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Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector

Dr. Jack Kitts, Chair, Health Council of Canada

In 2008, we released a progress report on all the commitments in the 2003 Accord on Health Care Renewal, and the 10-year plan to strengthen health care. We found much to celebrate and much that fell short of what could and should have been achieved. This spring, three years later, we will be releasing a follow-up report on five of the health accord commitments.

We have made progress on wait times because governments set targets and provided the funding to tackle them. Buoyed by success in the initial five priority areas, governments have moved to address other wait times now. For example, in response to the Patients First review, the Saskatchewan government has promised that by 2014, no patient will wait longer than three months for any surgery. Wait times are a good example that progress can be made and sustained when health care leaders develop an action plan and stick with it.

Toronto Star Fri Mar 6 2015

The rise of part-time, low-paying jobs and self-employment in Canada over the past 2 1/2 decades has lead to an irreversible decline in employment quality, according to a report from the Canadian Imperial Bank of Commerce. Job quality in Canada has been declining for 25 years and is now at a record low, CIBC said. Worse still, it's unlikely that low interest rates and a return of robust economic growth will reverse the trend. "Our measure of employment quality has been on clear downward trajectory over the past 25 years," CIBC deputy chief economist Benjamin Tal wrote in the report, released Thursday. "While the pace of the decline has slowed in recent years, the level of quality as measured by our index is currently at a record low - 15 per cent below the rate seen in the early 1990s and 10 per cent below the level seen in the early 2000s."

The CIBC Canadian Employment Quality Index measures the distribution of full- and part-time jobs, the split between self-employment and paid employment, and the compensation ranking of full-time paid employment jobs in more than 100 industry groups. The index, which uses January 1988 as a base year, has largely been in decline since 1990. On a year-over-year basis, it is down by 1.8 per cent. "The long-term trends of our quality components suggest that the decline in employment quality in Canada is more structural than cyclical," Tal wrote. The chief culprit is often seen as the growth in the number of part-time jobs, which have risen much faster than full-time employment since the 1980s, CIBC said. "The damage caused to

Corporate chains tend to buy and sell lower-quality nursing homes, and quality remained low following transactions

May 2, 2016

Harvard Medical School

May 16 is Personal Support Worker Day. PSWs are increasingly providing the majority of direct care services to elderly or ill patients who live in long-term care institutions or who receive home care.

Richards noted that “they [PSWs] are constantly on the go … they have very little time to actually sit down and provide comfort to residents and build that important relationship between themselves as caregivers with the residents and their family members”.

There is a great deal of variation in what PSWs do, where they work, and how they are supervised. This has made many argue that there must be more standardized training and regulation of PSWs. Others point out that it is at least as important to ensure that their working conditions allow PSWs to provide the compassionate and high quality care that their clients deserve.

Discussion: An overall difference of approximately three work weeks in disability duration may have meaningful clinical and quality-of-life implications for injured workers. However, minimal differences in expedited surgical wait times by private clinics versus public hospitals, and small differences in return-to-work outcomes favouring the public hospital group, suggest that a future economic evaluation of workers' compensation policies related to surgical setting is warranted.

In 2004, for example, WorkSafeBC (the workers' compensation system in British Columbia) paid almost 375% more ($3,222) for an expedited knee surgery performed in a private clinic than for a non-expedited knee procedure in a public hospital ($859) (both fees represent the aggregation of facility, surgical and anaesthetists' fees)

The Telegram (St. John's) Tue Jun 23 2015

With oil prices down, an aging population and high unemployment, the conservative government of Newfoundland and Labrador is looking for a silver bullet to cut costs for public services and infrastructure. Their sights are settling on privatization to be that silver bullet. What is privatization? In its most narrow sense, privatization is the whole or partial sale of public services and/or infrastructure. It can include the sale of assets, functions or the entire institution.

With privatization, the service or infrastructure becomes funded and/or run by a private corporation. Privatization usually includes not only a change in ownership but also a change in the priorities, responsibilities and role of the state. Advocates of privatization offer free-market competition as the path to economic and social success, with promises of cost savings, lower risk, greater efficiency and more individual choice. Privatization takes several forms in Canada, including:

BC Quality Forum 2015 Dates: 18 – 20 Feb, 2015 Location: Vancouver, BC Address: Hyatt Regency Vancouver

Quality Forum 2015 will feature two days of presentations and interactive workshops on a variety of topics related to improving quality across the continuum of care. For more information or to register visit the conference website:http://qualityforum.ca/program-guide/

According to data from Statistics Canada, staffing levels in Ontario’s nursing homes have historically been below the national average (behind only British Columbia for the lowest staffing levels in the country).

