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Govind Rao

Hospital re-admission rates debated - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|pgsf|20151008|230920202

from heather Ontario cupe hospital readmissions campaign rural cuts

shared by Govind Rao on 08 Oct 15 - No Cached
  • Smiths Falls EMC Thu Oct 8 2015
  • A union representing employees at the Perth and Smiths Falls District Hospital (PSFDH) is charging that re-admission rates have risen 16.5 per cent over the past several years. Hospital management, however, is disputing this, pegging the number much lower, at about seven per cent. During a press conference at the Smiths Falls branch of the Royal Canadian Legion on Tuesday, Sept. 29, Michael Hurley, president of the Ontario Council of Hospital Unions (OCHU), said that their statistics were drawn from information stretching from 2009 to 2014 from the Canadian Institute for Health Information, and focused specifically on the PSFDH but also the Brockville General Hospital too.
  • "A re-admission is a system failure," said Hurley. "People who were discharged were coming back in...in significant numbers." John Jackson, president of CUPE (Canadian Union of Public Employees) local 2119, who works at the Perth and Smiths Falls District Hospital, agreed.
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  • "Where beds have been cut in the community, there has been a spike in re-admission rates," said Jackson. His own hospital saw 12 beds, six at each site, cut back in 2013. "I can't speak about individual cases," he added, but Mike Rodrigues, vice president of CUPE local 1974, who works at the Kingston General Hospital (KGH), has seen, first-hand, patients being sent home to free up beds at his workplace. "There are two huddles a day," said Rodrigues, where upper management and the hospital's chief executive officer confer at 9:15 a.m. and 2:15 p.m. to discuss "Who can go today? Who can we get out?" when there is "gridlock," at the hospital, such as long waiting room times. "It's difficult," Rodrigues said. But, "you tow the party line. They do what they are told."
  • He conceded that the doctors and nurses likely do a triage of who is best able, of all of the patients on the floor, to go home, but he has seen, in the last 10 years alone, women being sent home 10 to 12 hours after giving birth to a child, whereas, in 2005, that mother could have stayed three to four days in the hospital. Hurley said he has heard of patients who "are not well enough to be sent home...fighting with their doctors," who are trying to discharge them. "A lot of pressure is put on the family," from the hospital administration and doctors, Hurley added, with the hospital threatening to charge families as much as $300 to $1,000 a day for each additional day their loved one remains in hospital - something he says is illegal. He saw such a scenario with his own mother.
  • "She can't stay here," he was told. "'What're you going to do with her?' She died in hospital." Very often, according to Hurley, a patient may acquire a hospital-borne virus while recovering from a surgery, but "people are being moved through the system much more quickly," than they used to be, sometimes without sufficient recovery periods, and then, "the system has a second go at making them better." But this not only causes distress for the family and the health system, but also in the workforce too. "A huge number of people in Ontario do not have paid sick leave," said Hurley. "The personal cost to me (as a returning patient) is significant...It's a health setback, it's a psychological setback."
  • Hurley added that hospitals in both Kingston and Ottawa were experiencing similar re-admission rates. He added that he did not think that it was "entirely valid," to dismiss re-admission rates on the rising number of older people in the area, as Baby Boomers reach their retirement years. "They will try to downplay this," said Hurley, before adding that it was not a problem created at the Smiths Falls or Perth hospital sites themselves. "This is a system problem because they have been starved of funding." As for blaming the issue on the elderly, Hurley said that that was ageism.
  • Jackson lamented that while the hospital administration has tried its best to be as kind as it can with its cuts - with only one outright layoff - getting 12 beds cut from the local hospital system seems to be "how you get rewarded for efficiency." "It's time for the province to start funding the hospitals properly," said Hurley. One way that this could be addressed would be to raise the corporate tax rate. Administration response Later that week, in her office at the Great War Memorial Hospital site of the Perth and Smiths Falls District Hospital, president and chief administrative officer Bev McFarlane held a mini press conference of her own, alongside board chair Richard Schooley, to refute some of the union's allegations, starting with some of their numbers. "There is often another aspect of re-admissions," said Schooley during the interview on Thursday, Oct. 1. A patient could be, theoretically, discharged from hospital after recovering from heart surgery, then be re-admitted two weeks later after falling on some ice while shoveling snow from his driveway. Any admission to hospital within 30 days after a discharge would be counted as a re-admission - even if the cause was not directly related to the initial admission.
  • She hastened to add that her hospital was recently awarded the distinction of being one of the top five hospitals in the province for quick-time responses, for getting patients seen to and into an in-patient bed. According to the hospital's numbers, the occupancy rate for acute care hospital beds was as low as the high 60s per cent over the summer, and in the high 70s per cent this past spring. "You have to look at all of the other indicators," said Mc-Farlane. Schooley also noted that the hospital's admissions have gone up from more than 31,000 in 2009 to more than 37,000 in 2014-15, and that they estimate the real re-admission rate at about seven per cent.
  • How can you deal with more admissions with fewer beds?" asked McFarlane. "We are able to make you feel better in a shorter period of time." Gall bladder surgery used to require a seven-day stay in hospital, she said. Now, it is considered day surgery. "You aren't even admitted," she said. "The business of hospital care has changed over the years. The worst thing you can do is keep someone in an acute care bed when they don't need to be there." As for charging patients who refuse to leave the hospital because they do not believe that they are fully healed yet, Mc-Farlane did admit that "there is a rate that is charged, if there is a reasonable discharge plan and people refuse to leave," but she added that "I don't think we've ever done that here."
  • As for the union's assertion that the hospital had less money on hand, Schooley pointed out that gross hospital revenues rose from $43 million in 2010 to $51 million in 2015. In fact, the LHIN is giving the hospital more money as a type of efficiency bonus, having wrestled five years worth of deficits into a $1.2 million surplus in 2014, with a projected surplus of $1.6 million for 2015. "That's the cushion we are building," said Schooley, in anticipation of the LHIN providing them with less money in the coming years. "In case some of these funding change realities manifest themselves."
  • We have seen increases in our LHIN and Ministry of Health funding," added Schooley.
Govind Rao

Secrecy, sloppy oversight and the hospital suicide rate; Details on deaths have been wi... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150927|230149479

from heather hospital Ontario quality

shared by Govind Rao on 28 Sep 15 - No Cached
  • Toronto Star Sun Sep 27 2015
  • The noose was a 54-inch shoelace. Fresh white, it was pulled out of an unworn New Balance running shoe, size 14. The knot was tied in a hospital room in the cold midnight hours of Feb. 24, 2013. Ken Coyne, a 68-year-old semi-paralyzed stroke victim, was somehow able to unthread the lace with only his left hand, tie the noose to the mechanical hoist above his wheelchair and hit the raise button to be slowly lifted to death - all while under 15-minute suicide watch.
  • A Star investigation that sampled almost half of Ontario's hospitals found that at least 96 in-patients have died by their own hand while under care since 2007. A further 760 were seriously harmed while attempting suicide in hospitals. Coyne's death was born of a system characterized by secrecy, inconsistency and lack of oversight, the Star found in a probe that looked into 70 hospitals, including the largest teaching facilities and major mental health centres in the province.
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  • The Star's analysis shows that at least one patient is seriously injured attempting suicide every three days, and 13 patients take their own lives every year. The hospital suicide rate is too high for psychiatrist Dr. Ian Dawe. "We are committed to making in-hospital suicides a 'never event,'" he said, noting that many hospitals in the United States are in the process of adopting what is known as a "zero suicide" strategy. Last May, after the Star started investigating this story, the government created a task force to develop standards on suicide prevention in hospitals and appointed Dawe as chair.
  • Suicides and attempts occur in all hospital departments, from maternity to neuro-clinical, emergency, medical and psychiatry. Methods range from strangulation and suffocation to drowning, overdose and electrocution, according to the data. Records show that a 12-year-old patient attempted to hang herself with her nightgown in the Sault Area Hospital, a 71-year-old woman went missing from Homewood Health Centre and jumped to her death from a parking garage and a patient at Alexandra Marine and General Hospital used a broken vase to slit his or her wrists. The three hospitals declined to comment on these incidents. Secrecy is a big part of the problem, the Star found.
  • Following an in-patient suicide, hospitals hold reviews behind closed doors to identify what went wrong and what can be done to prevent further deaths. But hospitals are not required to share these results publicly, or even with other institutions, under Ontario's health secrecy legislation - the Quality of Care Information Protection Act.
  • Details about deaths have even been withheld from grieving families. The family of Prashant Tiwari, 20, had to fight Brampton Civic Hospital for basic details about how he died by suicide last year. Tiwari was taken to the hospital after stabbing himself and placed under 15-minute suicide watch. His family eventually learned he had hanged himself in a bathroom after he was not checked for three hours. (Earlier this month, the health minister introduced changes to the protection act to address the problem of families being left in the dark.) Brampton Civic Hospital has refused to comment publicly on the Tiwari case, other than expressing its condolences, but in a letter to the family it said three staff members have not worked at the hospital since the day of his death. The Star's investigation found significant inconsistencies in how hospitals approach suicides: Some hospitals use only clothing and shoes without drawstrings, ties and shoelaces. Others don't take such precautions. Some confiscate personal medication from patients to prevent overdoses. Others don't.
  • Some lock the windows of mental health units and remove the window handles. Others don't. It's not surprising then that there is confusion about the exact number of in-patient suicides province-wide. While the Star's investigation found more than 96 patients had taken their own lives in half of Ontario's hospitals since 2007, the coroner's office, to which all hospitals must report suicides by law, says there have been only 60. "(I) cannot account for the reasons why our data differs from that offered by the specific hospitals," Chief Coroner Dirk Huyer said. There hasn't been a single coroner's inquest into a hospital suicide in the past nine years because, Huyer said, it is not the coroner's role "to raise issues that are already known." In the previous decade, the coroner's office held six inquests into in-patient suicides resulting in numerous recommendations aimed at preventing these deaths, including the establishment of task forces targeted toward the most at-risk patients. But little has been done and the problem continues.
  • A few weeks before Ken Coyne committed suicide at Providence Healthcare in Scarborough, he told his sister, Jean Brewster, that he wanted to die because the stroke had left him with only "half a body." She says the doctors knew of his suicidal intent and that she will never understand how he managed to hang himself while he was bed-bound and under 15-minute suicide watch. She recalls exactly what she said to the police officer who delivered the news: "I remember saying to the officer: 'Hang on, how did he do that in a hospital?'" Providence Healthcare said staff members continued to be deeply affected by Coyne's "tragic" death.
  • Just last week, two major Canadian health organizations identified suicides in hospitals as "preventable" incidents. Health Quality Ontario and the Canadian Patient Safety Institute released a report, "Never Events for Hospital Care in Canada," which said suicides in hospitals "should never happen" when patients are under suicide watch.
Doug Allan

