite prolonged, with C. difficile, so we're pleased to see the rates drop like this." C. difficile, which is found in stool, is typically spread in hospitals after patients or stafftouch soiled surfaces such as toilets, handles and bedpans. Patients taking antibiotics are especially vulnerable because the medication kills good bacteria as well as bad, allowing C. difficile bacteria to multiply more easily.
  • Suh attributed the reduction to several initiatives, including an emphasis on hand hygiene, the use of bleach to clean patients' rooms and a program to improve the use of antibiotics, a key driver for C. difficile. A team of physicians and pharmacists reviews individual cases to ensure that antibiotics are only used when necessary, that they're stopped when no longer needed and that the most appropriate antibiotics are prescribed, Suh said. The hospital also continues to use anti-infection "SWAT teams," first introduced two years ago, whenever cases of C. difficile are diagnosed. The multi-disciplinary teams review processes in the affected unit and ensure that patients are promptly isolated and tested.
  • It all seems to be working. The General reported just three new C. difficile cases in December, a month when infections often spike. In December 2013, for example, it reported 11 new cases. In December 2012, there were 15. At the Civic, there were seven new C. difficile infections in December, the most since February 2014. But most months, the numbers have been low. In three separate months - June, August and November - the Civic reported just a single new infection.
  • The hospital's objective is to keep infection rates below the 0.45 threshold, Suh said.
  • BY THE NUMBERS C. difficile infections in Ottawa hospitals in 2014 (2013 numbers in brackets) 74 (112) Ottawa Hospital, General campus 45 (81) Ottawa Hospital, Civic campus 25 (28) Queensway-Carleton Hospital 18 (23) University of Ottawa Heart Institute 19 (34) Montfort Hospital 14 (12) Children's Hospital of Eastern Ontario
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CMAJ: Too many patients with cancer die in acute care hospitals despite palliative opti... - 1 views

www.cmaj.ca/...spite-palliative-options.xhtml hospital palliative
shared by Doug Allan on 27 May 13 - No Cached
  • The institute’s End-of-Life Hospital Care for Cancer Patients examined hospital data for 25 114 cancer patients from all provinces except Quebec. The study reviewed the final 28 days of patients age 20 or older, and found palliative care was the main reason 53% of all patients with cancer were in hospital. But acute care hospitals are not generally designed to provide the specialized care required by patients who are terminally ill with cancer require, the report points out.
  • The report also found a wide variance in the percentage of people with cancer who died in acute-care settings, depending upon the province in which they died.
  • The likelihood of a patient with terminal cancer dying in hospital was 39% in British Columbia and 40% in Ontario,
  • ...7 more annotations...
  • for example, compared to 66% in New Brunswick and 69% in Manitoba.
  • Differences among provinces also reflect different types of hospital care, says Kathleen Morris, the institute’s director of system analysis and emerging issues. Palliative units exist in most Manitoba hospitals, for example, and the study’s data did not specify what units patients were admitted to when they died.
  • Cancer is the leading cause of death for Canadians. About one-third of all deaths, or an estimated 75 700, were attributed to cancer in 2012.
  • The report does contain some good news about patient care, says Morris. Unlike past practice, acute care hospitals are not subjecting patients to overly aggressive treatment in their last weeks of life.
  • “We’re seeing some really encouraging news about what happens to patients when they’re in hospital,” Morris says. “Many worry it’s a very high-tech, inhuman end of life. We looked for clues of that, and saw that only about one in 10 cancer patients were in the [intensive care unit] during last few weeks.”
  • Additionally, only 3% of patients with cancer received chemotherapy in the last two weeks of life.
  • Morris hopes the report will help open more palliative care options so people have more control over where and how they spend their final days. She also hopes it will prompt more “good, frank discussions” about what patients want at the end of life.
  • Doug Allan on 27 May 13
     
    45% of cancer deaths occur in hospitals, lower in BC and Ontario.  Some provinces have palliative units in hospitals
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Provincial supervisor for Brockville hospital a distraction for real problem of governm... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nxbg|20160922|256705516 cupe Ontario hospital admin cuts
shared by Heather Farrow on 23 Sep 16 - No Cached
  • BioMedReports Thu Sep 22 2016,
  • TORONTO, ONTARIO--(Marketwired - Sept. 22, 2016) - The appointment of a provincial supervisor for Brockville General Hospital (BGH), a Mike Harris strong-arm tactic that the Ontario Liberals once railed against, is a "surface distraction from the real problem; provincial underfunding of our hospitals, including BGH, that is causing deficits," the Canadian Union of Public Employees (CUPE) charged today.
  • Reports suggest that the hospital borrowed $5 million in addition to a $4 million deficit. "Suggesting that mismanagement is at the root of the hospital's deficit deflects blame from the culprit, a provincial government intent on starving hospitals of the funding they need to provide adequate patient care. Putting the hospital under administration is an optics exercise to distract from the significant provincial funding shortfall," says Michael Hurley, president of CUPE's Ontario Council of Hospital Unions. CUPE represents several hundred BGH front line staff.
  • ...2 more annotations...