While Ontario legislation requires there to be a nurse on duty at all times in nursing homes, Ontario has not legislated a minimum staffing ratio – the ratio between the number of nursing home staff (nurses and non-nurses) compared to the number of patients they care for.

Statistics Canada data shows the average staffing ratio in Ontario nursing homes was 4 hours per resident day in 2010 (the last year for which data is available). This was 25% less than in Alberta, where nursing homes averaged 5.3 hours per resident day. (This is only a measure of the hours paid to all staff in nursing homes, not of the actual time care staff spend providing care ‘at the bedside.’)

Abstract The World Health Report launched the Health Workforce Decade (2006-2015), with high priority given for countries to develop effective workforce strategies including healthy workplaces for health workers. Evidence shows that healthy workplaces improve recruitment and retention, workers' health and well-being, quality of care and patient safety, organizational performance and societal outcomes. Over the past few years, healthy workplace issues in Canada have been on the agenda of many governments and employers. The purpose of this paper is to provide a progress update, using different data-collection approaches, on knowledge transfer and uptake of research evidence in policy and practice, including the next steps for the healthy workplace agenda in Canada. The objectives of this paper are (1) to summarize the current healthy workplace initiatives that are currently under way in Canada; (2) to synthesize what has been done in reality to determine how far the healthy workplace agenda has progressed from the perspectives of research, policy and practice; and (3) to outline the next steps for moving forward with the healthy workplace agenda to achieve its ultimate objectives. Some of the key questions discussed in this paper are as follows: Has the existing evidence on the benefits of healthy workplaces resulted in policy change? If so, how and to what extent? Have the existing policy initiatives resulted in healthier workplaces for healthcare workers? Are there indications that healthcare workers, particularly at the front line, are experiencing better working conditions? While there has been significant progress in bringing policy changes as a result of research evidence, our synthesis suggests that more work is needed to ensure that existing policy initiatives bring effective changes to the workplace. In this paper, we outline the next steps for research, policy and practice that are required to help the healthy workplace agenda achieve its ultimate objectives. The early decades of the 21st century belong to health human resources (HHR). The World Health Report (World Health Organization [WHO] 2006) launched the Health Workforce Decade (2006-2015), with high priority given for countries to develop effective workforce strategies that include three core elements: improving recruitment, helping the existing workforce to perform better and slowing the rate at which workers leave the health workforce. In this recent report, retaining high-quality healthcare workers is discussed as a major strategic issue for healthcare systems and employers, and improving workplaces as a key strategy for achieving this goal. The workplace can act as either a push or pull factor for HHR. Heavy workloads, excessive overtime, inflexible scheduling, safety hazards, poor management and few opportunities for leadership and professional development are among the push factors that result in poor recruitment and retention of HHR. Evidence shows that healthy workplaces improve recruitment and retention, workers' health and well-being, quality of care and patient safety, organizational performance and societal outcomes. What are healthy workplaces? Based on existing definitions, there is not yet a standardized and comprehensive definition of healthy workplaces. In this paper, we define healthy workplaces as mechanisms, programs, policies, initiatives, actions and practices that are in place to provide the health workforce with physical, mental, psychosocial and organizational conditions that, in return, contribute to improved workers' health and well-being, quality of care and patient safety, organizational performance and societal outcomes (Griffin et al. 2006). Over the past few years, healthy workplace issues in Canada have been on the agenda of many governments and stakeholder organizations. Nationally and internationally, robust evidence has been accumulated on the impact of healthy workplaces on workers' health and well-being, quality of care, patient safety, organizational performance and societal outcomes. This evidence has provided guidance for governments and employers in terms of what should be done to make the workplace healthier for healthcare workers. Across Canada, many initiatives to improve the working conditions for HHR are currently under way, but the continuing concerns suggest that barriers remain. An assessment of the progress to date is necessary in order to inform the next steps for research, policy and practice.

Health Care Quality Summit 2012April 17 & 18, 2012TCU Place, 35 - 22nd Street EastSaskatoon, Saskatchewan

Are you a Quality Improvement champion?  Share your story and and inspire others to make care better and safer for patients!