Dirty hospital rooms a top concern for Canadians - Health - CBC News - 2 views

www.cbc.ca/...hospitals-patient-survey.html

shared by Doug Allan on 09 Apr 13 - No Cached
  • "They couldn't keep up with the amount of time she had to go to the washroom [so] she'd have an accident,"
  • Nearly a third of respondents, who included patients, health-care workers and relatives and friends of patients, said hospital rooms and bathrooms were not kept clean. Stories shared by res
  • Stories shared by res
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  • Karl Rinas, 61, who was treated for a bleeding ulcer at a Leamington, Ont., hospital last February, says he ended up wiping down the bathroom himself after his complaints about the dried liquid waste he found on the floor and toilet seat failed to get a reaction, but he worried about older, less mobile patients.
  • Despite all her efforts, Martin says she has no doubt that the antibiotic-resistant superbug Clostridium difficile infection her mother contracted soon after surgery was related to the hospital's level of cleanliness.
  • "I know everybody nowadays has to work more with less, but to me, a hospital should be absolutely clean," she said.
  • Of the respondents who wrote into the fifth estate's survey about being harmed in hospital, most said the harm was a hospital-acquired infection such as MRSA and C. difficile.
  • Unlike in the food industry, there are no standardized inspections for cleanliness in hospitals.
  • A World Health Organization report that compared Canada's infection data with that of 12 other wealthy countries found that Canada had the second-highest prevalence (11.6 per cent) of hospital-acquired infections after New Zealand — much higher than that of Germany (3.6 per cent) or France (4.4 per cent).
  • Is outsourcing to blame?Those who work in hospitals have pointed to the increased outsourcing of housekeeping in recent years as one reason behind the decline in hospital cleanliness that patients and hospital workers have observed
  • The Canadian Nosocomial Infection Surveillance Program is the closest thing to a federal overview that Canada has, but it relies on voluntary reporting by only 54 hospitals in 10 provinces, most of them teaching facilities, which, according to infection control experts, generally have higher infection rates than other acute care hospitals because they tend to see more seriously ill patients.
  • But health authorities in other countries are moving away from private cleaning services. Four years ago, Scotland reversed its decision to allow outsourcing of cleaning and catering services because it felt private contractors were not doing a good enough job keeping the spread of infections in check.
  • Blamey says as long as housekeeping is done on a for-profit basis, employers will reduce the number of staff and cut corners on staff training and cleaning supplies.
  • "There's no question there's been an impact on the quality of cleaning, and you can see that throughout the years as various hospitals have struggled with very high-profile superbug outbreaks," said Margi Blamey, spokesperson for the Hospital Employees' Union (HEU), which represents 41,000 hospital cleaning and support staff in B.C.
  • Michael Gardam, who oversees infection prevention and control at the three hospitals that are part of Toronto's University Health Network, agrees that hospitals have fewer resources for housekeeping these days and have to concentrate cleaning on areas that are most likely to transmit bacteria — primarily the surfaces that multiple patients touch.
  • "I probably get more emails about dust bunnies in the stairwells than anything else in the hospital, and yet, we've done that for a reason. You're not going to catch anything from a stairwell, but you're going to catch it from your bed rails," Gardam said.
  • About two-thirds of hospital-acquired infections are preventable, Gardam said, but making a direct link between cleanliness and infection is not as straightforward as it might seem. Some hospital-acquired infections such as ventilator-associated pneumonia or central line-associated bloodstream infections have little to do with the hospital environment and can be controlled through proper protocols around equipment use. But a superbug like C. difficile is a lot trickier because it is hard to pinpoint its source.
  • Increasing cleaning staff on nights and weekends could also help. A typical medium-sized B.C. hospital that contracts out cleaning services has 24 cleaners by day but only four at night, says Blamey, and workers are often not backfilled when ill or on vacation.
  • "Bacteria don't care what time it is," said Gardam.
  • The infection expert says it doesn’t matter whether a private or public entity oversees cleaning; both have had problems with cleanliness. The bottom line is that hospitals generally undervalue the importance of cleaning staff, Gardam said.
  • "People don't really think of them as part of the team, but if you think about how infections are spread in hospitals, they're actually an incredibly important part of the team that goes far beyond just the cosmetic appearance of the room."
  • Doug Allan on 09 Apr 13
     
    CBC story discusses importance of hospital cleaning, and debates demerits of contracting out. 
Govind Rao

Budget cuts put union, hospital at odds - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|otct|20150912|229100118

from heather cupe Ontario hospital cuts campaign readmissions

shared by Govind Rao on 14 Sep 15 - No Cached
  • Ottawa Citizen Sat Sep 12 2015
  • Rising readmission rates are a sign funding cuts are taking a toll on The Ottawa Hospital, the union representing hospital workers charges. The Canadian Union of Public Employees released data from the Canadian Institute for Health Information Friday showing 9.6 per cent of The Ottawa Hospital patients are readmitted within 30 days. That number - considered an important marker of hospital effectiveness - is above provincial and national averages and has been on the rise in recent years. In 2009, the readmission rate at The Ottawa Hospital was 8.8 per cent. CUPE, which represents about 4,000 workers at the hospital, says the jump reflects recent cuts that have reduced the workforce by more than 10 per cent since 2012.
  • "This increase reflects the impacts of four years of deep cuts to beds and services at The Ottawa Hospital," said Rob Driskell, president of CUPE Local 4000. "Without enough beds and staff, some patients are sent home before they are well and larger numbers are returning to hospital because they were too sick to have been discharged in the first place." The Ottawa Hospital disagrees with the union's link between the readmission rate and budget cuts and maintains that its readmission rates, although up from previous years, are in line with similar hospitals across the country.
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  • Dr. Alan Forster, chief quality and performance officer at the hospital, said readmission rates have generally been "trending up" for complex reasons that include an aging population and the fact that medicine can now keep more people alive than in the past, which means "we have more sick people going home and it is likely some of them will come back." Age, he said, is the biggest risk factor for readmission to hospital. Forster said connecting readmission rates to hospital cuts is "not correct." The hospital, which has faced a funding freeze over the past four years, has not made cuts in areas that would affect the patients being readmitted, he added.
  • Forster said he believes the numbers should promote some action but that should go beyond the hospital and involve improving supports and care for the elderly, largely, in the community. "We need to think about how we look after people." Michael Hurley, president of the Ontario Council of Hospital Unions, said CUPE looked at readmission numbers from the Canadian Institute of Health Information after it began hearing reports from hospital workers about patients they believed were being discharged too soon.
  • The CIHI numbers back up that anecdotal evidence, he said, and point to a problem at The Ottawa Hospital, whose readmission rates are higher than national and provincial averages, higher than the average within the Champlain Local Health Integration Network and higher than other teaching hospitals (a category The Ottawa Hospitals says includes some facilities less complex and therefore not directly comparable). Hurley said being readmitted to hospital after discharge represents a huge setback for individuals as well as a significant additional cost to the health care system.
  • Hurley warned a decision to discharge most new mothers 24 hours after giving birth, which began last year and is not reflected in current statistics, could result in a higher readmission rates at The Ottawa Hospital and admission of more newborns to the Children's Hospital of Eastern Ontario. The Society of Obstetricians and Gynecologists of Canada released a policy statement in 2007 citing studies that have found that early discharge increases the risk to newborns. epayne@ottawacitizen.com
Heather Farrow