  • Ontario is among Canada's lowest provincial funders for hospital care. Based on the latest figures from the Canadian Institute for Health Information (CIHI), Ontario government funding for hospitals is $1,395.73 per capita. The rest of Canada, excluding Ontario, spends $1,749.69 per capita. In other words, provincial and territorial governments outside of Ontario spend $353.96 more per person on hospitals than Ontario does. That is a whopping 25.3 per cent more than Ontario. "BGH is not alone in racking up a deficit. Every hospital in Ontario is struggling because hospital funding is far too low," says Hurley. Research done by CUPE has found that average Ontario hospital funding for the population the size of Brockville in 2005/6 would have been about $1.04 million less than average funding for the same population outside of Ontario. But by 2015/16 the funding shortfall for a population the size of the City of Brockville would have exploded to $7.74 million.
  • "$7.74 million a year for the Brockville hospital would have them operating solidly in the black. This hospital is struggling valiantly to provide services through eight consecutive years of provincial funding cutbacks. The solution here isn't a supervisor and more cuts to care, staff and programs but to increase this hospital's funding," says Hurley.The views expressed in any and all content distributed by Newstex and its re-distributors (collectively, the "Newstex Authoritative Content") are solely those of the respective author(s) and not necessarily the views of Newstex or its re-distributors. Stories from such authors are provided "AS IS," with no warranties, and confer no rights. The material and information provided in Newstex Authoritative Content are for general information only and should not, in any respect, be relied on as professional
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Hospitals too full to be safe | The London Free Press - 0 views

www.lfpress.com/...spitals-dangerously-overloaded beds
shared by Doug Allan on 05 Feb 14 - No Cached
  • While many countries keep hospital bed capacity at 85% or less to manage surges in demand, some Ontario hospitals are operating near or above 100% — a jam that risks patient care and backs up emergency departments.
  • “You have to have some empty beds to efficiently and safely manage patient flow,” said Dr. James Worthington, a senior vice-president at Ottawa’s civic and general hospitals, which Tuesday were operating at 109% capacity.
  • Ottawa isn’t alone in its crunch: University and Victoria hospitals in London averaged 104% and 102% capacity from April to December last year.
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  • “There is strong evidence of an association between high bed occupancy and (the superbug C. difficile),” researchers wrote recently in the journal Infection Control and Hospital ­Epidemiology.
  • Ontario has 2.4 hospital beds for every 1,000 residents, less than half the European average. Of 39 countries compared by the Organization for Economic Co-operation and Development, only three had fewer hospital beds than Ontario: Mexico, India and Indonesia.
  • Precisely how bad the bed crunch is now in Ontario isn’t clear. Last summer, a period when demand for hospitals typically drops, the average occupancy was 92%. Health Ministry bureaucrats were unable this week to provide more current data.
  • Asked about overcrowding, Health Minister Deb Matthews wouldn’t say if more beds are needed. Just because infection rates rise when wards get crowded doesn’t mean the latter causes the former, she said.
  • But data collected by her ministry tells another tale: While beds were freed up from 2008-11, progress has stalled for a year or two, experts say.
  • Sinha isn’t convinced the jam in all hospitals is the result of too few beds — some hospitals have been slow to adopt best practices to free up beds faster, he said.
  • But hospitals that operate at or above 100% capacity do so at the risk of patients, he said. “Everyone agrees that’s not a safe level to run,” he said.
  • Some hospitals may need more beds, said Dr. Michael Schull, president of at the Institute for Clinical Evaluative Sciences, which independently analyses Ontario health care.
  • Doug Allan on 05 Feb 14
     
    Experts: Ontario hospitals dangerously overloaded
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Province urged to pay air ambulance bills ; HEALTH CARE - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|kldn|20150819|227403941 from heather medicare cupe Ontario hospital ems campaign
shared by Govind Rao on 19 Aug 15 - No Cached
  • The Kirkland Lake Northern News Wed Aug 19 2015
  • Critics say the Ontario government should pay the bill when patients are forced to take air or ground ambulances because their local hospital doesn't offer the service or treatment they need. The Liberals made a deliberate decision to allow only certain hospitals to offer services such as neo-natal or cardiac care, which forces patients in Northern Ontario to travel great distances, said New Democrat health critic France Gelinas. Hospitals in northern and rural Ontario are "shells of what they used to be," and offer very little in the way of actual services for many patients, said Gelinas.
  • "They stabilize you long enough for Ornge (air ambulance service) to ship you out," she said. "This has become our hospital service in Northern Ontario, and hospital services are covered by medicare and should be covered by the government." The recent case of an Alberta woman hit with a huge bill for an Ornge air-ambulance ride from Timmins to Sudbury highlights the problem, said Gelinas. Staff at the Timmins hospital advised Amy Savill to fly to Sudbury because they were unable to care for her safely after she went into labour prematurely. "Timmins should have had a neonatal unit to handle the needs of her newborn baby," said Gelinas. Ornge could not comment on a specific case, but said a one-hour flight on a helicopter ambulance would cost between $8,000 and $10,000. The Progressive Conservatives said the government should pay the tab because its policy forces patients to fly to distant hospitals. "They should have allocated for these types of situations to arise," said PC critic Bill Walker. "Ten thousand dollars would cripple most people."