After a successful and inspiring 2012 Summit, the 2013 Health Care Quality Summit will return on Wednesday, April 10 – Thursday, April 11, 2013 at the Queensbury Conference Centre, Evraz Place, Regina, SK.

by Shawn Whatley (Show all posts by Shawn Whatley) February 24, 2014

The Ontario government deserves applause for tackling global funding for hospitals. “Global budgets provide[d] little incentive for hospitals to focus on efficiency, innovation, improving access, coordinating care across facilities and sectors or improving quality.” In 2012, the Ontario Ministry of Health announced its commitment to patient-based funding. It promised to deliver patients: • Shorter wait times and better access to care in their communities • More services, where they are needed • Better quality care with less variation between hospitals

The performance of hospitals and care homes is to be subject to a new tier of inspection criteria that will include basic standards of care, such as whether an individual has been given adequate food and drink, a senior adviser at the Care Quality Commission has said.

Alan Rosenbach, special policy adviser at the CQC, said that providers that fail to deliver the basics will be fast tracked to prosecution under new powers awarded to the regulator. The new powers will include the ability to place providers into a “quality failure regime.”

the government wanted the regulator to include basic elements of care in its inspection regime.

Workshop seminar, 8-9 October 2014 at the Westin Bayshore Hotel in Vancouver, British Columbia Do your clinicians know your financial analysts? They should. 

CFHI is hosting IHI’s Driving Quality, Lowering Costs workshop seminar October 8-9 at the Westin Bayshore Hotel in Vancouver, British Columbia to help you get on the same track. This workshop is a synthesized, fast-paced version of IHI’s two-and-a-half year initiative that has been adapted by CFHI and IHI for the Canadian context in partnership with BC Patient and Safety Quality Council and the Health Quality Council of Saskatchewan. Now, you will learn in two days the proven strategies, tools, and best practices to save money and drive quality from more than two and a half years of IHI’s in-depth initiative.

For-profit, or proprietary, home health agencies were banned from Medicare until 1980 but now account for a majority of the agencies that provide such services. Medicare home health costs have grown rapidly since the implementation of a risk-based prospective payment system in 2000. We analyzed recent national cost and case-mix-adjusted quality outcomes to assess the performance of for-profit and nonprofit home health agencies. For-profit agencies scored slightly but significantly worse on overall quality indicators compared to nonprofits (77.18 percent and 78.71 percent, respectively). Notably, for-profit agencies scored lower than nonprofits on the clinically important outcome “avoidance of hospitalization” (71.64 percent versus 73.53 percent). Scores on quality measures were lowest in the South, where for-profits predominate. Compared to nonprofits, proprietary agencies also had higher costs per patient ($4,827 versus $4,075), were more profitable, and had higher administrative costs. Our findings raise concerns about whether for-profit agencies should continue to be eligible for Medicare payments and about the efficiency of Medicare’s market-oriented, risk-based home care payment system.

Waterloo Region Record Thu Mar 5 2015

Here's a little thought quiz: Which of the following characteristics come to mind when you hear the term "monopoly service": efficient, customer-oriented, innovative, high quality, low cost? If you answered "none of the above," you probably recall the days when hooking up your telephone, sending a package or even travelling by air offered few or no choices. Today, we have a wide variety of competing providers that offer higher quality service at a lower cost.

But in health care, by far the most important and costly service, Canada is the only country that forbids competing with the public system. A 2014 Commonwealth Fund Report found the performance of Canada's monopoly health-care system ranked well behind Australia, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom. And a 2013 Organization for Economic Co-operation and Development (OECD) report found that, despite spending 36 per cent more per capita than the OECD average, Canada has the longest wait times for elective surgery.

Vancouver Sun Tue Apr 5 2016

The vast majority of governmentfunded long-term care homes for seniors in B.C. do not meet Ministry of Health staffing guidelines. The Residential Care Facilities Quick Facts Directory, a report released by the Office of the Seniors Advocate, compiles staffing, serious incident reports and other qualityof-life measures for all publicly funded seniors homes in B.C. in 2014-15. Of the 292 governmentfunded facilities, 232 did not meet the ministry's staffing guideline, a recommendation of 3.36 hours of care per senior every day. This includes help with tasks such as toileting, feeding and bathing. Just 17 facilities

Of the 232 government-funded seniors homes below the staffing guidelines, 74 per cent were owned and operated by private businesses instead of health authorities or by a non-profit group, such as a church. All but two of the 25 care facilities providing the lowest number of staffing hours were in the Vancouver Coastal Health Authority. Isobel Mackenzie, the B.C. Seniors Advocate, and Jennifer Whiteside of the Hospital Employees Union, which represents care aides in long-term facilities, are calling on government to legislate minimum staffing levels instead of leaving it up to facility operators. "We regulate the staffing ratios in child care, why don't we regulate it in senior care?" said Mackenzie. She said she was surprised to learn how many seniors homes fall below provincial guidelines.