Province has 'cheated' city out of 234 hospital nurses, union leader says - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|wist|20160805|253154278

cupe Ontario hospital cuts campaign

shared by Heather Farrow on 08 Aug 16 - No Cached
  • Windsor Star Fri Aug 5 2016
  • A "growing and enormous" $4.8-billion funding gap is to blame for declining care in Ontario's acute-care hospitals, says the president of the Ontario Council of Hospital Unions. The damage for Windsor amounts to 234 fewer hospital nurses, 696 fewer hospital staff and a $74-million funding shortfall, when you compare Ontario's per-capita hospital funding to the funding in the rest of Canada's provinces, according to the union.
  • "You are being cheated out of the equivalent of 234 nurses, RNs and RPNs," Michael Hurley said at a news conference Thursday at the Royal Canadian Legion Branch 255 in Riverside. The funding for acute hospitals has dropped so below other provinces that patients in Ontario receive six fewer hours of nursing care, he said. And the result is fewer hospital beds and higher rates of medical errors, hospital-sourced infections, and readmission of patients who were sent home too early. "People don't get the attention they need when they're in a health crisis," said Hurley. "All these things together are the explanation for the backlogs and waits people experience when they go to the hospital." Hurley's union, CUPE, represents about 600 staffat Windsor's two hospitals - non-acute Hotel-Dieu Grace Healthcare and acute care Windsor Regional Hospital, which earlier this year cited a $20-million budget shortfall as it announced the elimination of 166 full-time equivalent positions, most of those RNs (169 full-and part-time positions according to their union). However, 80 of those FTEs are being replaced by 80 RPNs. Before the cuts, the hospital had about 1,550 RNs.
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  • Hurley is travelling throughout the province, to explain how over the last decade Ontario's acute hospital funding has been on the slide compared to other provinces. In 2005-06, Ontario was "in the ballpark," with per capita funding of $1,112 compared to $1,159 for the rest of Canada, Hurley said, citing figures from the Canadian Institute for Health Information. Ten years later, Ontario's funding was $1,396 compared to $1,750 for the rest of Canada. He said the numbers extrapolated for Windsor are conservative, taking into account only the City of Windsor's 211,000 population, even though Windsor Regional's patients come from all over the Windsor-Essex region (population 389,000) and beyond.
  • Hurley said while Ontario did increase its funding for hospitals during the last decade, it did not come close to accounting for inflation, population growth and the aging population. This year, hospitals received a one per cent increase, but their actual costs rose 4.5 per cent, he said. "So their budgets have been cut again." Windsor Regional declined to comment on Hurley's assertions. In a statement, Health Minister Eric Hoskins said his government is doing what citizens want - continuing to invest in a health-care system that "puts patients first," asserting that 94 per cent of Ontarians now have a family doctor, and that wait times for some procedures are among the shortest in the country.
  • This year, it's increasing health funding by $1 billion, a 2.1 per cent increase, and it's increasing funding to hospitals by $345 million this year. "In Windsor, (since 2003) we've increased funding for local hospitals by more than $126 million - an increase of almost 50 per cent," said Hoskins. He also said Ontario is investing additional millions into home care, community health centres and home-based hospice and palliative care, because people prefer to receive their health care at home instead of a hospital. Hurley said the province argues that while it has been actively downsizing the acute care system, at the same time it's increasing investments in home care and longterm care, to "pick up the slack." But he said Ontario is actually spending less on long-term care and home care than the rest of the provinces. He said Ontario's high readmission rates are a sign the system is suffering. "So we have fewer beds, there's tremendous pressure to get people out of those beds and send them home, and often when they're sent home they haven't been made well actually and they return to hospital for a more lengthy and expensive readmission." Hurley said his council is calling on the government to fund hospitals "at least" at a level that reflects their rising costs, to stop reducing the number of beds and staffing, and to increase access to the people who need it.
  • The people being hardest hit by this are elderly, he said, who often have lived a long time without serious health problems, until they're hit with a health crisis that lands them at a hospital doorstep. "First they queue up in an ER for hours, and if they're going to be admitted it's likely a stretcher in a hallway," he said. And once admitted, there's likely pressure to get them discharged before they're fully well, he added. "For the elderly in particular they feel the brunt because there's rationing going on, the beds are so scarce." bcross@postmedia.com
  • Michael Hurley, president of the Ontario Council of Hospital Unions, discussed health-care funding in the province Thursday during a news conference at the Royal Canadian Legion Branch 255.
Irene Jansen

Can We Cure Hospital Food? | Reader's Digest - 0 views

www.readersdigest.ca/...can-we-cure-hospital-food

hospital food quality contracting out environment

shared by Irene Jansen on 30 Mar 12 - No Cached
  • Health-care administrators— who believe their first priority is treating patients, not feeding them—have long viewed the food budget as the first place to slash. Ontario hospitals, for example, spend a daily average of less than $8 per patient on three meals and two snacks.
  • more than 30 per cent of those low-budget meals boomerang back to the kitchen; one recent audit by a Nova Scotian health authority put the figure as high as 40 per cent.
  • Around the world, organizations are trying to change the way hospitals source, prepare and deliver food. The Soil Association, the U.K.’s largest organic food and farming trade group, has aggressively campaigned against the “rotten” quality of British hospital food for more than a decade and has scored some victories. Last year, the group released a detailed report called “First Aid for Hospital Food,” which boasted that dozens of health-care institutions now “leading by example” have, without raising costs, embraced wholesome, seasonal and local ingredients.
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  • In 2005, Health Care Without Harm, an international group of health-care professionals, put together the Healthy Food in Health Care Pledge to give hospitals guidance in improving the food they served in cafeterias and to patients. By the end of 2011 more than 350 U.S. hospitals had signed on. Almost all managed to substantially reduce their use of processed foods and saturated fats and to increase their offerings of local fruits and vegetables when available—one hospital even subsidized prices so that the healthiest choices were the least expensive. It’s still too soon to assess the pledge’s full effect, but given that some of these facilities have 600 to 1,200 beds and can cook as many as 10,000 meals a day, the impact—on patient health, on local economies—is likely to be profound.
  • The Canadian Medical Association and Canadian Healthcare Association both have policies on the importance of food and nutrition, but to date neither has taken a position on the issue of hospital food as a public-health tool.
  • rethermalization system that reheats pre-cooked food prepared in factories off-site. A money-saving measure that North American hospitals adopted en masse a decade ago, the method can cut labour costs by more than 20 per cent when compared to conventional scratch cooking. “Retherm” is largely responsible for hospital food’s present image—and taste—problem.
  • one percent of the institution’s global budget
  • “Many products don’t retherm well. It’s not as easy as it sounds.”
  • Quigley tells me it would take a huge investment to dismantle the existing system and bring back a conventional kitchen, not to mention the expense of retraining staff.
  • St. Mary’s has also devoted more of its budget to crops grown closer to home, buying cherry tomatoes and Ontario peaches at peak season to take advantage of lower prices.
  • Maharaj is a 35-year-old chef and health-food activist who, for the last seven months, has been feverishly working alongside staff at Toronto’s Scarborough Hospital to reinvigorate its patient menu with locally sourced ingredients and homemade dishes. With a $191,000 grant from the Broader Public Sector Investment Fund (a partnership between the Ontario government and Greenbelt Fund), Scarborough hired Maharaj to shake things up in their kitchen.
  • At the end of her one-year tenure, patients will be able to choose their meals from a carte du jour offering more than 20 dishes, such as salmon with a yogourt-dill sauce, Moroccan chicken and Greek roasted vegetables with fava beans.
  • Maharaj is quick to point out she has a major advantage: Scarborough still has a working kitchen (almost half of Ontario’s hospitals no longer do).
  • “Not a lot of money is devoted to hospital food, but there are ways we can make what we’ve got work better. The best way is to trim waste, and that means giving patients a real choice.”
  • hospitals across the U.S. have been holding farmers’ markets for more than a decade. And as it happens, the Kitchener- Waterloo area is home to some of Ontario’s oldest and busiest food markets. Putting up stalls at St. Mary’s seemed a natural extension
  • Canadian Coalition for Green Health Care (CCGHC)
  • Last year, the Ontario government awarded public institutions $1.5 million in grants to help with local food purchasing, which CCGHC hopes will inspire hospitals still lagging behind.
  • food quality is the primary objective driving St. Michael’s Hospital, a retherm facility in downtown Toronto, to introduce Ontario fruits and vegetables into its menu. Alex MacEachern, who heads up the hospital’s local food program
  • Since 2011 the hospital has in- creased its use of local produce by more than 30 per cent.
  • while St. Michael’s can’t prepare patient meals on-site, MacEachern and her team have nonetheless developed their own version of scratch cooking. They bring in fresh ingredients they assemble raw and cook on the hot side of the retherm cart, to create dishes such as blueberry crisp, baked apple crumble and red pepper frittata.
  • Almost 50 percent of the new Ontario items are actually less expensive than the imported item
  • In Ontario alone, more than 115 million meals are served every year in long-term-care homes and hospitals
  • hospitals have begun hosting regular farmers’ markets—Winnipeg’s Seven Oaks General Hospital and Cape Breton Regional Hospital among them. The Vancouver Island Health Authority debuted a new meal-delivery program, called Steamplicity, which steam-cooks raw ingredients inside sealed, heat-resist- ant packages. The method is quick— meals are ready in less than six minutes—and allows food to keep its flavour and texture.
  • Food is not seen as crucial to recuperation and healing. This is where Maharaj thinks doctors like me should do more. “You have an influential role to play in patients’ lives— you need to start advocating for people to eat better food. The bottom line is we need to find the political will to repurpose all those misspent dollars on a national scale.
Govind Rao

