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Govind Rao

A new Quebec study says health-care reforms are inevitable - Business News - Castanet.net - 0 views

www.castanet.net/...th-care-reforms-are-inevitable

from heather Quebec privatization

shared by Govind Rao on 27 May 14 - No Cached
  • The Canadian Press | Story: 115902 - May 26, 2014
  • MONTREAL - A new study says Quebec will be able to keep most of its current social system as long as it reforms its health-care network and achieves a balanced budget as quickly as possible. The study was conducted for the Institut du Quebec and was headed by former provincial finance minister Raymond Bachand. Its release today comes about one week before the tabling of the new Liberal government's first budget. The study predicts Quebec's structural deficit could find itself at an insupportable level by 2035 because of an aging population.
Doug Allan

Elevators carrying bacteria: study; Hospital elevator buttons coated with more germs th... - 0 views

www.fpinfomart.ca/...200074465

HAIs

shared by Doug Allan on 10 Jul 14 - No Cached
  • You might want to use an elbow to push the elevator button the next time you are in a hospital.
  • A new study suggests that elevator buttons in hospitals have more bacteria on them than surfaces in public bathrooms in hospitals.
  • "It's a theoretic risk. But the main point here is that it's also an avoidable risk through hand hygiene."
  • ...7 more annotations...
  • Analysis of the swabs taken in the study found most of the bugs were benign. But that might not always be the case, said senior author Dr. Donald Redelmeier.
  • "They can't be cleaned again and again and again, every second of the day," Redelmeier said. "Once they're clean, they don't stay clean very long."
  • While elevator buttons are certainly among the surfaces hospital cleaners target, they are touched so often, by so many people, that it's a bit of a losing battle.
  • Studies have found bacterial contamination on neckties worn by male doctors, lab coats, stethoscopes, curtains separating beds in multiple-bed rooms, computer keyboards as well as smart phones and digital tablets health-care workers use to enter and check patient data.
  • For the study, swabs were taken from 120 different elevator buttons and 96 toilet surfaces in three different hospitals in Toronto. Swabbing was done on weekdays and weekends, and a variety of elevator buttons were tested. As well, the public washrooms closest to the elevators were also tested, with swabs taken of the door handles on the inside and outside of the main door, the latch used to close cubicle doors and the toilet flush handle or button.
  • Redelmeier said people should consider using an elbow, a pen or some other item to push elevator buttons in hospitals, or make sure they use hand sanitizer after exiting an elevator. He suggested hospitals should put sanitizer dispensers in elevators.
  • "Often when people use a hand cleanser, they're very good at washing their palms, but not their fingertips. And yet most of the transmission does not occur in the middle of the hand, it occurs at the periphery of the hand."
Govind Rao

Are Income-Based Public Drug Benefit Programs Fit for an Aging Population? - 0 views

irpp.org/...study-no50

from heather pharmacare drugs

shared by Govind Rao on 11 Feb 15 - No Cached
  • Govind Rao on 11 Feb 15
     
    A IRPP Research Program Study Steven G. Morgan, Jamie R. Daw and Michael R. Law Provinces should provide full and universal pharmacare December 3, 2014
  • Govind Rao on 11 Feb 15
     
    A IRPP Research Program Study
Govind Rao

Study sparks renewed interest in universal pharmacare plan | canada.com - 0 views

o.canada.com/...t-in-universal-pharmacare-plan

from heather pharmacare

shared by Govind Rao on 24 Mar 15 - No Cached
  • The study, published in the Canadian Medical Association Journal, found that universal drug coverage would save Canada $7.3 billion every year, with a 32 per cent reduction in overall spending on prescription drugs. At the same time, the annual cost of having such a system would be just $1 billion. With this study, health care experts and industry leaders are once again pointing to the need for a single, coherent and effective national pharmacare strategy. The case for it, as the latest study suggests, may in fact be strong. But the likelihood of any such proposal soon being implemented as policy remains unclear. A surprising void in Canadian medicare
  • Govind Rao on 24 Mar 15
     