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  • The Ontario Council of Hospital Unions said Savill's air-ambulance ride was a direct result of the Liberal government's "aggressive" downsizing of obstetric services. "No Canadian should be forced to personally bear the cost of a deliberate policy of centralization of birthing services," said union president Michael Hurley.
  • The Liberals turned some hospitals into "centres of excellence" that specialize in services no longer offered by hospitals in other communities, said Gelinas. Hospital and physician services are supposed to be free to all Canadians, she added. "You've changed the model in Ontario to fly everybody, so the transportation costs becomes part of that and should be covered by medicare," said Gelinas. "This is now part of medically necessary hospital services." The Ministry of Health said funding was not the issue in Savill's case because the Timmins and District hospital never had a level 2/3 neonatal intensive care unit that was needed to deliver and care for her premature baby.
  • The suggestion that Timmins could have done this before any alleged cuts is simply inaccurate," the ministry said in a statement. Ontario residents with a valid OHIP card pay $45 for an ambulance as long as a doctor deems it medically necessary, but if not, it's a $240 co-payment for each land ambulance service--or the actual cost of each air ambulance trip. Out of province residents also pay the actual cost of an air ambulance unless its between two Ontario hospitals and they return to the first one within 24 hours.
  • The Ministry of Health always recommends Ontario residents buy private travel insurance when leaving the province, even when staying within Canada. The Canadian Automobile Association says insurance would help in emergencies with the costs of such things as drugs, laboratory and diagnostic services outside of hospitals as well as with devices such as crutches and prosthetics. But the Travel Health Insurance Association cautions coverage "would be subject to insurance policy wording and exclusions, such as premature birth and preexisting condition clauses."
  • Health Minister Eric Hoskins said coverage of air ambulance services for patients travelling outside their home province is something he will raise with his counterparts across the country.
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Hospital cuts hitting north hardest - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|kldn|20150710|224572767 from heather cupe hospital Ontario campaign cuts rural
shared by Govind Rao on 10 Jul 15 - No Cached
  • The Kirkland Lake Northern News Fri Jul 10 2015
  • The update features additional anecdotal experiences of patients who have been let down by the health care system as a result of issues such as understaffing, overcrowding, early discharge and insufficient community support or home care. It also focuses specifically on cuts in the North. The report indicates that cutbacks in North Bay, which is the first stop of the campaign, include the closure of an eight-bed mental health rehabilitation unit and more than 56 positions -representing an estimate of more than 50,000 nursing care hours per year, affecting departments throughout the facility.
  • As a P3 facility, he said the North Bay hospital shoulders higher operating costs than those that are owned outright by the province. "The hospital cuts in North Bay have probably been among the deepest in the province," said Hurley, who was in the city Wednesday, as part of campaign to highlight the impact of reductions in recent years on Northern Ontario patients. Hurley, who was joined by Sharon Richer, a hospital worker from Sudbury and an OCHU regional vice-president, hosted a news conference at the Royal Canadian Legion on First Avenue to provide an update to a 2014 report that concluded the health care system actively discriminates against frail, elderly patients, pushing them out of hospital instead providing the care they require. The report, entitled Pushed out of Hospital, Abandoned at Home, chronicled the experiences of hundreds of patients and their families from more than 30 Ontario communities who called a 1-800 patient hotline set up for a year by the OCHU and Ontario Association of Speech-Language Pathologists and Audiologists.
  • ...3 more annotations...
  • North Bay -Hospital cutbacks have been made worse in Northern Ontario by socio-economic conditions that have led to more prevalent chronic medical conditions and lower life expectancies, says the president of the Ontario Council of Hospital Unions. According to Michael Hurley, large aboriginal and senior populations in the North, coupled with issues such as geography and underemployment, should be the basis for increased services. But he says Northern hospitals have instead suffered devastating cuts. Hurley suggests North Bay has been even harder hit as a result of the province's $1-billion deal with the private sector to build, finance and maintain the North Bay Regional Health Centre.
  • Although the local hospital has indicated resources are being transferred to the community, Hurley suggested such transfers do not commensurate with the cutbacks and often come at the expense of acute care services. "With the cuts that are happening across Northern Ontario, this is only going to get worse," said Richer, who share some the anecdotal experiences of patients included in the report. One account was that of an elderly man who had suffered a stroke and whose family believed he had been discharged too soon from hospital and did not receive adequate physiotherapy. Although the family struggled to pay for some private therapy, but the man never regained the ability to walk and died within two years of his stroke.
  • Hurley said hospitals have been forced to make cuts because they are now in the fourth year of a five-year freeze on their budgets. And he said estimates cited by the auditor general calculate that hospitals need a 5.8% increase annually to meet their basic costs. The report calls for the reopening of chronic and alternate level of care beds, a halt to the closure of acute care beds, adequate hospital funding, hospital reinvestment, the elimination of fees for home care, therapies and services and a move away from private for-profit home care, long-term care and pharmaceuticals. Hurley said the OCHU is also preparing to file a complaint to the Ontario Human Rights Commission of discrimination in the health care system against the elderly when it comes to acute care services.
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