Skateboarders scare as they show off skills ; Don't accept Trenton hospital cutbacks: c... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|peex|20151019|231707258

from heather Ontario coalition campaign cuts hospital

shared by Govind Rao on 19 Oct 15 - No Cached
  • The Peterborough Examiner Mon Oct 19 2015
  • QUINTE WEST -Natalie Mehra was blunt with her assessment of the proposed cost-cutting measures facing Trenton Memorial Hospital. On a scale of one to ten, Mehra rated the severity of cuts at nine. "They are setting the ground work for the demise of the hospital. There will be no future in it," said the executive director of the Ontario Health Coalition. But the Coalition wants Quinte West and Brighton to keep fighting back, even harder than in previous years. "I am a bit worried because people get tired of fighting back. But our (the Coalition) message is that when you push back hard enough we can often win. Every community should be demanding long term stability when it comes to their hospitals. The bottom line is there should be a basket of good services available in every hospital," said Mehra.
  • The Coalition and Our TMH are planning a massive day of protest set for Friday, Nov. 13 at Trenton's Centennial Park beginning at 12- noon. Mehra said the protest will include the involvement from people from across eastern Ontario from Perth to Brockville and west to Quinte West and the Peterborough region. "We're asking community volunteers, residents, nurses, and medical staff to be there. It's extremely important," said Mehra. Trenton Memorial isn't the only small hospital that's being hit.
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  • "Hospitals across the Southeast LHIN face a devastating restructuring plan that's all about cuts and centralizing services," said Mehra. Mehra described relocating complex continuing care beds to TMH as nothing more than a smokescreen. Retaining cataract surgery at TMH is also misleading. "The plan is to elimin
  • ate cataract surgeries at hospitals and move the service to private clinics," she same. The same goes for complex continuing care beds. Mehra said the ultimate plan is to relocate those beds to facilities outside hospitals. "Another kicker is losing half the acute care beds at TMH," said Mehra.
  • Mehra said other hospital across the province are, and have faced, a similar pattern to what's taking place at TMH. She also noted that hospitals in Ontario are chronically under-funded compared to other provinces. Mehra said hospitals in Welland, Fort Erie, Port Colborne, Niagara on the Lake and Niagara Falls are being gutted and face possible closure. Hospitals in those communities are part of the Niagara Health System.
  • "The first phase includes removing, diagnostics, surgical services and acute care beds, followed by replacing emergency rooms with urgent care centres," said Mehra. The final phase is closure. Mehra said amalgamated hospital systems have never worked. She used Quinte Health Care and the resulting yearly service cuts at TMH as a prime example.
  • "The current funding model has never worked. It means those hospitals face deficits every year. Virtually all hospital are under stress because the plan is to reduce the scope of services, resulting in the fact that residents will have to travel a lot further," said Mehra. The end result is that smaller hospitals inside large amalgamations are being "completely" gutted. But the local community, said Mehra, shouldn't give up hope. The Coalition has kept a watchful eye on Quinte West and Brighton, and its community hospital.
  • "Our TMH has done a fantastic job of generating great ideas that are constructive. They have great integrity and have done a great job of rallying the community," said Mehra. On that front, Mehra said the idea of a one-stop health centre and community operated hospital with inpatient beds has the potential to provide a "robust" range of care to tens of thousands of residents. Mehra said a proposed veteran's care centre is a natural extension of that plan. The idea has received attention from national party leaders during the federal election campaign.
  • But is that enough to convince the province, and those bureaucrats in charge at the LHIN and QHC? Ultimately, said Mehra, it depends on how hard the community pushes its agenda. De-amalgamating from larger hospital corporations wouldn't be precedent setting.
  • Mehra said smaller hospitals in Georgetown and St. Joe's Island (near Sault Ste. Marie) have successfully divorced from larger corporations. "But it's up to the community to raise a huge stink with the province and present a good plan," said Mehra. Mehra suggested Trenton Memorial, if it were locally owned and operated, form a coalition with other independently run hospitals such as Napanee, Campbellford or Northumberland.
  • "The bottom line is people have to fight for what they want. They have to stand up and be heard," said Mehra. Local organizers want that fight to continue in Trenton on Nov. 13. -The Trentonian
Irene Jansen

The Challenges of Improving Hospital Food - 1 views

healthydebate.ca/...hospital-food

food hospital ontario

shared by Irene Jansen on 01 Jun 12 - No Cached
  • Ontario’s hospitals feed patients 3 meals a day, and 2 snacks, on an estimated budget of less than $8 per day per patient , excluding labour costs.
  • Research suggests that hospital food is an important part of the patient experience
  • Anne Marie Males, VP of Patient Experience at Scarborough General Hospitals says “Food service is not considered a key department of most hospitals. It’s a service that it has to be there. A lot of people don’t give it much thought, but when you talk to patients, its amazing how important food is to them.” Males, who is leading the introduction of more fresh and home-cooked foods at the Scarborough General Hospital through a grant from the Ontario Greenbelt Foundation
  • ...7 more annotations...
  • St. Michael’s Hospital serves 97 different diet types, and has 47 different diets to respond to allergy restrictions
  • Fletcher notes that efforts to add fresh, local foods to the hospital menu meant that the hospital had to engage in conversations and partnerships with suppliers, including farmers and help them learn how to participate in hospital food procurement processes
  • Many hospitals have adopted an approach, known as ‘rethermalization’
  • The “kitchenless” hospital has been described as an innovation that can save hospitals about 20% of food services costs.
  • Companies such as Compass Group and Aramark specialize in food preparation for hospitals at large, off-site industrial kitchens.
  • the Sioux Lookout Meno Ya Win Health Centre located in Northwestern Ontario and serving the needs of primarily First Nations communities was required to have specific legislative authority in order to serve traditional foods, such as game meats and fish, which are non-inspected foods
  • The Scarborough Hospital is also aiming to improve the cultural appropriateness of food services, through their pilot project.
Doug Allan

When a Stressful Hospital Stay Makes You Sick - NYTimes.com - 0 views

well.blogs.nytimes.com/...l-hospital-stay-makes-you-sick

shared by Doug Allan on 16 Jun 14 - No Cached
  • Her husband’s description led me to a diagnosis that my colleagues and I are increasingly recognizing: post-hospital syndrome.
  • It’s long been known that hospitals can be the source of illness — 1.7 million Americans develop hospital-acquired infections each year. But post-hospital syndrome is something different and more ominous.
  • In a 2013 paper, Dr. Harlan Krumholz, a professor of medicine and public health at Yale School of Medicine, described a syndrome that emerges in the days and weeks after a hospital stay: “Physiologic systems are impaired, reserves are depleted, and the body cannot effectively avoid or mitigate health threats.” He called this period of vulnerability “post-hospital syndrome.”
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  • The syndrome was identified as a result of new Medicare rules that hold hospitals responsible for re-admissions within 30 days after discharge.
  • When health systems began studying patients who returned to the hospital soon after discharge, two critical facts emerged. First, the problem is common and widespread, occurring after nearly one in five hospitalizations of patients on Medicare. Second, and even more surprising, the majority of cases represent an illness distinct from the initial hospitalization.
  • Post-hospital syndrome is therefore not a relapse, it is a state of susceptibility that most often leads to a new affliction.
  • Beeping machines, frequent needle sticks, unpredictable waits to see the doctor, unappetizing food and sleep deprivation are among the barrage of stressors he cites.
  • “The result is that hospitalized patients are often deconditioned, in pain, malnourished, stressed, with circadian disruptions,” he said. “And we ask why patients return to the hospital? Maybe it’s what we’ve done to them.”
  • To help solve the problem, Drs. Detsky and Krumholz have proposed sweeping changes in hospital care. Their recommendations range from more cheerful décor and preserving dignity by having patients wear their own clothing, to reducing needles and procedures. In the kind of self-searching language rarely seen in scientific journals, they call out most hospitals for serving a “draconian unsavory diet” at a time when eating well is critical for healing. They also cite sleep deprivation caused by machine alarms, unnecessary wake-ups, and preventable room traffic.
  • Many of the changes proposed in the paper have already been put in place in some institutions. In pediatric hospitals, certainly, décor is often bubbly and bright; painful procedures are minimized. Most hospitals now have wards that offer, at a cost, amenities including better food, and service that is centered around a patient’s needs — proof that care can be structured with the patient in mind.
  • Doug Allan on 16 Jun 14
     
    Better hospital food prescribed to help combat "post hospital syndrome"
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.
  • ...8 more annotations...
  • 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.
  • 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."
  • "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.
  • 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.
  • 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
Doug Allan