    March 23 2015
  • Govind Rao on 24 Mar 15
     
    March 23 2015
Doug Allan

Customize local food for hospitals - Infomart - 0 views

www.fpinfomart.ca/...164408217

food hospitals

shared by Doug Allan on 25 Mar 13 - No Cached
  • Setting out to find ways to incorporate local food into hospitals and long-term care facilities was a noble pursuit for University of Guelph researcher Paulette Padanyi and her team.
  • the team's vision for a 20 per cent increase in local food in institutional care facilities
  • But while all this sounds great, when it comes to hospitals and institutions, a new level of business propriety must take hold. There's no end-of-the-lane sales. No late deliveries allowed. No excuses - even reasonable ones - such as the truck broke down, or we had a crop failure. A deal with a hospital entails people having to eat local food, rather than making it some personal choice.
  • ...5 more annotations...
  • So in their study, Report on Food Provision in Ontario Hospitals and Long-Term Care Services: The Challenges and Opportunities of Incorporating Local Food, it follows that Padanyi and her team found substantial barriers to requiring that all public health-care facilities in Ontario incorporate local food into their patient and visitor food service.
  • Realistically, though, not much will change on the hospital-food frontier as long as the province gives hospitals peanuts for food care. True, no one checks into the hospital for its food. But it's sure one more reason to check out.
  • Having looked at some institutional case studies in our area, they say local food can be offered to patients and residents very successfully, on a facility-by-facility basis.
  • Simply put, we're not there yet. We have a hard enough time agreeing on the definition of local food, let alone providing it en masse to sick and elderly people.
  • Report on Food Provision in Ontario Hospitals and Long-Term Care Services: The Challenges and Opportunities of Incorporating Local Food
  • Doug Allan on 25 Mar 13
     
    Local food study for institutions is out/
Cheryl Stadnichuk

Older women more likely to be prescribed inappropriate drugs: study - The Globe and Mail - 0 views

www.theglobeandmail.com/...article30120533

senors prescription drugs women

shared by Cheryl Stadnichuk on 25 May 16 - No Cached
  • That does not necessarily mean that doctors treat older women differently. Morgan noted that women are more likely to seek medical attention for anxiety and sleeplessness, whereas men are more likely to self-medicate with alcohol and other drugs, according to previous research.Overuse of tranquilizers in both sexes may stem from long-term prescription renewals, he said. “We suspect that many people actually started using them 10 or 15, or maybe 20 years earlier, when they were middle-aged.”
  • The study, published this month in the medical journal Age and Ageing, analyzed population-based data from British Columbia’s PharmaNet, a province-wide network that links B.C. pharmacies to central databases.Rates of inappropriate prescribing for older adults are similarly high in other parts of the country, according to a 2012 study conducted by the Canadian Institute For Health Information.
Irene Jansen

Threat to Health care is a Myth - 0 views

www.straightgoods.ca/...ViewArticle.cfm

sustainability

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Irene Jansen on 23 Jan 12
     
    http://www.troymedia.com/2011/09/21/grey-tsunami-threatening-health-care-is-a-myth/# VANCOUVER, September 21, 2011/Troy Media/ - You've heard it before: the boomers are aging and jeopardizing our health care system by the sheer number of them swanning into their golden years. Sounds right - except it isn't true. Let's check the evidence: the older you are, the more likely you are to use health care services. This is a fact, but it does not necessarily follow that the coming bulge of boomers will bankrupt the health care system. Study after study in Canada over the last 30 years shows that aging is an issue, but it exerts only a small and predictable pressure on health care spending (less than one percent annually from 2010 to 2036). More recent research shows that increases in utilization - how many and how often Canadians use health services - are twice as important as aging in increasing costs year by year. In other words, while population aging does increase costs, the kinds and amount of services provided to people in every age group are a far more important factor. How and why are these changes occurring?
Irene Jansen

Critiques of World Health Report 2000 (comparison of health systems). - 0 views

www.who.int/...overallframework_docs.htm

international international comparisons

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Irene Jansen on 23 Jan 12
     
    The anti medicare folks often refer to a 2000 WHO report which ranked every health care system in the world according to a number of indicators which saw France come out at #1. This report was subsequently panned by health policy experts all over the world because of data problems (quality, different comparators, comparing apples & oranges). Notwithstanding the problems with the study it still gets a lot of reference. This site is a collection of the critique of the study.
Irene Jansen