Hospital Crowding: Despite strains, Ontario hospitals aren't lobbying for more beds - 3 views

healthydebate.ca/...canadian-hospitals-overcrowded

hospital ALC beds

shared by Doug Allan on 30 Jan 13 - No Cached
  • Patients languishing on stretchers in hospital hallways, hospitals issuing capacity alerts when they can’t take more patients, tension in emergency departments as patients wait hours and even days to be admitted. That’s too often the reality in our hospitals
  • Canada has 1.7 acute care beds per 1,000 residents, which is only half of the average per capita rate of hospital beds among the 34 countries of the OECD.
  • The average occupancy rate for acute care beds in Canada in 2009 was 93%, the second highest in the OECD, surpassed only by Israel’s rate of 96%, according to OECD figures.
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  • The United Kingdom and Australia consider an 85% acute care bed occupancy rate to be the safe upper limit, according to the OECD. But Campbell, who says the OECD’s figures on Canadian occupancy rates are probably accurate, is not interested in debating appropriate overall rates.
  • It may come as a surprise that despite these statistics, Ontario Hospital Association president Pat Campbell is not advocating for more hospital beds.
  • Between 1998 and 2011, the number of all types of hospital beds in Ontario remained “virtually constant at approximately 31,000” while the population increased by 16%, according to a 2011 Ontario Hospital Association document.
  • Rose says, for example, that occupancy rates in surgical critical care units, characterized by rapid turnover and short stays, should be about 75% to be efficient.
  • This kind of cooperation could also work when hospital crowding becomes excessive, for example when flu season hits, says Mike Tierney, vice-president for clinical programs at The Ottawa Hospital and one of the editors of Healthy Debate. What is needed is “an ability to look at hospital occupancy
  • Still, Schull does not advocate for more hospital beds. “It would be a mistake to add beds to a dysfunctional system,” he says.
  • Occupancy rates matter if you accept the premise that high rates lead to poor access for patients who need to be admitted from emergency departments, notes Michael Schull, an emergency room doctor at Sunnybrook who has published on wait times in emergency and overcrowding risks.
  • and bed availability across a region in real time, rather than each hospital trying their best to manage on their own
  • The sobering reality is that Ontario hospitals are tight for capacity largely because of the number of beds occupied by patients, most of them elderly, waiting for admission to another facility (such as rehabilitation or long-term care) or for support to return home.
  • Administrators at Health Sciences North in Ontario have discovered the benefit of very active cooperation between the 459 bed Ramsey Lake Health Centre (formerly the Sudbury Regional Hospital) and the local Community Care Access Centre (CCAC).
  • Working together, the result has been a reduction of ALC patients at the health centre from 133 to 78 in the period between September and December 2012, says David McNeil, vice president of clinical services and chief of nursing.
  • The challenge for the CCAC was to expand its capacity for community-based care, and some funding was received from the province for new programs including behavioural support and mobility programs. For its part, the hospital recruited a new geriatrician, gradually closed beds at the former Memorial Hospital site that had been used for ALC patients, and redirected money towards chronic disease management.
  • As well, community groups have been engaged “to help them understand that the hospital is no longer the centre of the universe,” McNeil says
  • Doug Allan on 30 Jan 13
     
    Defense of nionew beds from health care establishment
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
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  • 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.
Heather Farrow

Hospital contracts went to firms with family ties to executives, audit reveals - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20160817|254020940

hospital corporation fraud Ontario

shared by Heather Farrow on 17 Aug 16 - No Cached
  • The Globe and Mail Wed Aug 17 2016
  • A Toronto hospital awarded the family business of its former chief executive, Vas Georgiou, $223,000 in renovation contracts after his departure. Almost all of those invoices were approved by St. Joseph's Health Centre's thendirector of redevelopment, Suman Bahl - whose husband was a subcontractor on a third of those renovation jobs.
  • These findings - which are detailed in a report from auditing firm Deloitte - are the latest developments in a year-long Globe and Mail investigation into hospital executives and lucrative construction contracts, an investigation that has ensnared three Toronto-area hospitals, and triggered four independent probes as well as the departures of some high-profile executives - Mr. Georgiou and Ms. Bahl among them. At the centre of the story is Mr. Georgiou, who for decades has moved through senior positions at half a dozen Ontario hospitals, including St. Joseph's, where he was vice-president and later interim CEO.
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  • After leaving that hospital in July, 2005, Mr. Georgiou took a top position with the province's procurement agency, Infrastructure Ontario. But outside of his day job, the former executive began working for a private family construction business, Toronto Engineering Company (TECO). By March, 2006 - and until December, 2007 - TECO was working for St. Joseph's hospital. During this period, Mr. Georgiou became involved in a scheme to defraud York University with bogus construction invoices.
  • Mr. Georgiou used two family businesses, including TECO, to invoice the university for $64,800 worth of renovation work he acknowledges his company never performed. (Mr. Georgiou was not charged criminally and reached a settlement with the university.) When The Globe presented evidence to St. Joseph's last September that the hospital had also done business with TECO, the health centre hired Deloitte to investigate. The firm completed its probe this past spring. Deloitte found that over the course of nearly two years, St. Joseph's Health Centre processed 18 TECO invoices worth about $223,000 for repairs, painting and project management. The report shows Ms. Bahl approved all but five. (The hospital's thenproject manager of redevelopment, Doug Wilson, signed off on the rest.)
  • Deloitte found no evidence that Mr. Georgiou declared his TECO ties to the hospital, although internal hospital e-mails suggest Ms. Bahl was aware of his connection, the review states. Through their lawyers, Mr. Georgiou and Ms. Bahl criticized the fairness of the reviews. The report was not a full-blown audit and drew no conclusions. Deloitte did not interview Mr. Georgiou, Ms. Bahl or any other former hospital employees or vendors.
  • In a letter to The Globe, Mr. Georgiou's lawyer, Gavin Tighe, said TECO's dealings with St. Joseph's began after Mr. Georgiou left, so there was no conflict, but that, regardless, his client disclosed those ties. "TECO competitively bid on work at St. Joseph's Health Centre," Mr. Tighe wrote, adding that "TECO did not at any time contract or pay BJ Quality Flooring or Darwin Fisher Flooring to perform work." Deloitte also determined that there "may also have been an attempt to conceal" the involvement of Ms. Bahl's husband in the renovation projects.
  • Travis Walker, a lawyer representing Ms. Bahl, wrote to The Globe that Ms. Bahl "denies any impropriety" and that "any potential conflict of interest was disclosed to senior management" and "no concerns were ever raised." It is not clear exactly what policies Mr. Georgiou and Ms. Bahl may have violated, because St. Joseph's has refused to comment on the rules it had in 2007. A hospital spokesperson said "gaps in the procurement process at the time are historical and have since been mitigated" and that Deloitte unearthed "no substantive findings that indicate any further exploration is required." St. Joseph's would not answer questions on the report. When Mr. Georgiou left St. Joseph's Health Centre, he was one of the most powerful and connected members of the hospital, having served as vice-president for five years and interim CEO for 10 months.
  • About a month before he began working for Infrastructure Ontario in January, 2006, Mr. Georgiou's family members registered TECO in Ontario. Mr. Georgiou's wife, Helen Saoulli, and her parents were listed as directors. Mr. Georgiou acted as a project manager for TECO, according to a statement he made during the York investigation. Over the next two years, TECO invoiced St. Joseph's for work that included installing a new security gate for the emergency department, wall patching and painting, and disposal of chemical waste, documents obtained through a Freedom of Information request show. BJ Quality Flooring, the company owned by Ms. Bahl's husband, Bojidar Danef, was listed as a subcontractor on seven of the quotes, the Deloitte review found.
  • The auditing firm noted there may have been an attempt to conceal Mr. Danef's involvement because, at some point in the process, BJ Quality Flooring was changed to "Darwin and Fisher" [sic] - except that the contact name, telephone number and price stayed the same. Doug McDonald, owner of Darwin Fisher, a commercial flooring company in Mississauga, says his company has never done business with TECO and he has no idea why TECO invoices would include it. Mr. McDonald noted that during that period, Darwin was doing extensive work for St. Joseph's, and that on some occasions, he hired Mr. Danef as a subcontractor. Last November, Mr. Georgiou's employment as vice-president of St. Michael's Hospital was terminated after The Globe revealed his involvement in the York fraud, and later the fact that he had private business ties to the president of a construction company that won a $300-million contract with the hospital that Mr. Georgiou had overseen and helped award. After those stories were published, Markham Stouffville Hospital - where Ms. Bahl was then a senior executive overseeing a redevelopment project - launched an internal probe when a whistleblower came forward with concerns. The findings brought a wave of departures, including those of Ms. Bahl and Mr. Wilson, who had left St. Joseph's and was working with Ms. Bahl in Markham. Mr. Wilson could not be reached for comment.
  • The Markham Stouffville review, which Deloitte also conducted, found that Ms. Bahl hired five of the hospital's contractors to renovate her 6,480-square-foot home, received favourable pricing from some and awarded renovation contracts at Markham Stouffville to her husband's flooring company and her late uncle's window-covering business. It appears Ms. Bahl also mixed her professional connections with her personal life when she was at St. Joseph's hospital. Deloitte found evidence that one of the hospital's furniture vendors "assisted Ms. Bahl in procuring office furniture for her home at a 50-per-cent discount from the list price," the report said. In another instance, Deloitte noted Ms. Bahl may have tried to circumvent hospital procurement policy by counselling an art supplier to invoice through a company that was already doing work for the hospital, rather than submit a payment request directly.
  • "This is the only way I can cover the cost," Ms. Bahl wrote to the art supplier in an e-mail obtained by Deloitte.
Heather Farrow

Premier 'unprincipled' - union official; Wynne accused of throwing hospital officials u... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nbng|20160816|253948606

cupe Ontario hospital cuts campaign

shared by Heather Farrow on 16 Aug 16 - No Cached
  • North Bay Nugget Tue Aug 16 2016
  • Blame for ongoing cuts to staff and services at North Bay and other hospitals across Ontario lies squarely with the provincial Liberal government, says Michael Hurley, president of the Ontario Council of Hospital Unions (OCHU/CUPE). In an interview Friday with The Nugget, Premier Kathleen Wynne blamed hospital administrators for the cuts.
  • We've committed $1 billion in additional funding in health care dollars and that translates to $340 million for hospitals -North Bay will be receiving an additional $2.3 million this year," Wynne said. "There's been no funding cuts.
  • ...6 more annotations...
  • Every year there has been an increase, but it's health care facilities and hospitals who make the decisions on how they're going to staff." "She is completely wrong," Hurley replied in a release. "Blame goes to her government's health policies and too low funding for hospitals. "Throwing hospital administrators under the bus for provincial government funding decisions is, in our view, unprincipled."
  • North Bay's hospital, built as a private-public partnership (P3) facility, is more expensive to operate than a typical hospital, Hurley said. During the 2003 election, the provincial Liberal's promised to cancel the North Bay P3 and to build the hospital as a publicly owned entity. "They reneged on that promise and yet have provided no special support for the significantly higher costs of this model. Now they are blaming them for cuts," said Hurley.
  • OCHU says successive Ontario Liberal health ministers have made no bones about downsizing hospital care. Since the Liberals were elected over a dozen years ago, funding for hospitals has fallen compared to other provinces. In the past several years, Ontario hospital funding "has lagged well behind the cost pressures associated with an aging population and inflation, OCHU says. This too low funding - well under the hospitals' real operating costs - has resulted in serious cuts to staff and services at North Bay and many other hospitals province-wide.
  • That's the root of blame for hospital staffing and program cuts," said Hurley. Provincial funding at its current levels has meant that in the past five years alone, North Bay has cut $20.7 million, OCHU says. The 2016 provincial budget gives hospitals a one per cent increase, it adds. However costs, driven by drugs and medical technologies will be closer to four per cent, "so another round of cuts is coming. It is completely unfair and below the premier to blame the managers of the hospital for this," said Hurley.
  • Wynne said the province is in the midst of a transformation of health care. "People want health care at home. People are looking for care for themselves and for their parents or grandparents. They want to know we are going to continue to invest in home care."
  • When asked what types of investment the province will commit to long-term care, Wynne acknowledged there are gaps in long-term care beds. "A review of the province's longterm care beds has been done by the Ministry of Health and Long-Term Care and decisions will be out soon." © 2016 Postmedia Network Inc. All rights reserved.
Heather Farrow

Ontario and Kingston come up short in terms of health spending: unions - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|pgki|20160811|253577119

cupe Ontario hospital campaign cuts

shared by Heather Farrow on 11 Aug 16 - No Cached
  • Kingston Heritage Thu Aug 11 2016
  • News -According to a new study done by the Ontario Council of Hospital Unions (OCHU) and CUPE, hospital funding in Ontario is much lower than hospital funding in the rest of Canada "It is a big problem and it is getting worse," said Mike Rodrigues, president of CUPE 1974 (Kingston General Hospital). "We have done some research and now we are ready to present our findings to both the public and the government." The findings, which were acquired using data available from the Canadian Institute of Health Information (CIHC),
  • were released on Aug. 2 at the Seniors Centre in Kingston. CUPE and the OCHU looked at data relating to hospital beds, levels of care, admissions and readmissions and of course overall funding and they focused on comparing Ontario to the rest of Canada. "We wanted to release this report to draw attention to the fact that provincially, by our calculations, Ontario is about $4.8 billion short compared to all the other provinces in terms of how we fund our hospitals," said Michael Hurley, president of the OCHU. "We are calling on the government to make a real investment and at least fund these hospitals at their real costs."
  • ...8 more annotations...
  • According to CIHI, Ontario government per capita funding for hospitals is $1,395.73. The rest of Canada, excluding Ontario, spends $1,749.69 per capita on hospitals. In other words, provincial and territorial governments outside of Ontario spend $353.96 more per person on hospitals than Ontario does, or roughly 25 per cent more. According to the findings, these numbers have increased steadily over the years and in 2005-2006 the gap between Canada and Ontario was at just 4.3 per cent.
  • "With working in the hospital you see reductions and they may seem small at first, but year-to-year you really see their growing impact," said Rodrigues. "Our front line workers hear the frustrations. They also hear about being sent home too early and see the readmissions." According to the report, Ontario has the fewest number of hospital beds in
  • any province and the length of hospital stays continue to be reduced for this reason. This decrease leads to an increase in readmissions. "We have a drop in admissions and an increase in readmissions," explained Hurley. "In terms of readmissions, Ontario is higher than the rest of Canada and Kingston is actually higher than the rest of Ontario. From our point of view, readmissions represent failures of the system to actually repair people properly."
  • The report also looked at funding for homecare and long-term care, an area the government has claimed they are expanding to meet growing needs. "We have been told that investments are being made in those areas," said Hurley. "But long-term care is 7.2 per cent behind the rest of the country and for homecare and community care we spend 14.3 per cent less. We have the fewest number of hospital beds, so you think we would have the most vibrant homecare system, but in fact we underspend."
  • Overall, Hurley emphasized that while hospitals require about a three per cent increase year to year to keep up with inflationary needs, hospitals in Ontario and in Kingston are only receiving about one per cent. "The increase should actually be around five per cent when you take into account additional pressures like population growth and aging and we are nowhere near that," he said. "Because of that we see nursing and staff cuts as a result and that is not acceptable." In terms of staffing, the reports conclude that in Kingston, across all hospitals, approximately 137 registered nurses and about 407 other staff would need to be added to equal comparable staffing in other provinces like Manitoba or New Brunswick.
  • That is a lot of people," said Hurley. "This lack of staffing means there is less care in the hospital for mothers who have just given birth, or people recovering from surgery and than again leads to readmissions and complications." So what can be done about these issues?
  • "People can talk to their Member of Provincial Parliament about these issues. That would be really appreciated," said Hurley. "We are doing these reports in every major community in the province and we are hoping to get some traction with the government to increase the funding." Illustration:
  • Mandy Marciniak / Michael Hurley, president of the OCHU (left) and Mike Rodrigues, president of CUPE 1974 (Kingston General Hospital).
Heather Farrow