The Oprah effect and why not all scientific evidence is valuable - Science-ish - Maclea... - 0 views

www2.macleans.ca/...cientific-evidence-is-valuable

research methods

shared by Irene Jansen on 23 Jan 12 - No Cached
  • On the question of type, it’s important to differentiate between primary research (such as control studies and clinical trials) and secondary research (meta-analyses and systematic reviews). In the media, you often read about primary research, like this jewel from earlier this week: “Study touts new way to spot babies at risk for obesity.” Greenhalgh points to a useful “evidence hierarchy” that ranks the relative weight of research from highest to lowest: 1. Systematic reviews and meta-analyses 2. Randomised controlled trials with definitive results (confidence intervals that do not overlap the threshold clinically significant effect) 3. Randomised controlled trials with non-definitive results (a point estimate that suggests a clinically significant effect but with confidence intervals overlapping the threshold for this effect) 4. Cohort studies 5. Case-control studies 6. Cross sectional surveys 7. Case reports
Irene Jansen

Shift workers and seniors socially excluded - Health - CBC News - 0 views

www.cbc.ca/...shift-work-study.html

seniors uk

shared by Irene Jansen on 23 Jan 12 - No Cached
  • People who do shift work and work outside standard hours as well as older people feel more excluded from society, according to a new U.K. study.
  • lead author Dr. Matt Barnes
  • On average, older people spend 11 hours alone on a weekday and 10½ hours alone at weekends, the study finds.
  • ...1 more annotation...
  • The study, "Making time use explicit in an investigation of social exclusion in the U.K.," was carried out by researchers at the National Centre for Social Research. It was funded by the Economic and Social Research Council.
Irene Jansen

Hospital study looks at frequency of cardiac arrests in Toronto neighbourhoods - The Gl... - 0 views

www.theglobeandmail.com/...article2294146

determinants

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Increasingly, scientists in Canada, the U.S., UK and elsewhere are mapping the spread of diseases on a micro-geographic level – looking to social determinants of health neighbourhood by neighbourhood. Some argue that urban polarization makes for big differences in health outcomes in small areas.
  • A 2011 study done by the Direction de Santé Publique de Montréal found men in poorer neighbourhoods lived a almost 11 years less than their counterparts in wealthier areas. The study found people in better-off neighbourhoods go longer without disabilities, and are far less likely to have their babies die shortly after birth. Children and teenagers in poor neighbourhoods die at twice the rate of youth in rich areas.
Irene Jansen

Social Interactions, Identity and Well-Being Research Progress | CIFAR - 0 views

www.cifar.ca/d-well-being-research-progress

empowerment ltc quality culture change social cure

shared by Irene Jansen on 09 Feb 12 - No Cached
  • program members identify that a major contributor to happiness, which traditional economics ignores, is the sense of identity that comes from belonging to groups and from having control over one’s outcomes and surroundings
  • employees become more productive and satisfied when they have greater input into the design of their workspace; senior citizens adapt more effectively to moves to long-term care facilities if they maintain memberships in formal clubs or informal groups of friends
  • In long-term care facilities, changes such as aging and declining health are a threat to residents’ sense of self and well-being. A range of studies known collectively as “The Social Cure” use theory, experimentation and field trials to show how well-being can be improved simply by helping people engage with each other more. Studies of identity loss among seniors when they move from their homes to long-term care facilities found that those who remain engaged in social groups and clubs fare better. This study and others demonstrate that health care interventions that get people involved with social networks can foster new social identities that can buffer adverse effects of aging, promote recovery from heart surgery and stroke, and delay the onset of degenerative diseases.
  • ...1 more annotation...
  • A range of studies known collectively as “The Social Cure” use theory, experimentation and field trials to show how well-being can be improved simply by helping people engage with each other more.
  • Irene Jansen on 09 Feb 12
     
    Haslam, Jetten, Haslam, Knight, The Importance of Remembering and Deciding Together: Enhancing the Health and Well-Being of Older Adults in Care. in The Social Cure: Identity, Health and Well-Being. Edited by Jolanda Jetten, Catherine Haslam and S. Alexander Haslam.
Govind Rao