Sad history of our 'Indian hospitals' - Infomart - 0 views

www.fpinfomart.ca/...249911118

hospital aboriginal research

shared by Heather Farrow on 22 Jun 16 - No Cached
  • St. Catharines Standard Wed Jun 22 2016
  • "Why can't they just let it go?" This is a common refrain heard when talking about First Nations issues in Canada that does nothing to address the problems the country faces. At this point, I think most Canadians understand, and hopefully respect, that our aboriginal brothers and sisters were atrociously treated by the federal government for a shamefully significant portion of our history. Forced Christianization. Residential schools. The refusal to recognize treaty rights. The deliberate attempt to extinguish aboriginal culture. None of it can be denied by any thinking person.
  • However, Canadians as a culture, as a body politic, still have a difficult time grasping the legacy of it. We look at a place like Attawapiskat in 2016, and cannot draw the links between the past and the present. What do, for instance, residential schools have to do with teenagers in a First Nations community forming suicide pacts? Kids in Attawapiskat today didn't attend those schools, so why is the issue brought up when taking about what is happening now? Why can't people today just put the past behind them where it belongs? History, however, is like ripples in a pond. Some events can shape people or entire communities for generations. And when it comes to Canada's First Nations communities, that history isn't just about events from 200 years ago. They exist in living memory.
  • ...5 more annotations...
  • Brock University history professor Maureen Lux has documented a part of this recent past in her new book, Separate Beds: A History of Indian Hospitals in Canada, which describes a period from the 1920s to 1980s, when the nation effectively had two health-care systems - one for aboriginals and one for everyone else.
  • In these hospitals, First Nations patients often received substandard care in facilities that were, in Lux's words, underfunded by design. Some patients were experimented on by surgeons using outdated and ineffective treatments for illness like tuberculosis, leaving them disfigured. "It was all part of an attempt, frankly, to prevent white Canadians from having to share hospital space with aboriginals," she said. Although there were so-called Indian hospitals prior to the mid-1940s, they didn't really take off until after the Second World War ended. This was the period where Canada began to move toward universal health care. While the politicians argued over what that might look like, federal funding was made available to build hospitals. Lux said that by 1948, that money created more than 46,000 new hospital beds in Canada. At the same time, the federal Indian Health Service was responsible for a separate, segregated hospital system for First Nations communities.
  • Unlike the facilities for non-aboriginal Canadians, these hospitals were not new buildings, but established in army bases Ottawa no longer needed. The pay for medical staffin these hospitals was low, attracting doctors and nurses who, Lux said, "could not get a job anywhere else." Lux tracked how tuberculosis patients were treated in these Indian hospitals compared to the rest of the nation, and the results are chilling. Prior to the 1950s there were few effective treatments for tuberculosis. Beyond bed rest, there were some surgical attempts, including deflating lungs and removing ribs, to halt the disease.
  • "But that was never very effective, but at the time there were no other options," Lux said. "But by the 1950s, you have effective antibiotics and instead of staying at the hospital, most times you were given your meds and sent home." Unless you were an aboriginal person. The prevailing attitude was that First Nations people could not be trusted to take their medications, so they were kept in hospital and, instead of using antibiotics, doctors continued to use ineffective, invasive treatments. In fact, First Nations people could not even use Canada's proper hospitals. Prior to national health care, Canadians still needed private health insurance. So if an aboriginal person came to a hospital, they were asked how they would pay. Usually the answer was the Indian Health Service, which only paid for treatment in Indian hospitals. Patients often died. If an aboriginal person was in a facility far from home, the federal government would only pay for them to be buried at the nearest grave yard, rather than be sent home for a funeral. Lux said many First Nations people were buried in unmarked graves in the back of graveyards as a result.
  • The decommissioning of this segregated system didn't start until 1968 with the arrival of universal health care, but some facilities continued to operate until the 1980s. Lux said in a few remote communities, a few of the hospitals still exist, although they operate more as medical clinics than hospitals. The point is there are First Nations Canadians alive today who were treated in those hospitals, and would have been subjected to poor, even dangerous, care simply because they were aboriginals. So when someone asks why, when it comes to First Nations issues, the past cannot be left in the past, you can tell them it's because that history is very much alive for many people. And until we learn to deal with the reality of that, nothing is going to change. Lux's book is available from the University of Toronto Press and on Amazon.
Govind Rao

We Need More Nurses - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246198|nytm|20150528|221425925

from heather nursing US staffing cuts

shared by Govind Rao on 29 May 15 - No Cached
  • The New York Times Thu May 28 2015
  • SEVERAL emergency-room nurses were crying in frustration after their shift ended at a large metropolitan hospital when Molly, who was new to the hospital, walked in. The nurses were scared because their department was so understaffed that they believed their patients -- and their nursing licenses -- were in danger, and because they knew that when tensions ran high and nurses were spread thin, patients could snap and turn violent. The nurses were regularly assigned seven to nine patients at a time, when the safe maximum is generally considered four (and just two for patients bound for the intensive-care unit). Molly -- whom I followed for a year for a book about nursing, on the condition that I use a pseudonym for her -- was assigned 20 patients with non-life-threatening conditions.
  • "The nurse-patient ratio is insane, the hallways are full of patients, most patients aren't seen by the attending until they're ready to leave, and the policies are really unsafe," Molly told the group. That's just how the hospital does things, one nurse said, resigned.
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  • Unfortunately, that's how many hospitals operate. Inadequate staffing is a nationwide problem, and with the exception of California, not a single state sets a minimum standard for hospital-wide nurse-to-patient ratios. Dozens of studies have found that the more patients assigned to a nurse, the higher the patients' risk of death, infections, complications, falls, failure-to-rescue rates and readmission to the hospital -- and the longer their hospital stay. According to one study, for every 100 surgical patients who die in hospitals where nurses are assigned four patients, 131 would die if they were assigned eight.
  • In pediatrics, adding even one extra surgical patient to a nurse's ratio increases a child's likelihood of readmission to the hospital by nearly 50 percent. The Center for Health Outcomes and Policy Research found that if every hospital improved its nurses' working conditions to the levels of the top quarter of hospitals, more than 40,000 lives would be saved nationwide every year.
  • Nurses are well aware of the problem. In a survey of nurses in Massachusetts released this month, 25 percent said that understaffing was directly responsible for patient deaths, 50 percent blamed understaffing for harm or injury to patients and 85 percent said that patient care is suffering because of the high numbers of patients assigned to each nurse. (The Massachusetts Nurses Association, a labor union, sponsored the study; it was conducted by an independent research firm and the majority of respondents were not members of the association.)
  • And yet too often, nurses are punished for speaking out. According to the New York State Nurses Association, this month Jack D. Weiler Hospital of the Albert Einstein College of Medicine in New York threatened nurses with arrest, and even escorted seven nurses out of the building, because, during a breakfast to celebrate National Nurses Week, the nurses discussed staffing shortages. (A spokesman for the hospital disputed this characterization of the events.)
  • It's not unusual for hospitals to intimidate nurses who speak up about understaffing, said Deborah Burger, co-president of National Nurses United, a union. "It happens all the time, and nurses are harassed into taking what they know are not safe assignments," she said. "The pressure has gotten even greater to keep your mouth shut. Nurses have gotten blackballed for speaking up."
  • The landscape hasn't always been so alarming. But as the push for hospital profits has increased, important matters like personnel count, most notably nurses, have suffered. "The biggest change in the last five to 10 years is the unrelenting emphasis on boosting their profit margins at the expense of patient safety," said David Schildmeier, a spokesman for the Massachusetts Nurses Association. "Absolutely every decision is made on the basis of cost savings."
  • Experts said that many hospital administrators assume the studies don't apply to them and fault individuals, not the system, for negative outcomes. "They mistakenly believe their staffing is adequate," said Judy Smetzer, the vice president of the Institute for Safe Medication Practices, a consumer group. "It's a vicious cycle. When they're understaffed, nurses are required to cut corners to get the work done the best they can. Then when there's a bad outcome, hospitals fire the nurse for cutting corners."
  • Nursing advocates continue to push for change. In April, National Nurses United filed a grievance against the James A. Haley Veterans' Hospital in Tampa, which it said is 100 registered nurses short of the minimum staffing levels mandated by the Department of Veterans Affairs (the hospital said it intends to hire more nurses, but disputes the union's reading of the mandate).
  • Nurses are the key to improving American health care; research has proved repeatedly that nurse staffing is directly tied to patient outcomes. Nurses are unsung and underestimated heroes who are needlessly overstretched and overdue for the kind of recognition befitting champions. For their sake and ours, we must insist that hospitals treat them right. ☐
Govind Rao

Morale crisis at Alexandria hospital?; Staffturnover is high; union has asked Minister ... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|cosf|20151216|235964782

from heather cupe hospital Ontario campaign survey

shared by Govind Rao on 16 Dec 15 - No Cached
  • Cornwall Standard Freeholder Wed Dec 16 2015
  • What would cause 116 staffmembers to leave an organization in under 10 years? In the case of the Glengarry Memorial Hospital, the Ontario Council of Hospital Unions said it's low morale and it is affecting patient care. The OCHU is concerned the low staffmorale and high staffturnover rates are creating internal turmoil and taking a toll on patient care and wants the Minister of health to do something about it.
  • "The situation at the hospital should not be ignored by Ontario's health minister and we are again urging him to intervene and investigate what's going on at the hospital," said OCHU president Michael Hurley. The OCHU is the hospital division of the Canadian Union of Public Employees, the union at the hospital representing registered practical nurses, clerical, cleaning, dietary and other staff.
  • ...4 more annotations...
  • CUPE has written to, and is publicly calling on, Ontario's health minister to look into why the hospital has lost 116 staffmembers since 2007. "What our members are reporting to us is a work environment very hierarchical," said Hurley. "People are not able to speak of issues freely without repercussions. If they do speak up they suffer consequences." Hurley said the high degree of turnover isn't just with union members. Members of management have been leaving the hospital as well. "The info I have been given is the morale is low," said North Glengarry Mayor Chris MacDonell, so he is aware of the situation. Hurley said the hospital has brought in a company to survey staff, but nothing has changed and morale remains low. "The survey suggested a work environment
  • out of step with a modern healthy work environment," said Hurley. "We asked Dr. (Eric) Hoskins, our health minister, to send in an independent investigator. But there has been no response to the valid concerns that we and others have raised," said Hurley. According to a survey of CUPE members at the hospital, 70 per cent of stafffeel people have left because of management at the hospital, and 50 per cent would leave if given the opportunity. Hurley said he has requested to have a meeting with the whole hospital board, but one hasn't been scheduled yet. "That absence of willingness to dialogue shows the deeper problem," he said. "If their employees have serious issues, you would think they would want to hear about them.
  • "Of greatest concern is the fact 47 per cent of respondents feel that the quality of patient care is not a priority at the hospital," said Hurley. "The minister has an obligation to investigate complaints about a toxic work environment at the Glengarry Memorial Hospital, which we believe affects the quality of patient care. Healthcare workers are under enormous stress. They are working hard to try to deliver high quality patient care. When they speak up to call attention to a situation they believe to be hazardous to patients, the minister should listen carefully. That Dr. Hoskins hasn't acted, is just inexplicable." The minister's office said in an email they were familiar with the hospital's situation and have contacted the Champlain Local Health Integration Network about the matter.
  • "In Ontario, LHINs are responsible for planning, funding and integrating services at the local level," said the email from David Jensen, media relations co-ordinator. "We expect that the LIHN will continue to work with the hospital and its board of directors to continue improving care for their patients. We encourage the Glengarry Memorial Hospital senior leaders to continue to work with their staffand unions towards effective communication and a solution that benefits everyone." A message left for Linda Morrow, CEO of the hospital, was not returned. lois.baker@sunmedia.ca twitter.com/LoisAnnBaker © 2015 Postmedia Network Inc. All rights reserved. Illustration: • Greg Peerenboom, Standard-Freehol / The Glengarry Memorial Hospital is shown in this Dec. 14
Heather Farrow