Sick babies cost Nunavut millions CBC - 0 views

www.cbc.ca/...-hospital-admission-rates.html

from heather aboriginal

shared by Govind Rao on 08 Aug 13 - No Cached
  • Govind Rao on 08 Aug 13
     
    Estimated $15.6 million spent on hospital visits for respiratory illnesses CBC News Posted: Aug 8, 2013 12:17 PM ET A new study says Inuit children's hospital admissions for respiratory illnesses such as RSV, pneumonia or bronchitis are costing Northern governments millions of dollars. The study was published this week in the International Journal of Circumpolar Health. In the Northwest Territories, less than four per cent of Inuit babies are hospitalized because of a lower respiratory tract infection. In Nunavut it's almost 25 per cent and in Nunavik, almost half of all babies are admitted to hospital. The Kitikmeot region had Nunavut's highest rate, with almost 40 per cent of babies admitted to the hospital. That's costly when many babies have to be medavaced out of their communities to a regional hospital or to hospitals in the south.
Govind Rao

NorthumberlandView.ca Study Compares Insurance Coverage for New Medicines Between Canad... - 0 views

www.northumberlandview.ca/index.php

from heather drugs

shared by Govind Rao on 07 Oct 13 - No Cached
  • National News: Study Compares Insurance Coverage for New Medicines Between Canada's Public and Private Sector Drug Plans [ Edit ] Contributed by admin on Sep 20, 2013
  • A new study published by the Canadian Health Policy Institute (CHPI) compares insurance coverage for new medicines between Canada's provincial and federal public drug programs; and between public sector drug programs and the benchmarks currently set in a competitive market by private-sector drug insurance. Using data from Health Canada and IMS Brogan, the study specifically examined insurance coverage for new medicines in five (5) select therapeutic classes - allowing Canadians to see how they are uniquely impacted by differences in drug insurance benefits across plans, according to the treatment areas that affect them most directly.
Doug Allan

Trends in long-term care staffi ng by facility ownership in British Columbia, 1996 to 2006 - 0 views

www.statcan.gc.ca/...11390-eng.htm

LTC privatization

shared by Doug Allan on 23 Jan 12 - No Cached
  • Long-term care facilities (nursing homes) in British Columbia consist of a mix of for-profit, not-for-profit non-government, and not-for-profit health-region-owned establishments.  This study assesses the extent to which staffing levels have changed by facility ownership category.
  • From 1996 to 2006, crude mean total nursing hours per resident-day rose from 1.95 to 2.13 hours in for-profit facilities (p=0.06); from 1.99 to 2.48 hours in not-for-profit non-government facilities (p<0.001); and from 2.25 to 3.30 hours in not-for-profit health-region-owned facilities (p<0.001). The adjusted rate of increase in total nursing hours per resident-day was significantly greater in not-for-profit health-region-owned facilities.
  • While total nursing hours per resident-day have increased in all facility groups, the rate of increase was greater in not-for-profit facilities operated by health authorities.
  • ...3 more annotations...
  • American studies have found that not-for-profit ownership of nursing homes is associated with higher staffing levels, lower staff turnover, and better outcomes on a range of measures, compared with for-profit-ownership. 
  • Only three Canadian studies have quantitatively examined associations between long-term care facility staffing levels and facility ownership, and the results have not been consistent.
  • What does this study add? Total nursing hours per resident day have increased over the past decade for all facility ownership groups in British Columbia. The rate of increase in not-for-profit facilities owned by a health region was significantly greater compared with for-profit facilities. Total nursing hours per resident day were also significantly lower in for-profit facilities, compared with not-for-profit facilities.
  • Irene Jansen on 23 Jan 12
     
    Long-term care facilities (nursing homes) provide housing, support and direct care to frail seniors who are unable to function independently. Nursing care in these facilities is provided by a combination of registered nurses (RNs), licensed practical nurs
Govind Rao

Rural ERs better in Quebec than Ontario - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150506|219898181

from heather rural emerg Ontario Quebec hospital cuts

shared by Govind Rao on 06 May 15 - No Cached
  • National Post Wed May 6 2015
  • Rural emergency departments in Ontario have dramatically fewer CT scans, specialists and nearby intensive-care units than those in Quebec, suggests a new study that adds to evidence of wide quality gaps in Canada's emergency health care. The findings parallel a similar disparity the researchers discovered earlier between rural ERs in British Columbia and Quebec.
  • They are now studying whether that lack of specialists and equipment affects the number of non-urban Canadians who die from trauma, stroke, heart attack and severe infection. The early results are "concerning," said Richard Fleet, a Laval University emergency-medicine professor who co-authored the newest research. "In a rural emergency department, people actually save lives by working as teams," said Dr. Fleet, who practised in a small-town B.C. emergency department before heading to Quebec. "For emergencies ... it's really good to have these backup systems in house."
  • ...4 more annotations...
  • One prominent rural ER physician in Ontario rejected the notion that his province's departments are inferior, saying the focus is more on sending the sickest patients to big trauma centres. Across the country, however, wide variations in emergencydepartment standards definitely do exit, said Alan Drummond, a spokesman for the Canadian Association of Emergency Physicians. "It's a crapshoot, when you go to any hospital in this country, in terms of what you're going to get in the type and quality of care," he said. "We have national variability and for 23 per cent of Canadians (who live outside cities), that's unacceptable." About 6 million Canadians live in rural areas, tend to be older on average, have greater health needs, and are more likely to suffer traumatic injury, partly due to the prominence of dangerous professions like farming and logging.
  • Fleet became interested in the relative quality of emergency service after cutbacks meant his former hospital in Nelson, B.C., could offer only "bare-bones services to a high-risk population." He lobbied for additional funding, but realized there were no published data comparing different Canadian emergency departments. In the most recent study, just published in the journal PlosOne, he and colleagues looked at rural departments with 24/7 service and an ability to admit patients to acute-care beds in their hospitals - 26 facilities in Quebec and 62 in Ontario. If anything, the Ontario ERs appeared more isolated on average, with a greater percentage of them being at least 300 kilometres from a trauma centre.
  • Yet 92 per cent of the Quebec emergency departments had a local intensive-care unit, compared to 31 per cent of the Ontario ones. Just over 80 per cent of the Quebec ERs had a general surgeon available on call, versus a third of the Ontario emergency departments. Fleet said he is not sure why Quebec's rural ERs are better equipped, given the provinces' spending on health care is similar per capita. It may relate to the fact its rural hospitals have fewer foreign-trained doctors, who may feel less empowered to demand better facilities. But Drummond said Ontario has a different protocol that ensures rural ER physicians are well-trained to provide basic emergency services - such as treating shock and blocked airways - and emphasizes funnelling critically ill patients to trauma centres in larger cities. The province's CritiCall system helps rural hospitals find facilities that can take their patients.
  • However, he agreed that having a CT scanner is now crucial to emergency departments anywhere making accurate diagnoses; the one his hospital in Perth, Ont., acquired five years ago "changed the way we practice." Just nine of 62 full-time rural Ontario departments had a CT scanner, according to the new study.
Govind Rao