Referendum on agenda; Health coalition to introduce effort to save local hospitals - In... - 0 views

www.fpinfomart.ca/...245347159

Ontario coalition hospital cuts campaign

shared by Heather Farrow on 22 Apr 16 - No Cached
  • Welland Tribune Fri Apr 22 2016
  • A provincewide referendum could make it "politically impossible" to close hospitals, says an Ontario Health Coalition board member. Doug Allan said a referendum the coalition is planning will "make it so that these cuts, and the threatened closure of the Port Colborne hospital, can be stopped - to make it politically impossible for that to happen." Allan, a Toronto area resident, told a group of about 80 people at the Guild Hall in Port Colborne Wednesday night that "saving your hospital will be like a beacon for the rest of the province of what a community can do that stands up for it."
  • Niagara Heath Coalition chair Sue Hotte said details about a referendum will be released during a media conference Monday, but the initiative will include ballot boxes set up in public locations in communities across Ontario, such as businesses, municipal offices and physician clinics and workplaces. Although petitions bearing tens of thousands of signatures submitted to the provincial government in recent years have failed to stop the province's plans for Niagara hospitals, Hotte said the scope of the referendum should allow it to garner far more response. Hotte said it will have a profound impact on the provincial government.
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  • Allan said similar provincewide campaigns have had significant impacts in the past, such as stopping health-care privatization plans. He said the most recent referendum the Ontario coalition organized pertained to allowing private clinics to conduct some hospital surgeries, "and we collected 100,000 votes on an issue that I don't think is quite as well known as the cuts to our hospitals." "This is a much bigger issue, and I think we can get an even bigger vote," Allan said. "We need to collect the votes, send them offto the legislature, we need to do it collectively right across the province and send a very loud message. I think we can send an extremely loud message in Port Colborne because of the circumstances that we're looking at here." The meeting was organized to discuss the provincial government's plans to close hospitals in Port Colborne, Welland and Fort Erie and replace them with a single new hospital in Niagara Falls.
  • Niagara Health System in an e-mail to The Tribune Tuesday said Angela Zangari, executive vice-president and project lead, and NHS president Suzanne Johnston "have been across all NHS sites over the past few weeks sharing the preferred designs for a new south hospital at Lyons Creek and Montrose roads and a new ambulatory care/urgent care and longterm care development in Welland at King and Third streets. "We believe it is important to share information with our staff, many of whom have been engaged in planning activity for the projects. "Dr. Johnston is committed to working with staffto discuss planning on a regular basis. In addition she will be continuing to meet with community leaders to plan forward." At Wednesday' night's coalition meeting, several residents shared concerns about access to health-care services, including Aubrey Foley. "I don't want to offend anyone from Welland, but I live in Port Colborne, my hospital is in Port Colborne and this is where it should remain," the 71-year-old said.
  • He said his city of 19,000 people has a "deplorable walk-in service for health care." "It is not acceptable. There is no reason for it to be the way it is today," he said, while noting Dunnville, a town of 11,000 people, has a "fully functional hospital with free parking." "If Dunnville can do that, we can do this very easily," Foley said. Former mayor and regional councillor Bob Saracino said he will do whatever he can to save the Welland hospital, but the community must also work together to keep the urgent care centre running in Port Colborne. "When it comes to health, we must be one," he said.
  • Saracino said health care "is not a privilege, but it is a fundamental right that we have under the Canada Health Act." While Hotte said she agrees Niagara Falls needs a new hospital, "it should not be at the expense of people in Port Colborne, Welland, Wainfleet, Pelham - over 94,000 people losing access to hospital services." "No way! We need to keep the hospitals open and access to services," Hotte said.
  • About 80 people attend Wednesday night's meeting at Guild Hall about the planned closure of Port Colborne hospital. • Photos By Allan Benner, Tribune Staff / Ontario Health Coalition board member Doug Allan speaks at a meeting to discuss efforts to save Port Colborne hospital.
Govind Rao

Contracting out of surgical preparation and delivery - 2 views

www.ochu.on.ca/contracting_out.php

from heather cupe ontario hospital private clinics privatization

shared by Govind Rao on 24 Nov 14 - No Cached
  • Contracting Out Hospital Work to Private Clinics – Backgrounder For years CUPE has been concerned the Ontario government would transfer public hospital surgeries and diagnostic tests to private clinics. CUPE began campaigning in earnest against this possibility some years ago with a tour of the province by British Health Secretary Frank Dobson who talked about the disastrous British experience with private surgical clinics.Unfortunately, the provincial Liberal government has now moved in this direction. The door opened a few years ago with the introduction of fee for service hospital funding (sometimes called Activities Based Funding). Then in the fall of 2013 the government announced regulatory changes to facilitate this privatization, with the government finally announcing Request for Proposals for the summer of 2014.
  • Hospitals are the main focus of the government’s health care cuts. They do not see community hospitals as providing a broad range of services to the local ... [Read More]population, but instead wish to remove an untold range of services from local hospitals and transfer them to specialized private clinics. The proposal would remove the most lucrative, high volume and easiest procedures from community hospitals. The remaining community hospitals would be left with the most difficult services. If they chose to compete with the private clinics, they would have to specialize in a narrow range of services. The government’s plan is the opposite of one-stop, integrated public health care. This proposed privatization of surgeries and diagnostic tests is in addition to the aggressive attempts to remove non-acute care services from hospitals (e.g. outpatient clinics, complex continuing care, rehabilitation, long-term care, primary care, etc.). As acute care currently accounts for only about 1/3 of current hospital funding, these attacks are a grave threat to the viability of community hospitals, and in fact we are now seeing a wave of hospital shut-downs that is somewhat reminiscent of the Mike Harris era. Despite the government’s rhetoric about keeping care non-profit, services that are being cut from local hospitals now are being privatized to for-profit owned corporations. Even if the private clinics did start out as non-profit (which has not been the case so far) the whole system of private clinics could be privatized with a stroke of a pen.
  • Ontario Health Care Privatization: The push for health care privatization in Ontario picked up in 2001 when Ontario Health Minister Tony Clement announced two privatized P3 hospital projects, the Royal Ottawa and the Brampton Civic (part of William Osler Health Centre). Spirited community-based campaigns, including P3 plebiscites in many towns, forced the Liberal government to greatly narrow the scope of the privatization of support jobs (i.e. CUPE jobs) in subsequent P3 hospitals. Nevertheless privatization of the hospital financing continues, despite revelations by the provincial Auditor General that confirmed claims by CUPE and others that the Osler project cost hundreds of millions more due to the P3.
  • ...2 more annotations...
  • MRI and CT Clinics: The PC government also tried to set up private MRI and CT clinics outside of hospitals. Community/labour campaigns however were able to stop this. A key factor was that, to increase their revenue, the private clinics were allowed to bill private patients for a certain number of hours each week (with the rest of the week dedicated to patients paid for by the public system). As the public insurance system must pay for all ‘medically necessary’ hospital services, the government was left to try to explain why any reputable clinic would allow patients to subject themselves to such tests for medically unnecessary reasons. Since this episode, private clinics have been in the news – but mostly for the wrong reasons. Private surgical and diagnostic clinics: Initially, the government let the emerging industry slip entirely free of public reporting and oversight. However, after the September 2007 death of Krista Stryland, a young mother who underwent liposuction at a Toronto cosmetic clinic, the government required the industry to face some modest oversight in 2010. Unfortunately this was not by a public authority, but through self-regulation by the doctors (even though the doctors themselves had lobbied to expand this private industry).
  • Then in the fall of 2011, following disclosure that 6,800 patients would have to be notified that faulty infection control procedures at a private clinic could have exposed them to HIV or hepatitis, the then Health Minister, Deb Matthews, declined to introduce oversight by a public authority, despite public pressure. Instead she comments, “Government can’t do everything. A professional (regulating body) like the College of Physicians and Surgeons, they take responsibility for their members....At this point I am delighted the College is taking that responsibility seriously and has found a problem that we need to fix.” Eventually the College of Physicians and Surgeons released a report on the private clinics that mentions that some 29% of the private clinics fall short in some way – but the College would not indicate which ones – or how they fell short. This caused public uproar, with the Toronto Star playing a leading role (as it would continue to do). Again, the government promised improvements. In the last two months however, the Star has followed up and revealed (after our urging) that the public reports from the College of Physicians and Surgeons fall far short. They also ran a series of often front page stories on serious quality problems at private clinics.
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