Canada can afford universal pharmacare - no more excuses - 0 views

www.cmaj.ca/...475

from heather pharmacare cma

shared by Govind Rao on 20 Apr 15 - No Cached
  • Matthew B. Stanbrook, MD PhD, Deputy Editor
  • Correspondence to: CMAJ editor, pubs@cmaj.ca See also page 491 and www.cmaj.ca/lookup/doi/10.1503/cmaj.141564 Canadians embrace universal public health care as a core national value. We are proud to say that we live in a country that ensures access to health care for all, regardless of means — the problem is, that statement isn’t true. A gaping hole in our supposedly universal system is the lack of public coverage for prescription drugs for most Canadians. Many Canadians face drug costs they can’t afford, forcing them to either take their medicines less often than prescribed or do without them entirely, with predictable adverse health consequences.1
  • Universal pharmacare has been recommended by virtually every national study and Royal Commission from the time medicare was first introduced in Canada to the 2002 Romanow Report, yet we still don’t have it. Governments past and present have defended their inaction on this issue by arguing that pharmacare would cost too much. Although it’s not clear that there was ever good reason to assume that would be true, providing scientific evidence to refute such a claim requires a study with access to comprehensive data about the sources and magnitude of drug costs, prescribing patterns and the effects of introducing universal drug coverage from the experience of other national and international jurisdictions.
  • ...8 more annotations...
  • In their recent CMAJ article, Morgan and colleagues present just such a study.2 Using recently available national data on drug use and costs, they report an economic model that estimates the cost of implementing national public drug coverage. The model anticipates several key evidence-based consequences of universal pharmacare. Patients who were previously unable to access drugs would now receive them, which would drive up costs. However, the greatly enhanced purchasing power of a single national third-party payer would be expected to confer an ability to negotiate substantial reductions in the prices of many drugs, as other countries have experienced and as Canadian provinces are already trying to achieve through collaboration. The model also assumes that patients would incur modest copayments, as is the case in other countries with universal pharmacare.
  • The bottom line? The best estimate would require the federal government to spend an extra $1 billion per year. That’s a lot of money, but considering that federal transfers for health care to the provinces and territories amount to $35 billion — not to mention everything the federal government spends directly on health — relatively speaking, it’s not that much of an increase. As with all modelling studies, these estimates rely on assumptions, and the associated uncertainties mean that costs could be higher — as much as $5.4 billion per year in the worst imaginable case. Equally, though, national pharmacare could well result in net savings for government — perhaps as much as $2.9 billion per year.
  • Morgan SG, Law M, Daw JR, et al. Estimated cost of universal public coverage of prescription drugs in Canada. CMAJ 2015;187:491–7. Abstract/FREE Full Text
  • A small number of drug classes are key drivers of overall costs and would continue to be so with or without pharmacare. Some (e.g., biologic agents) represent classes in which many emerging new therapies are expected to arise. Thus, the $1 billion estimate might not be stable going forward. But knowing this information may now enable policy-makers to develop specific interventions focused on reducing the impact of these key cost drivers even further.
  • Although the Canada Health Act has long enshrined the value of equitable, public health care coverage for all Canadians, its enactment by governments to date has been hypocritical in the absence of pharmacare. Canada has the dubious distinction of being the only country with universal health care coverage, but not universal pharmacare. As we have said before,3 the time to end this hypocrisy is long overdue; all of our peer nations have already done so. The moral case for universal pharmacare has always been apparent. With a strong economic case for pharmacare also evident, there can be no more excuses for delay. In this election year, it is especially timely for Canadians to demand that their next government enact national pharmacare.
  • Tang KL, Ghali WA, Manns BJ. Addressing cost-related barriers to prescription drug use in Canada. CMAJ 2014;186:276–80. FREE Full Text
  • Even more striking are the potential benefits to the private sector: no matter what, it would save a lot of money from pharmacare. Currently, nearly half of all drug expenditures in Canada are incurred by the private sector, divided almost evenly between individuals, whose costs would drop by more than half under pharmacare, and private drug plans, whose current costs for nearly all prescription drugs would disappear completely. Of note, a big chunk of public savings would arise from what governments presently spend on private drug coverage, such as for civil servants. With projected savings like these, one would expect that private companies, governments and individuals alike should be clamouring for pharmacare.
  • tanbrook MB, Hébert PC, Coutts J, et al. Can Canada get on with national pharmacare already? CMAJ 2011;183:E1275. FREE Full Text
Govind Rao

$300,000 Mac-led study examines PSWs' safety - 0 views

www.insidebrockville.com/...led-study-examines-psws-safety

from heather psw Ontario research

shared by Govind Rao on 21 Apr 15 - No Cached
  • Mar 30, 2015
  • While an estimated 26,000 personal support workers (PSWs) are working in home and community care in Ontario, no one has reliable statistics about injuries on the job or even a clear understanding of the health and safety issues these workers face. A two-year, $300,000 McMaster University-led study will be used by the Ministry of Labour to try to quantify work-related injuries and illnesses in the sector, and draft regulations and guidelines aimed at making the work safer. "They are often referred to as a vulnerable workforce," said Catherine Brookman, one of the researchers in the study.
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.
  • ...9 more annotations...
  • 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

CETA will result in higher drug costs for Canadians: study | National Union of Public a... - 0 views

nupge.ca/...her-drug-costs-canadians-study

from heather drugs trade ceta

shared by Govind Rao on 06 Nov 13 - No Cached
  • CETA will result in higher drug costs for Canadians: study
  • While we still don’t know all the details of the CETA, one thing is clear: the agreement will seriously impact the ability of Canadians to afford quality health care,” concludes Dr. Lexchin. Ottawa (05 Nov. 2013) - The Comprehensive and Economic Trade Agreement (CETA) will result in significantly higher drug costs for Canadians, says a study released by the Canadian Centre for Policy Alternatives (CCPA).
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